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GI > GI Infectious Disease > Flashcards

GI Infectious Disease Flashcards

1
Q

Norovirus

A 
nonenveloped ss+ RNA
Fecal Oral transmission 
Cruise ship, adult population
<101 fever
Genetic drift
Causes Gastroenteritis
Tx: supportive and proper food and hand washing
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2
Q

Adenovirus

A

ds DNA icosahedral nucleocapsid
Serotypes 40,41,42
Major cause of acute infant gastroenteritis, Fecal oral
Local inflammation in proximal small intestine,
Dx. pcr of stool sample,
tx. Self limiting supportive care preventitive

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3
Q

Rotavirus

A

ds RNA Double layered capsid and all the machinery it needs
NSP4 is viral toxin
cell lysis vomiting diarrhea has no blood. Typically only in kids develop lifelong immunity. FO transmission.
upper 2/3 of small intestine

Dx. via stool specemin and serology, RT-PCR

tx. 2 vaccine available, fluid replacement

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4
Q

Viral Gastroenteritis

A

Watery diarrhea, no leukocytes, no blood.

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5
Q

Staph Aureus

A 
Gm+ cocci, cat+ coag+ toxin.
sx. N&V 1-7 hours after eating
dx. find toxin in food
typically in foods which sit at room temp
tx. self limiting
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6
Q

Bacillus Cerus

A

gm+ Box car shaped rod Beta hemolytic, faculative anaerobe, motile, biofilm, spore producer
rice overnight
Vomiting: exotoxin produces holes in membranes
Diarrheal: watery and cramps, large enterotoxin causes fluid secretion, created in small intestine

tx. Generally self limiting vomiting, poor outcomes in systemic infection, vanco!

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7
Q

Clostridium Botulinum

A

Gm+ spore forming rod obligate anaerobe, motile
spores and toxin are main issues of botulism
Commonly in ingested food
sx. double vision, blurred vision, drooping eyelids, slurred speech,
dx. sx and hx, organism or toxin in stool
tx. ventilatory for respiratory distress, antitoxin remove contaminated food.

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8
Q

Clostridium Perfringens

A

gm+ spore forming bacilli (matchstick) nonmotile, obligate anaerobe food sitting out at room temp enterotoxin binds endothelial cell junctions and creates pores.
sx. diarrhea and cramps,
no fever or vomiting
dx. detection of toxin or lots of bacteria in stool
tx. self limiting, serious cases get treated

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9
Q

Campylobacter jejuni

A

gm- bacilli, microaerophillic cold sensitive, difficult to culture. see (bloody) diarrhea, cramping and fever.
symptoms last a week, Guillain Barre syndrome
Dx. stool culture

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10
Q

Salmonella Shigella

A

Gm- bacilli nonspore forming, H2S + lactose-, motile flaggela

sx. diarrhea, fever, abdominal cramps for 4-7 days. reactive arthritis
dx. stool culture
tx. hydration, antibiotics if systemic

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11
Q

Vibro parahaemolyticus

A

gm- curve rod with single flagella, faculative anaerobe, oxidase +
toxin forms pores in red blood cells and epithelial cells
sx. mild bloody diarrhea, cramps, fever N/V less than a week can spread in the immunocompromised
dx. isolated from stool, wound, blood

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12
Q

Listeria Monocytogenes

A

Gm+ rod shaped bacteria flaggelated, nonsporeforming, oxidase+ betahemolytic
sx. mild GI infection, Pregnant women most succeptible, opportunisitic fever, chills, muscle aches leading to meningitis and sepsis.
dx. bacteria in sterile site.
hijacks our tubulin and membranes
Raw milks soft cheeses

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13
Q

Shigella

A

Gm- bacillus, faculative anaerobe, nonmotile, nonsporeforming, lactose- H2S- NO flagella
Invasive
Tx. antibiotics

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14
Q

Shigella Vs E. Coli

A

Ecoli have flagella and are lactose +

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15
Q

Dysentery

A

frequent small BMs with blood and mucus with rectal pains and spasams.

