Gastrointestinal Infections III Flashcards
1
Q
What is the name for inflammation of the angles of the mouth?
What are te usual etilogical agents responsible?
A
Angular Cheilitis
Angular stomatitis or perleche
- Etiology:
- Candida albicans- usually
- Yellow crusting – Staphylococcus aureus
2
Q
Angular Cheilitis is most common in which demographic?
A
- elderly, children who suck their digits, adn in people with riboflavin or irion deficiency
- Elderly
- sagging facial muscles adn ill filling dentures
- causes maceration of skin resultin in inflammation
- can be sign of anemia or vitamin deficiency
3
Q
Angular Ceilitis Diagnosis?
Treatment?
Prevention?
A
- Diagnosis
- swab & culture
- S. aureus - blood plates/others
- C. albicans - sabouraud dextrose agar
- swab & culture
- Treatment
- Antigungal or antibacterial agent depending on cause
- hydrocortizone if chronic
- Prevention
- proper nutrition
- proper fitting dentures
4
Q
A
- Oral candidiasis
Oral hairy leukoplakia usually occurs at the corners of themouth & you cannot remove it
5
Q
A
Oral hairy leukoplakia
6
Q
What is the most common cause of benign viral parotitis?
A
Paramyxovirus
mumps
7
Q
What are the possible complicated associated with mumps?
A
- Aseptic meningitis (parotitis absent up to 50%)
- asymptomatic infections occur in 40-50% mumps
- symptomatic CNS infections occur in 10% clinical cases
- adults & boys at higher risk
- perminant sequelae occur in 25% – 1% die
- can result in encephalitis (fatal 1.4%)
- Oophoritis and Epididymoorchitis
- testicular swelling, tenderness, nausea, vomiting, and fever
- most common complication postpubertal males
- ovarian inflammation in 5% postpubertal females
- Deafness
- 1 in 15,000– usually unilateral
- sudden onset & damage is permanant
- During pregnancy can lead to fetal death in 1st trimeser
8
Q
Incubation period for Mumps?
Symptoms?
A
- Incubation: 14-25 days
- Usually asymptomatic
- may present as lower respiratory tract infection– esp in preschool children
- If symptomatic
- prodrome: myalgia, headache, anorexia, malaise, low-grade fever
- parotitis: swollen and tender salivary glands with earache (30-40% patients)
- can be bilateral or unilateral
- symptoms occur w/in first 2 days, usually gone after 10 days
9
Q
How is mumps transmitted?
What is the most affected demographic?
A
- highly contagious
- airborne transmission w/ infected droplet nuclei or saliva
- direct person-person contact
- most common in winter-spring
- infections 3 days before symptoms & 9 days after symptoms disappear
- primarily childhood infection w/ 60% cases occurring in children <15 years of age
- no carrier state is known
10
Q
Mumps Pathogenesis
A
- Virus replicates in nasopharynx and regional lymph nodes
- viremia 12-25 days later
- multiple tissues infected durign viremia
- hemagglutinin-neuraminidase or virus binds to trisaccharids (alpha2,3-linked sialic acid) on host cells
- Tropisms for glandular tissue & CNS
- meninges, salivary glands, testes, ovaries, pancreas, kidneys, thyroid, eyes, and mammary glands
11
Q
Mumps diagnosis
A
- clinically obvious
- jelly-like feel; NOT warm
- isolate virus from saliva, urine, and CSF
- serology EIA fro IgM and IgG
- IgM: first few days (acute)
- IgG: requies 2 samples 2 weeks apart
- if titer is rising, indication acute case
- not rising = past case/immunized
12
Q
Mumps treatment and prevention
A
- Treatment
- treat the symptoms
- Prevention
- MMR vaccine (live attenuated)
- not given to pregnant people
- 95% develop immune response – given 12-15 months
- booster 4-6 years
- MMR vaccine (live attenuated)
13
Q
What is the etilogical agent of acute bacterial parotitis?
Manifestations?
A
- Etilogy
- S. aureus
- Manifestations
- swellign salivary glands
- chewing increases pain
- skin- erythema, warm
- massage- purulent saliva (differentiate bacterial vs. viral)
14
Q
What demographic is most commonly affected by acute bacterial parotitis?
A
- elderly- takign medications that affect flow of saliva
- dehydrated
- choronically ill
- postoperative patients
- patients with dry mouth
15
Q
Pathogenesis of Acute bacterial parotitis
A
- flow of saliva affected
- bacteria enter duct
- ascend to gland
- inflammation adn pain
17
Q
A
Ludwig’s angina
- w/ bacterial parotitis, movement of the tongue wouldn’t cause pain– chewing will, though
18
Q
A
Viral Parotitis
19
Q
A
bacterial parotitis
20
Q
A
Oral hairy leukoplakia– caused by Epstein Barr
25
Q
How is esophagitis diagnosed?
A
- odynophagia is unique to infectious esophagitis
- Esophagogastroduodenoscopy (EGD)
- to see and biopsy the esphagus
- Candida albicans
- thrush
- plaques in esophagus, creamy white or pale yellow w/ underlying raw base
- stain & look for yeast
- HSV
- abrupt onset
- early lesions- small vesicles middle to distal esophagus
- later- ulcers with raised edge (volcano lesions
- Lok for Tzanck cells
- CMV
- onset of symptoms gradual
- only in immnocompromised hosts
- large solitary shallow ulcer or multiple discrete lesions at distal end esophagus
- culture
- HIV
- multple small thrush-lie lesions
- durign priamry HIV infection
- later on giand deep uncers
- fistula, perforation, hemorrhage or superinfections
- VZV
- usually has skin lesions consisten w/ chicken pox or shingles
28
Q
Symptoms of Chronic active gastritis?
A
- often asymptomatic
- moderate
- pain or discomfort in pit of stomach
- pain in left upper abdomen
- travels to back of belly
- burning, gnawing, sore, vague discomfort
- belching w/o relief, nausea, vomiting
- critically ill
- pale and sweaty
- may have tachycardia
- severe illness- bleeding from stomach, faint or feel like fainting
- vomit blood
- blood or dark sticky, foul smelling stools
29
Q
Symptoms of peptic ulcer disease
A
- Gnawing or burign pain inepigastrium
- bleeding that may result in anemia, weakness, and fatigue
- hematemesis, melena or hematochezia
- gastric ulcers
- pain made worse by eating
- duodenal ulcers
- pain relieved by eating or antacids
