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Pathophysiology Of Infectious Diseases > GI > Flashcards

GI Flashcards

1
Q

Definition of Diarrhea

A

≥3 loose/watery stools x day
> frequent passage than usual

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2
Q

Intoxication vs. Gastroenteritis

A

Intoxication:
faster onset <day
NO fever

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3
Q

3 symptoms associated with Inflammatory Diarrhea

A

Fever
Tenesmus
Abdominal pain

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4
Q

Type of diarrhea @Clostridium dificille

A

Inflammatory

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5
Q

Type of diarrhea @V.cholerae

A

NONinflammatory

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6
Q

Type of diarrhea @EIEC

A

Inflammatory

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7
Q

Type of diarrhea @ETEC

A

NONinflammatory

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8
Q

Type of diarrhea @EPEC

A

NONinflammatory

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9
Q

Type of diarrhea @EAEC

A

NONinflammatory

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10
Q

Type of diarrhea @EHEC

A

Inflammatory

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11
Q

Type of diarrhea @Entaomeba hystolitica

A

Amebic Dysentery

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12
Q

Acute Diarrhea

A

≤14 days

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13
Q

Persistent Diarrhea

A

15-30 days

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14
Q

Chronic Diarrhea

A

> 30 days

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15
Q

Dx of not severe Inflammatory Diarrhea

A

Stool culture

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16
Q

Management of Acute Noninflammatory Diarrhea with moderate to severe symptoms

A

For Travelers Diarrhea START empiric antibiotics

<72hrs symptom control
>72 hrs stool sample

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17
Q

Possible causes of chronic diarrhea

A

Clostridium difficile
Entaomeba hystolitica

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18
Q

Risk factors for C.dificille

A

Recent antibiotic tx
- clindamycin
- cephalosporins
- fluoroquinolone

Gastric acid suppression

Advanced age

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19
Q

Complication @Salmonella infection

A

Permanent carrier status @gallbladder

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20
Q

Pathogens to most commonly cause reactive arthritis as a complication

A

Salmonella
Shigella

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21
Q

Pseudomembranous colitis is an associated disorder to which pathogen

A

Clostridium dificille

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22
Q

Type of diarrhea that doesn’t change with fasting and is present @night

A

Noninflammatory secretory diarrhea

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23
Q

Red flags @Diarrhea

A

Chronic illness or immunocompromised
>65 yo
Recent use of antibiotics

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24
Q

Supportive Tx @Diarrhea

A

Bland diet
Oral rehydration
Pharmacotherapy (not usually recommended)
- antiemetics (ondasteron)
- anti motility (loperamide) ** consider @immunocompetent adults with acute diarrhea

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25
Q

When and why should anti motility drugs should be avoided?

A

Px with fever or inflammatory diarrhea
Because of the risk of developing megacolon

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26
Q

Empiric antibiotcs recommended @Diarrhea Tx

A

Azitromicina (Macrolido)
Ciprofloxacin (Fluoroquinolona)

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27
Q

Antibiotics @Noninflammatory Diarrhea

A

NO

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28
Q

Antibiotics @Infammatory + NO blood

A

NO

porque es >probable que sea EHEC

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29
Q

Antibiotics @Inflammatory + Blood

A

NO

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30
Q

Antibiotics @Inflammatory + Blood + Chills

A

YES

Suspects Bacteremia

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31
Q

Where does Shigella invade?

A

Colon

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32
Q

T or F: Shigella needs a HIGH infectious dose

A

F

Low, because it resists gastric acid

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33
Q

Virulence factor of Shigella

A

Shiga Toxin
–> enterocyte damage + bloody diarrhea

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34
Q

Serotypes @Shigella

A

4

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35
Q

Reservoir of Shigella

A

ONLY humans

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36
Q

T or F: Shigelllia infections is usually self limited

A

T

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37
Q

Onset of symptoms @Shigella

A

1-3 days

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38
Q

Pathogens that can cause Dysentery

A

Shigella
Salmonella
E.coli

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39
Q

T or F: Shigelliosis is predominant in all ages

A

F

Primarily a Pediatric Disease

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40
Q

Serotypes @Salmonella

A

> 2500

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41
Q

Where does the Salmonella attach to?