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16
Q

Shigella dysenteriae

A

Gm- bacillus, faculative anaerobe, nonmotile, nonsporeforming, lactose- H2S- NO flagella, has SHIGA toxin, kills vascular endothelial cells

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17
Q

E. Coli

A

Gm- bacillus, faculative anaerobe, motile, non spore forming, lactose+
profuse watery diarrhea, fever, N/V, chills, less than 10 days infection
Tx. no antibiotics

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18
Q

EHEC

A

Shigella toxin producing E. coli

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19
Q

ETEC

A

E.coli which activates adenyl cyclase like cholera toxin

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20
Q

Vibro Choerae

A

Gm- curved rod, faculative anaerobes, flagellated, motile, oxidase+
water reservoir
Cholera toxin increases cAMP leading to increased cl excretion and less na absorbtion
rice water stools
dx. isolate from stool
tx. antibiotic can help but mostly rehydration

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21
Q

Salmonella Typhi

A

Gm- bacilli nonspore forming, H2S + lactose-, motile flaggela
untreated water source
vaccine available,
typhoid fever, life threatening illness, Gi to bloodstream High fevers, weakness, headache, stomach pains, carrier
tx. antibiotics yes

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22
Q

Low inoculum organisms

A

10s-100s shigella, giardia, entamoeba, norovirus

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23
Q

High inoculum organisms

A

10,000s cholera and c perfringens

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24
Q

Clostridium difficile

A

Gm+ spore forming rod, obligate anaerobe, motile, matchsticks on microscopy(clostridium) antibiotic associated diarrhea, exotoxins cause cell death, shallow ulcers, pseudomembranous colitis

dx. stool smear, toxin detection
tx. metronidazole, vancomycin bowel resection, fecal transplant

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25
Q

Ribovirin

A

Guanosine analog inhibiting RNA synthesis

26
Q

ABT450

A

Serine protease

27
Q

Ombitasvir

A

NS5A inhibitor

28
Q

Ritanovir

A

Inhibits CYP3A4 increasing concentration fo ABT 450

29
Q

Dasabavir

A

Ns5B inhibitor

30
Q

Parasitic infections

A

Long onset of symptoms, long lasting and chronic, individuals often asypmtomatic.

31
Q

Protozoans

A

Unicellular. Giardia, cryptosporidium, entamoeba

32
Q

Giardia lamblia

A

unicellular Most common parasite in US, sx.1-2 weeks remitting fever.
MOA: damage to epithelial absorptive area, do not penetrate. we pass cysts
sx. foul smelling diarrhea, farts, greasy stools malabsorption.

33
Q

Cryptosporidium Parvum

A

Unicellular. diarrhea sx. up to 1 month, absorption impaired and secretion enhanced.
dx. watery, nonbloody stools, fever oocysts in stool acid fast stain.
Envelops host membrane

34
Q

Entamoeba histolytica

A

unicellular. cytotoxic Causes Amebic dysentery, liver abscesses, onset gradual will no fever chills or pus. chronic course.
bloody mucousy stool. Cysts in stool sample.

35
Q

Antiparasitics targeting protazoans

A

Metronidazole, tinidazole,
Nitazoxanide, Iodoquinol
Paromomycin, TMP SMX

36
Q

Metronidazole

A

MOA: toxic metabolites and free radicles strand breakage.
Effective against protazoans, effective against giardiasis, amebic dysentery
AE: DISULFURAM rxn.
N&V, diarrhea,

37
Q

Tinidazole

A

MOA: toxic metabolites and free radicles strand breakage.
Effective against protazoans, effective against giardiasis, amebic dysentery
AE: DISULFURAM rxn.
N&V, diarrhea,

38
Q

Nitazoxanide

A

MOA: inhibits pyruvate:ferredoxin oxioreductase, used for giardia and cryptosporidosis. Rapidly metabolized to active drug

39
Q

Iodoquinol

A

MOA: unknown
AE: loss of visual acuity, caution in pts with thyroid disease.
Low absorbtion so useful for amebic dysentery in GI tract.

