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GI- Upper Flashcards

1
Q

What breaks down breast milk for digestion

A

Bifidobacterium

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2
Q

What is needed to digest formula

A

Lactobacilli

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3
Q

Normal flora of the mouth

A 
Strtococcus 
Neisseria
Actinomyces
Veillonella 
Lactobacillus 
Yeast
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4
Q

What kind of bacteria is found in stomach

A

Sterile
Streptococcus
Staphylococcus
Lactobacillus

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5
Q

What predisposes you to H pylori

A

Gastritis

Peptic ulcers

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6
Q

Do you find bacteria in the small intestine

A

No

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7
Q

Bacteria in duodenum

A

Aerobic streptococci
Staphylococci
Lactobacilli
Yeast

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8
Q

What bacteria do you find at LI

A

Anaerobic

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9
Q

Which part of the Digestive system has the most amt of bacteria

A

LI 10^10-10^12

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10
Q

What is Allogenic

A

Factors outside the ecosystem affecting the microbrial composition of GI flora

Diet 
Age
Georgraphic location 
Antibiotics 
Surgery
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11
Q

How does diet change flora of GI

A

Vegetarians have lower bacteroides, higher enterococci

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12
Q

How does antibiotics change flora of GI

A

Makes you susceptible to c. difficile

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13
Q

What is autogenic

A

Factors affecting GI from within the ecosystem
Environment
Activities of microorganisms

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14
Q

At risk groups of lower GI infections

A

CHildren <5
Elderly
Immunocompromised

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15
Q

Food hazards

A 
Microbial contamination 
Naturally occurring toxicants 
Environment contaminants 
Nutritional problems 
Pesticides 
Food additives
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16
Q

What are the routinely screened bacteria from stool samples

A

Campylobacter
Salmonella
Shigella
STECs (if stool is bloody)

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17
Q

What is the highest contamination for GI infections

A

Norwalk virus

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18
Q

What is food poisoning

A 
Toxin in food- short incubation period 
Toxemia 
C. Botulinum 
S. Aureus
B. Cereus
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19
Q

What is food associated infections

A

Consumption of food containing organism

Longer incubation period since organisms need to colonize first

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20
Q

Enteritis

A

Inflammation of intestinal mucosa

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21
Q

Gastro enteritis

A

Inflammation of stomach and intestinal linings

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22
Q

Colitis

A

Inflammation of LI

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23
Q

Enterocolitis

A

Inflammation of small and large intestine

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24
Q

Dysentery

A

Inflammation of GI tract and blood and pus in faeces

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25
Q

Acute Diarrhea

A

Resolves in 2 weeks

Infectious agents

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26
Q

Chronic diarrhea

A 
Persistent 
Lasts longer than 4 weeks 
Need to know what meds taken 
Possible syndrome
Parasite
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27
Q

What is the cause of non inflammatory gastroenteritis

A

Food poisoning

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28
Q

What are the infectious causes of gastroenteritis

A 
S. Aureus 
B. Cereus 
C. Botulinum 
Wild mushroom
Ciguatera 
Scrombroid 
Shellfish
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29
Q

What are the sx of food borne infections

A

Non inflammatory diarrhea

Inflammatory diarrhea

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30
Q

What the the pathogens of inflammatory diarrhea

A 
Shigella 
EIEC
Salmonella 
Campylobactor 
V. Vulnificus 
V. Parahaemolyticus 
Yersinia 
STEC 
C. Difficile
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31
Q

What are the pathogens of non inflammatory diarrhea

A 
ETEC
EPEC 
V. Cholerae 
C. Perfringens 
B. Cereus 
Rotavirus 
Norovirus 
Adenovirus 
Astrovirus 
C.difficile
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32
Q

Which pathogen is not food borne

A

c difficile

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33
Q

General sx of toxemia

A

Rapid onset
No fever/faecal leukocytes
Affects CNS and sometimes CNS and Intestines

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34
Q

Characteristics of S. Aureus

A

Aerobic
Coagulase/catalase +
Heat stable enterotoxin production

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35
Q

Is S. aureus found naturally in humans

A

yes

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36
Q

What are the toxins released by s. aureus

A

Exotoxins (8)

A&D typically implicated

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37
Q

What are the sx from s. aureus

A

Neurological (Vomiting)
Enteric (Diarrhea)
Self limiting recovery 24-48 hours

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38
Q

Is adenylate cyclase stimulated by s. aureus

A

No

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39
Q

Foods at risk for s. aureus

A 
Meat
Bakery foods 
Dairy produce 
Fruit
Veg 
Salad
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40
Q

What causes the spread of s. aureus

A

poor food handling

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41
Q

When is highest incidence of s aureus

A

summer

Winter holiday periods

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42
Q

S. aureus confirmation test

A

Coagulase test

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43
Q

Bacillus cereus characteristics

A 
Gram +
Rods 
Aerobic
Spore former 
Emetic toxin and enterotoxin
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44
Q

How does bacillus cereus spread

A

Air

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45
Q

How does b. cereus look under blood agar

A

Wrinkly

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46
Q

Baby sx to botulism

A 
constipation 
Lethargy 
Suck/gag reflex diminish 
Head control lost 
Infant becomes flaccid
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47
Q

