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Infectious Disease > Gastrointestinal Infections > Flashcards

Gastrointestinal Infections Flashcards

Botulism Campylobacter jejuni Shigellosis Salmonellosis Typhoid Fever Cholera

1
Q

Botulism Reportable/ Notifiable in Texas?

A

Call immediately (special number)

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2
Q

Campylobacter jejuni (Campylobacteriosis)

A

One week report

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3
Q

Shigellosis

A

One week report

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4
Q

Typhoid Fever

A

One week report

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5
Q

Cholera

A

Within one workday report

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6
Q

What causes Botulism?

A

Clostridium botulinum

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7
Q

What is Botulism named afterwards?

A

latin word sausage: botulus

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8
Q

Where do you found botulism?

A

spore-forming bacillus found in soil

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9
Q

What are the four types of botulism that causes human disease?

A

A, B, C, F

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10
Q

What organism can be weaponized?

A

Botulism

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11
Q

What organism is used for comestic use?

A

Clostridium botulinum

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12
Q

What does botulin toxin block?

A

acetylcholine (irreversible!)

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13
Q

What is the most common form of Botulism in the U.S. and the world?

A

Infant botulism

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14
Q

What form of botulism can come from IV drug use?

A

wound botulism

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15
Q

What form of botulism can come from home canned vegetables?

A

food- borne botulism

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16
Q

What is the first presenting symptom of botulism ingestion?

A

Constipation

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17
Q

What are 3 characteristic signs of botulism?

A
  • Fix dilated pupils
  • Ptosis
  • Cranial nerve palsies w/ impairment of extra-ocular muscles
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18
Q

What causes death in botulism poisoning?

A

Respiratory failure

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19
Q

T/F Most cases of infant botulism have NO history of honey exposure?

A

True

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20
Q

What is the definitive diagnosis for Clostridium botulinum?

A

isolating it in the stool

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21
Q

What is the biggest differential for botulism?

A

Myasthenia gravis

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22
Q

What is the most important thing for diagnosing botulism?

A

High Index of Suspicion!

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23
Q

What medical treatments are used for adult and child botulism?

A

BIG- IV and BabyBIG ( botulism immune globulin)

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24
Q

How many hours do you have for treating botulism?

A

24 hours

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25
Q

What are to treatments used for botulism?

A
  • Immunoglobulin IV

- Intubation and mechanical ventilation

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26
Q

When are antibiotics used in the treatment of botulism?

A

ONLY in wound botulism (along with antitoxin)

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27
Q

T/F there is a vaccine for botulism?

A

False

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28
Q

How long does acute diarrhea last?

A

< 2weeks

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29
Q

How long does chronic diarrhea last?

A

> 2weeks

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30
Q

What is mild diarrhea last?

A

< 3 stools per day

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31
Q

What is moderate diarrhea?

A

> 4 stools per day w/ local symptoms ( abdominal cramps, nausea, tenesmus)

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32
Q

What is severe diarrhea?

A

> 4 stools per day w/ systemic symptoms (fever, chills, dehydration)

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33
Q

Pt experiences vomiting after 1-6 hrs after food consumption, what type of food poisoning do they have?

A

preformed toxin induced

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34
Q

Pt experiences diarrhea after 8-16 hours after eating, what type of food poisoning do they have?

A

organism is in the food induced (organism then produces toxin)

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35
Q

What is the definitive diagnosis for infectious diarrhea?

A

stool culture

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36
Q

What is the symptom for infectious diarrhea?

A

Watery or blood or lots of mucus stool

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37
Q

What is the treatment for infectious diarrhea?

A

Symptomatic therapy- rehydration

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38
Q

What is the leading cause of acute diarrhea worldwide?

A

Campylobacter enteritis

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39
Q

Who dies due to campylobacter jejuni?

A

elderly or others with comorbid conditions

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40
Q

Where does the biggest consumption of campylobacter jejuni come from?

A

Chicken consumption (48%)

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41
Q

Where does the second largest consumption fo campylobacter jejuni come from?

A

Unknown (24%)

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42
Q

What are the symptoms of campylobacter enteritis?

A
  • frequently bloody diarrhea
  • abdominal pain
  • periumbilical cramping
  • fever
  • nausea (common)
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43
Q

T/F Campylobacter enteritis is self limited?

A

True

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44
Q

How long does campylobacter enteritis last?

A

~ 7 days

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45
Q

Who is a chronic carriage of campylobacter enteritis?

A

immunocompromised

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46
Q

What is the treatment for campylobacter enteritis?