40
Q

Paromomycin

A

Targets 30S subunit

AE: diarrhea, GI effects, luminal antiprotazoal, only partially effective against cryptosporidium.

41
Q

Trimethoprim Sulfamethoxazole

A

Broad spectrum, inhibits steps in folate pathway Do not use in pregnant women used for protozoans

42
Q

Enterobius Vermicularis

A

Pinworms. Children.
sx. perianal puritis, insomnia, abdominal pain, anorexia, irritability
due to ingestion of pinworm eggs. 2-3 week viable eggs. no eggs in stool sample fingernails.

43
Q

Roundworms

A

Necator (skin)
Trichuris (egg ingestion)
Ascaris (egg ingestion
Strongyloides(skin)

44
Q

Hookworm

A

Necator, larve in soil enter skin, circulatory system lungs, cough swallowing intestine.
AE: blood sucker, Fe defficient anemia.

45
Q

Strongolides Stercoralis

A

Worm enters skin with itchy red rash. Stomach and GI complaints.Dry cough and throat irritation. Autoinfection possible.

46
Q

Trichuris trichiura

A

Whipworm
dx. eggs in feces have barrel shaped appearance. Finger clubbing best indicator of severity of disease.
bloody diarrhea Fe deficency anemia.

47
Q

Ascaris lumbricoides

A

Tropical and subtropical areas.

sx. abdominal discomfort, intestinal blockages, ultrasound and radiology. Lung stage of life cycle can cause cough
dx. eggs with thick shells

48
Q

Antiparasitics for Helminthes

A

Goal to kill adult worms in GI tract, multiple infections common

49
Q

Albendazole

A

Broad spectrum for helminthes, roundworms and tapeworms. Limited oral absorption, better absorbed if targeting tissue larvae.
MOA: binds to parasite B tubulin inhibiting microtubule formation. more than one dose may be necessary

50
Q

Mebendazole

A

Broad spectrum for helminthes, roundworms and tapeworms. Limited oral absorption
MOA: binds to parasite B tubulin inhibiting microtubule formation. more than one dose may be necessary
AE: abdominal pain nausea, headache

51
Q

Pyrantel

A

opens nematode ACH receptor ion channels in nerve and muscle. spasic contraction and parasite cannot move. poorly absorbed
used for roundworms except whipworm

52
Q

levamisole

A

opens nematode ACH receptor ion channels in nerve and muscle. spasic contraction and parasite cannot move. poorly absorbed
used for roundworms

53
Q

Ivermectin

A

macrocyclic lactone. binds glutamine gated chloride channels in nerve and muscle cell causing deactivation of channel. worm paralysis and death by starvation.
Well tolerated, used for nematodes (ascaris, strongyloides and onchocerca

54
Q

Taenia

A

Typical human tapeworm from improperly cooked meat and fish. larvae grow into worms in intestine.
Dx. stool contains eggs and or proglottids

55
Q

Tapeworm treatements

A

benzimazoles, praziquantel

56
Q

praziquantel

A

increased permeability of parasite to catiions leading to contraction of worm musculature
used for tapeworms and flukes

57
Q

Schistosoma Mansoni

A

Two hosts, us and snail, immune response to egg. can become lodged in bladder
sx. rash or itchy skin, fever, chills cough, and muscle aches
chronic abdominal pain, enlarged liver eventual bladder cancer.
dx. stool or urine eggssamples
tx. praziquantel

58
Q

nematode transmission

A

(roundworms) soil**

59
Q

Nematodes transmission

A

zoonotic and eat them

60
Q

Protazoa transmission

A

unicellular water

61
Q

Trematodes transmission

A

flukes water

GI (8 decks)

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