A

Small Intestine

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42
Q

Replication of Shigellia occur @

A

Cytoplasm

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43
Q

Replication of Salmonella occurs @

A

Vacuole

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44
Q

Infectious Dose @Salmonella Typhi and Nontyphi

A

Typhi: Low, because they’re resistant to gastric acid

Nontyphi: High

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45
Q

Which pathogen causing gastroenteritis have flagger motility?

A

Salmonella
Vibrio cholera

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46
Q

Virulence factor: Vi capsule

A

Salmonella

= permite evasion of neutrophil chemotaxis

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47
Q

What serotypes of Salmonella are obligate pathogen

A

S.typhi and S.paratyphi

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48
Q

Resevoir of Salmonella

A

Animal
ONLY human @Typhi and Paratyphi

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49
Q

Incidence of Salmonella

A

Bimodal: <5yo + >60yo
summer-autumn

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50
Q

High Risk (need lower inculum) @Salmonella

A

Poor children @Developing countries
age
Inmmunosupresion
Low gastric acid

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51
Q

Route of Transmission of Salmonella

A

Poultry
Eggs
Diary

Poorly stored food

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52
Q

______ can cause septicemia causing localized suppurative infection –> osteomyelitis –> leukopenia

A

Salmonella

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53
Q

How does the Salmonella travel to the _______ and replicate @Enteric Fever

A

Engulfed by macrophages

Liver, Spleen, Bone Marrow

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54
Q

Enlarged spleen

A

Septicemia

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55
Q

Pathogen that causes symptomatic (chronic) colonization

A

Salmonella

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56
Q

Where does Salmonella acts as reservoir in chronic colinization

A

Gallbladder

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57
Q

Cultivo @Salmonella

A

SS
MacConkey

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58
Q

Suspected septicemia @Salmonella infected px, which dx exams

A

Blood culture
Mielocultivo

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59
Q

SS agar shows black bacteria growth

A

Salmonella

porque produce acido sulfidrico

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60
Q

Cultivo @Shigella

A

SS agar

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61
Q

T or F: Antibiotic Tx is indicated at all cases of Salmonella

A

F
ONLY if its severe, since it can cause chronic colonization @gallbladder

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62
Q

Antibiotic Tx vs. Salmonella

A

Ceftriaxone
Fluoroquinolonas

Porque se eliminan por vía biliar

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63
Q

T or F: There is a vaccine vs. Typhoid Fever

A

T

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64
Q

When is antibiotic tx indicated @Salmonella

A

Severe gastroenteritis
Bacteremia
High Risk Px

65
Q

Signs of Bacteremia

A

Chills
Pilorection
Motted Skin
↑ RR
Fever

66
Q

Type of E.coli that causes Travelers Diarrhea

A

ETEC

67
Q

Type of E.coli that causes Pediatric Diarrhea

A

EPEC - Enteropathogenic

68
Q

Type of E.coli that produces two enterotoxins

A

ETEC

heat-labile
heal-stable

69
Q

Enterotoxin @E.coli that causes activation of adenylate cyclase –> ↑cAMP –> ↑Chloride secretion

A

Heat- LABILE

70
Q

Type of enterotoxin produced by E.coli that causes activation of guanylate cyclase –> ↑cGMP –> ↓NaCl reabsorption

A

Heat-stable
ETEC

71
Q

T or F: ETEC (enteropathogenic) E.coli causes invasion of the mucosa

A

F

72
Q

T or F: ETEC causes NO inflammation of the mucosa

A

T

73
Q

Type of E.coli thaT BLOCKS absorto by attaching to the apical surfaces of the intestinal epithelium causing villi to flatten

A

EPEC (enteropathogenic)

74
Q

Type of E.coli with Type III secretion system

A

EPEC

75
Q

Type of E.coli that causes auto agglutination in a “stacked-brick” arrangement over the epithelium