A

Treatment not required in mild, self-limited infection

  • ONLY proper hydration
  • Correction of electrolyte balance
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47
Q

What are 3 unique manifestations of campylobacter enteritis?

A
  • Pseudoappendicitis
  • Colitis
  • Lymphoma
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48
Q

What two complications seen in late onset of c. enteritis?

A
  • Reactive arthritis

- Guillain- Barre Syndrome

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49
Q

Cholecystitis and Septic pseudoaneurysm is a acute or chronic complication of C. enteritis?

A

Acute

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50
Q

What is the gold standard for diagnosing C. enteritis?

A

Stool culture (only if necessary)

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51
Q

Which medication do you not give in C. enteritis?

A

anti-motility agents

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52
Q

When do you use antibiotics for C. enteritis?

A

pts with severe disease or risk for severe disease

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53
Q

What are risk for severe disease in C. enteritis?

A
  • elderly
  • pregnant
  • immunocompromised
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54
Q

What is the antibiotic of choice for C. enteritis?

A

azithromycin

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55
Q

What is the common cause of bacterial diarrhea worldwide?

A

Shigella species

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56
Q

Where does Shigella spread commonly occur?

A

predominately institutions (day care, custodial institutions)

57
Q

What is the less common source of contamination for Shigella?

A

Food or drinking water

58
Q

What does Shigella predominately infect?

A

lower gastrointestinal tract

59
Q

What is a complication of Shigella?

A
  • Proctitis or rectal prolapse

- Toxic megacolon

60
Q

What is the definitive diagnosis of Shigella?

A

Stool culture

61
Q

What symptom can be seen in Shigella?

A

Frequent, small volume, bloody stools

62
Q

What is the treatment for Shigella?

A

-Fluid hydration

63
Q

Imodium

A

a intestinal anti-motility drug to avoid in Shigella

64
Q

What are two cons of using antibiotics for Shigella?

A
  • Increasing antimicrobial resistance of Shigella species

- Antibiotic therapy is not essential since infection clears spontaneously

65
Q

What are two pros of using antibiotics for Shigella?

A
  • Antibiotics decrease the duration of fever, diarrhea by about two days
  • Shortening the duration- reduce the risk of spread
66
Q

What are two fluroquinolones used for Shigella?

A

-Levofloxacin
-Ciprofloxacin
(Azithromycin)

67
Q

What causes salmonellosis

A

Salmonella enterica

68
Q

What are the three serotypes isolated from salmonellosis?

A
  • typhi
  • typhimurium
  • choleraesuis
69
Q

What are the three patterns of infection of Salmonellosis?

A
  • Enteric Fever (typhoid fever)
  • Acute enterocolitis
  • “Septicemic” type
70
Q

What causes enteric fever (typhoid fever)?

A

Salmonella typhi

71
Q

What causes acute enterocolitis?

A

typhimurium

72
Q

What causes “septicemic” type?

A

choleraeusis

73
Q

What is salmonellosis transmitted?

A

orally (contaminated food/drink)

74
Q

Whom is Typhoid fever common?

A

children and young adults

75
Q

What is the biggest cause of typhoid fever?

A

poor access to sanitation

76
Q

Who has the most likelihood of contracting typhoid fever?

A

travelers to countries where typhoid fever is endemic

77
Q

Where can typhoid fever be found?

A

impoverished areas

78
Q

Which region has the most infections in returning travelers?

A

South Central Asia

79
Q

What symptoms are experienced during the Prodromal stage of typhoid fever?

A
  • Increasing malaise
  • Headache
  • Cough
  • Sore throat
80
Q

When does fever ascend in a stepwise fashion in Typhoid fever?

A

Prodromal stage

81
Q

Where is pea soup diarrhea seen?

A

typhoid fever

82
Q

Which illness reaches a plateau in 7-10 days?

A

typhoid fever

83
Q

What appears commonly during the second week of disease for typhoid fever?

A

rash (rose spots)

84
Q

What is found on the trunk, is a pink papule 2-3 mm in diameter, and fades on pressure?

A

rash rose spot

85
Q

How long does it take for rash rose spots to disappear?

A

3-4 days

86
Q

Where is typhoid fever usually found in?

A

women

87
Q

What occurs during the stage of chronic carriage in typhoid mary?

A

excretion of organism in stool or urine

88
Q

What is chronic carriage in the urine associated with?

A

defect in the urinary tract

89
Q

Who is Typhoid Mary?

A

Mary Mallon (New York)

90
Q

What causes 75% of deaths of Typhoid fever?

A

complications of untreated cases

91
Q

What are two dangerous complications of Typhoid?

