GI Bacteria: Colonization (+/- toxin) mediated

Question 1

Epi of Salmonella (non typhoidal)

Answer 1

• Contaminated animal products e.g. meat/eggs
• Reptiles
• 10% food borne illness USA

Question 2

Epi of Salmonella (typhoidal)

Answer 2

human-human evolution; human feces/carriers

Question 3

Epi of Shigella

Answer 3

Human-human fecal oral (4 Fs); High infectivity; daycare centers

Question 4

Yersinia Epi (3)

Answer 4

Animal hosts (rodents, pets, etc; contaminated pork/beef; anemia and infants high risk

Question 5

contaminated animal product (POULTRY, milk)

10-15% food poisoning in USA

Answer 5

Campy Epi

Question 6

H Pylori EPi

Answer 6

person to person saliva

Question 7

EHEC

Answer 7

Ground beef, cattle refuse: water, radishes, spinach, apple juice

Question 8

uncooked foods (salad fruits); childhood diarrhea developing countries

Answer 8

ETEC

Question 9

B. Cereus

Answer 9

Fried rice is risk for emetic form. Cream milk sauce is risk for diarrheal form.

Question 10

Listeria

Answer 10

cheeses, milk, veggies. Pregnant mothers, immunocompromised, neonates

Question 11

Vibrio

Answer 11

contaminated water/seafood/fish

Question 12

ddx for acute bloody diarrhea in bacterial setting

Answer 12

EHEC (starts watery)
EIEC
Campy
Shigella
Salmonella (non-typhoidal)
Yersinia Entercolitica
C. diff (possibly)

Question 13

List bacteria that are invasive and could result in bloody stools

Answer 13

Salmonella
Campy
Shigella
Yersinia
EIEC (similar but milder bloody diarrhea than shigellosis)
Vibrio (not bloody)

Question 14

invades terminal ileum and stops in lamina propria

Answer 14

non typhoidal salmonella

Question 15

invades intestinal epithelium and causes ulceration/bleeding of mucosa

Answer 15

campy

Question 16

shigella entry

Answer 16

invades m cells and lyses phagosome

Question 17

sort salmonella (both forms), shigella, vibrio (all forms), e coli (EPEC, EHEC, EAEC, DAEC, EIEC) as intracellular or extracellular

Answer 17

all intracellular except for vibrio cholerae and EPEC, EHEC, ETEC, EAEC, DAEC. Vib Vuln is either or.

Question 18

travelers diarrhea

Answer 18

ETEC or EAEC

Question 19

infants can get this form of E Coli

Answer 19

EPEC

Question 20

describe clinical presentation of typhoidal salmonella

Answer 20

malaise, fever, headache, myalgia, ROSE SPOT, constipation

Question 21

describe clinical presentation of EPEC

Answer 21

copious watery mucoid infant diarrhea everywhere

Question 22

describe clinical presentation of ETEC

Answer 22

travelers diarrhea (watery, profuse). Also, infant diarrhea in developing countries.

Question 23

describe clinical presentation of shigella

Answer 23

abd cramps, TENESMUS, frequent scant bloody stools with pus, fever. Can be just watery diarrhea, OR start out watery and progress.

Question 24

describe clinical presentation of yersinia

Answer 24

bloody diarrhea, mesenteric lymphadenitis

Question 25

describe clinical presentation of campy

Answer 25

diarrhea (bloody), fever, abd pain. Can have GBS or Reiters too.

Question 26

describe clinical presentation of Salmonella (both types)

Answer 26

Salmonella non typhoidal: NV, abd cramping, non bloody diarrhea x3-4 days, +/- bloody diarrhea, fever, septicemia, meningitis, osteomyelitis; Salmonella typhoidal: fever malaise constipation myalgia, headache, ROSE SPOTS, +/- GI hemmorhage, perf, metastatic spread, colonize GB

Question 27

name 8 causes of acute non inflammatory diarrhea (bacteria +virus +protozoa)

Answer 27

virus: rotavirus, norovirus protozoa: giardia, cryptosporidium Bacteria: staph aureus(?), vibrio cholerae, ETEC, bacillus cereus

Question 28

name 9 cases of acute inflammatory diarrhea (bacteria +virus+protozoa)

Answer 28

virus: cmv protozoa: entamoeba histolytica, schistosomiasis bacteria: campy, salmonella, shigella, ehec, c. diff, yersinia

Question 29

is small bowel mostly the target for inflammatory or non inflammatory diarrhea?

Answer 29

non inflammatory (exception: salmonella more often in small bowel)

Question 30

which conditions require abx therapy (5) (bacteria and protozoa)

Answer 30

shigella, salmonella, c diff, giardia, e histolytica

Question 31

what can you use for inflammatory diarrhea in terms of antimotility?

Answer 31

bismuth subsalicylate

Question 32

name infectious and inflammatory (but still infectious) causes of chronic diarrhea

Answer 32

v cholera, ETEC, whipple disease, c. diff, yersinia, cmv, e histolytica