A

EAEC (enteroaggregative)

76
Q

Type of E.coli associated with chronic diarrhea and growth retardation @children

A

EAEC (enteroaggregative)

77
Q

Type of E.coli that forms biofilm

A

Enteroaggregative (EAEC)

78
Q

Type of E.coli that produces Shiga-lika-Toxin

A

EHEC // STEC

79
Q

Strain most commonly associated with HUS worldwide

A

O:157:H7

80
Q

Incidence of EHEC

A

Warm months
<5yo

81
Q

Raw beef, milk and veggies

A

EHEC // STEC

82
Q

This type of bacteria are infected by bacteriophages that integrate genes into the bacterias genome, encoding for the production of toxins

A

EHEC

83
Q

Infective dose of EHEC

A

<100

84
Q

Hemolytic Uremic Syndrome

A

↓ urine
acute renal failure
petechiae
neurological manifestations
thrombocytopenia

85
Q

Why are children more perceptible to have HUS as a complication of E.coli enterohemorragic?

A

They have more Gb3 receptors found @renal tissue

86
Q

Verotoxin

A

EHEC

87
Q

E.coli that act @small intestine

A

ETEC
EPEC
EAEC

88
Q

E.coli that act @large intestine

A

EHEC
EIEC

89
Q

T or F: E.coli is part of the microbial flora @GI tract

A

T

90
Q

How often does E.coli replicate

A

cada 15min

91
Q

Virulence factors og E.coli

A

Adhesins
Exotoxins

92
Q

Enterobacteriae that is an opportunistic pathogen

A

E.coli

93
Q

Culture of E.coli

A

MacConkey agar

94
Q

Why isn’t antibiotic tx indicated @EHEC?

A

Because it causes death of the bacteria which causes and increase of the toxin release that may lead to HUS and other exacerbtions

95
Q

Enterobacteriae that grows at alkaline media (acid labile)

A

Vibrio cholerae

96
Q

Where does Vibrio cholera act?

A

Small intestine

97
Q

T or F: V.cholerae is invasive of the intestinal epithelia

A

F

98
Q

Rice Water Diarrhea

A

Vibrio cholerae

99
Q

Enterobacteriae that is oxidase positive

A

Vibrio cholerae

100
Q

Serotypes of epidemic cholerae

A

O1 and O139

101
Q

Raw or undercooked seafood

A

V.cholerae

102
Q

Enterobacteriae with aquatic reservoir

A

Vibrio cholera
= Brackish estuarine water

103
Q

Complication of cholera

A

Severe dehydration
metabolic acidosis
hipokalemia
hypovolemic shock

104
Q

Tx of Cholera

A

Reposición de líquidos

105
Q

Incubation period of cholera

A

0-2 days

106
Q

Inoculation dose for V.cholerae

A

High

107
Q

Virulence factor of Vibrio cholerae

A

Cholera toxin

–> ↑cAMP –>↑ chloride secretion

108
Q

Enterobacteriae transmission by reptiles (snakes, turtles)

A

Salmonella

109
Q

T or F: Rotavirus is an enveloped virus

A

F

110
Q

Serotypes @Rotavirus

A

7
A, B and C causing human disease

111
Q

Causes mucosal damage + villous atrophy @GI tract

A

Rotavirus

112
Q

Where does Rotavirus act?

A

Small intestine

113
Q

Incubation period of Rotavirus

A

1-3 days

114
Q

NSP4 protein

A

@Rotavirus

acts as a toxin by ↑Ca+ influx into enterocytes and enteric nervous system signaling causing alterations in H2O absoprtion

115
Q

Outer cased proteins @Rotavirus

A

VP7 and VP4

116
Q

T or F: Rotavirus does NOT survive well at furniture and toys

A

F

117
Q

Mayor cause of severe diarrhea @infants and children worlwide

A

Rotavirus

118
Q

Incidence of Rotavirus

A

@Winter
Worldwide

119
Q

At what age can a Rotavirus infection be serious?