A
  • Intestinal hemorrhage

- Intestinal perforation

92
Q

T/F immunization is available for typhoid?

A

True (not always effective)

93
Q

What is critical in typhoid fever?

A

good sanitation

94
Q

What is the most sensitivity available diagnostic tool for typhoid?

A

Bone marrow culture

95
Q

When is bone marrow culture used?

A

in suspected disease that is unresponsive to antibiotic therapy

96
Q

What is the biggest thing to consider in typhoid disease diagnosis?

A

Travel history

97
Q

What is the first line treatment for typhoid?

A

Fluoroquinolones

98
Q

What are 4 possible treatments for typhoid?

A
  • Fluoroquinolone
  • Chloramphenicol
  • Ampicillin
  • Ciprofloxacin
99
Q

What medication is used in chronic carrier state of typhoid?

A
  • Ampicillin plus probenecid

- Ciprofloxacin

100
Q

What is the most common form of salmonellosis?

A

acute enterocolitis

101
Q

What is the incubation period for salmonella gastroenteritis?

A

8-48 hrs

102
Q

What is the diagnosis for salmonella gastroenteritis?

A

stool culture

103
Q

What is the treatment for salmonella gastroenteritis?

A

self limiting (symptomatic care only)

104
Q

What antibiotic is used for immunocomprised patients with salmonella gastroenteritis?

A

Fluoroquinolone

105
Q

Which disease has prolonged or recurrent fevers?

A

Salmonella Bacteremia

106
Q

What is a complication of Salmonella Bacteremia?

A

Endovascular infection

107
Q

Where is mycotic abdominal aortic aneurysms is found?

A

Salmonella Bacteremia

108
Q

What is the treatment of Salmonella Bacteremia?

A

Fluoroquinolone (plus drainage any abscesses)

109
Q

What causes Cholera?

A

Vibrio cholerae (gram -) TOXIN

110
Q

How is cholera transmitted?

A

contaminated food and water

111
Q

What causes acute secretory diarrheal illness?

A

Cholera

112
Q

What are 3 things that happen within 24 hrs of cholerae infection?

A
  • Profound fluid loss
  • Electrolyte losses in the stool
  • Rapid development of hypovolemic shock
113
Q

Inadequate access to clean water sources?

A

Vibrio cholerae

114
Q

Which disease has the highest number of deaths related to diarrhea?

A

Vibrio cholerae

115
Q

Rice water stools?

A

cholera

116
Q

Vomiting frequently with watery emesis?

A

cholera

117
Q

Fishy odor stools?

A

cholera

118
Q

Sunken eyes, dry mouth, cold clammy skin, decreased skin turgor?

A

cholera

119
Q

What is the definitive diagnosis for cholera?

A

stool culture

120
Q

Hypokalemia, hyponatremia or hypocalcemia, and acidosis is seen in what disease?

A

Cholera

121
Q

What is the treatment for cholera?

A

aggressive volume repletion (orally or IV)

122
Q

WHO recommends what in children with cholera?

A

Zinc (20mg daily

123
Q

What reduces the duration of symptomatic cholera by 1.5 days and limit life threatening dehydration?

A

Antibiotics

124
Q

What antibiotic is used in adults with cholera?

A

doxycycline or tetracycline

125
Q

What antibiotic is used in children with cholera?

A

azithromycin

126
Q

What antibiotic is used in pregnancy with cholera?

A

azithromycin or erythromycin

127
Q

T/F there is a vaccine for cholera?

A

True

128
Q

What are the vaccines for cholera?

A

Dukoral and Shanchol/ mORCVAX

129
Q

T/F 95% of infant botulism occurs in infants younger than 6 months?

A

True

130
Q

What is associated with botulism?

A

Honey

131
Q

Where is food-borne botulism often come from?

A

home canned foods

132
Q

How is food borne botulism treated?

A

equine botulinum antitoxin and supportive care

133
Q

What section of the colon does Shigella infect?

A

rectosigmoid colon

134
Q

What is the most common identified food-borne illness in the U.S.?

A

Salmonella

135
Q

What is the most common cause of traveler’s diarrhea?

A

Salmonella

136
Q

What is the 1st most common bacteria isolated from diarrheal stool samples in the U.S.?

A

Campylobacter

137
Q

What is the 2nd most common bacteria isolated from diarrheal stool samples in the U.S.?

A

Salmonella

138
Q

What is the peak frequency months of Salmonella?

A

July to November

139
Q

What are synonymphs for typhoid fever?

A 
typhoid
typhus abdominalis
enteric fever
nervous fever
slow fever

Infectious Disease (6 decks)

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