A

Infants <24 months

120
Q

Is Rotavirus a self-limited disease?

A

YES

121
Q

Dx of Rotavirus

A

Usually clinical

122
Q

Vaccine for Rotavirus?

A

YES

Monovalente (rotarix) - 2 doses
Pentavalente (rotaeq) - 3 doses

123
Q

What age should the Rotavirus vaccine no longer be applied?

A

> 8 months
Because of risk of intestinal invagination

124
Q

______ has mechanical vectors such as flies and coackroaches

A

Entamoeba hystolitica

125
Q

Incubation period of Entaomeba hystolitica

A

1-4 weeks

126
Q

Routes of transmission of Entamoeba hystolitica

A

Infected stools
contaminated water
Ora-anal sex

127
Q

T or F: Both Trophozoite and Cysts of Entamoeba hystolitica survive @external enviorment

A

F
Trophozoites DO NOT survive

128
Q

Pathogen that causes Flasked shaped ulcerations @intestinal mucosa

A

Entamoeba hystolitica

129
Q

T or F: Amebae are found in O2 rich enviorments

A

F
ONLY at LOW O2 environments, protozoa are killed at ambient O2 concentrations

130
Q

What enables E.hystolitica cysts turn into trophozoites?

A

Gastric Acid @Stomach

131
Q

Infecting form fo Entamoeba hystolitica

A

Cysts

132
Q

Extraintestinal amebiasis

A

Heart
Brain
Liver

as a Trophozoite

133
Q

Where does Entamoeba hystolitica causes damage?

A

Colon

134
Q

Incubation period of extra intestinal amebiasis?

A

Weeks-years

135
Q

Px traveling to tropical or subtropical destinations with persistent diarrhea

A

Entamoeba hystolitica

** high risk of recurrence by self inoculation

136
Q

Popo Seca con sangre

A

Amebic Dysentery

137
Q

Stool analysis of Entamoeba hystolitica

A

Lugol

138
Q

Tx of asymptomatic intestinal amebiasis

A

Luminal agents

= in order to prevent development of invasive disease and shedding of cysts

139
Q

Tx of symptomatic intestinal or extra intestinal amebiasis

A

Metronizadole + Luminal agents

140
Q

GI: Bacteria that can cause pseudo appendicitis

A

Yersenia enterocolitica

141
Q

Bacteria found at pork products that causes gastroenteritis

A

Yersenia enterocolitica

142
Q

Bacteria associated with causing Guillian Barre Syndrome

A

Campylobacter jejuni

143
Q

Bacteria that causes gastroenteritis found at bird meat

A

Campylobacter jejuni

144
Q

Most associated with gastric cancer and gastritis

A

H.pylori

145
Q

Acid Stable Enterobacteriae

A

Shigella

146
Q

T or F: EHEC can grow @Sorbitol agar

A

F

147
Q

Enterobacteriae that ferments lactose

A

E.coli

148
Q

Neonatal Meningitis

A

E.coli

149
Q

Catalase + Enterobacteriae

A

E.coli

150
Q

“Pea soup diarrhea”

A

Salmonella Typhi

151
Q

Enterobacteriae with polysaccharide capsule

A

Salmonella
E.coli

152
Q

Type of E.coli that flattens villi and inhibits absorption

A

EPEC

153
Q

Antimicrobial Tx @Salmonella

A

Generally not required
It prolongs the duration of fecal shedding

154
Q

T or F: Antidiarrheal drugs are indicated @Shigella infection

A

F

Because they delay the fecal shedding

155
Q

Antimicrobial Tx @Shigellia

A

Shorten the duration of symptoms
Reduce fecal shedding

156
Q

T or F: All E.coli cause fecal leucocitosis

A

F
ETEC is the only that doesn’t.

157
Q

Shellfish consumption associated with…

A

V.cholerae

158
Q

Pathogen that causes osmotic diarrhea

A

Rotavirus

159
Q

GI infection that causes right upper cuadrante pain

A

E. hystolitica

Pathophysiology Of Infectious Diseases (4 decks)

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