Tx for botulism

A

Antitoxin hepatavalent

Baby- immune globulin

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48
Q

Mushroom toxin characteristics

A

Short acting- wild mushrooms

Long acting- uncultivated mushrooms (amantia toxin)

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49
Q

Mycotoxigenic fungi characteristics

A

Aflatoxin
Contamination of nuts
Causes: acute necrosis, cirrhosis, carcinoma of liver

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50
Q

Ciguatera poisoning characteristics

A

Caribbean tropical fish
Large predatory reef fish
Acute GI sx- Watery diarrhea
Neurological sx- paresthesia, temp reversal

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51
Q

Scromboid poisoning

A

Non allergic histamine
Tuna mahi mahi bluefin
metallic taste

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52
Q

Shell fish poisoning

A

Brevetoxin

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53
Q

Paralytic shellfish poisoning

A

Dinoflagellate algae
Saxitoxin
Muscular in coordination

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54
Q

What does ecoli activate via its toxins

A 
Heat Labile (LT)- adenylate cyclase 
Heat stable (ST)- gunylate cyclase
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55
Q

Action of E coli toxin

A

B binding subunit adheres to GM1 receptor of epithillia cells. Allows for subunit A entrance. Entry of A activates G proteins of adenylate cyclase… hyper secretion of electrolytes and water

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56
Q

What is a way to contract c. perfringens

A

Not well cooked pig

Papua new guinea

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57
Q

WHat type of c perfringens is food borne

A

Type A

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58
Q

What is the toxin from c. perfringens called?

A

CPE

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59
Q

WHat are the parasitic causes of diarrhea

A

Cryptosporidium
Cyclospora
Entamoeba
Giardia

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60
Q

CHaracteristics of Rotavirus

A

11 segments

ds RNA

61
Q

What are the important serotypes of rotavirus

62
Q

Epidemiology of rotavirus

A

ages 4-5
Asia, africa, latin america
Developed countries- winter
Less developed countries- summer

63
Q

What causes rotavirus

A

unsafe water

64
Q

When are kids asymptomatic from rota virus

A

5 years and older

6months and younger

65
Q

Pathogenesis of rotavirus

A

Fecal oral
Replication on epithelial cells of SMALL intestine
peaks in 8 days

66
Q

Histopath of rotavirus

A

Shortening and blunting of villi

67
Q

Clinical sx of rota

A

Sudden watery diarrhea

68
Q

Complications from rota

A

Extreme dehydration (more severe than cholera)

69
Q

Detection of rota

A

Latex agglutination

EIA

70
Q

Sapovirus is mostly seen in this population (norovirus)

A

Elderly

in Winter

71
Q

What is the main sx of sapovirus (norovirus)

72
Q

Transmission of noro virus

A

fecal oral

Spares large intestine (no faecal leukocytes)

73
Q

How long does noro last

A

24-60 hours

74
Q

Best way to detect noro in stool

75
Q

Adenovirus characteristics

A

Icosahedral
ds DNA
40/41 serotype, Group F

76
Q

Target of adenovirus in GI

A

Small intestine

77
Q

Epi of adeno

A

Children less than 5

Diarrhea w/ w.o vomiting

78
Q

Astrovirus characteristics

A

non enveloped
star shaped
Scotland
+ RNA

79
Q

Hepatitis A transmission

A

Fecal oral
Non enveloped
ss + RNA

80
Q

Hep E

A

Non enveloped
icoshedral
Endemic in India

81
Q

Inflammation Diarhea overview

A

Food associated invasion of intestines
Sx- bloody diarrhea
Toxin: enterotoxin/ cytotoxin

82
Q

Shigella groups

A

A-D

A is the most severe

83
Q

What are the virulence factors for Shigella

A 
Endotoxin (O toxin)
Exotoxin: Neurotoxin causes coma meningismus 
NAD glycohydrolase (destroys NAD in cells- cell death)
84
Q

Main sx of shigellosis sonnei

A

Watery diarrhea

85
Q

Main sx of shigellosis flexneri

A

Stool mucus

86
Q

Shigella pathogenesis

A

Invades distal ileum and colon through specialized epithelial cells (M cells) that overlie mucosal lymphoid follicles → escapes endocytic vesicle → replicates intracellularly, spreads cell-to-cell

87
Q

Action of shiga toxin

A

cytotoxin- inhibit protein synthesis
Enterotoxin: produces diarrhea
Exotoxin: inhibit sugar aa absorption in SI
Neurotoxin effects

88
Q

Epi shigella sonnei

A

Children <5

89
Q

Epi shigella flexneri

A

Homosexuals

90
Q

Transmission of shigella

A

Food
Fingers
Flies
Feces

91
Q

Diagnosis of shigella

A

MacConkey agar
S-S agar
Stool is watery to bloody

92
Q

General characteristics of shigella

A 
Gram -
No fermentation lactose 
No utilization of citric acid 
No H2S production 
No gas from glucose
93
Q

Which shigella produces H2S

A

Shigella flexneri

94
Q

Which is more infective shiga and enteroinvasive

A

Enteroinvasive Ecoli only 10 organisms needed for infection

95
Q

Enteroinvasive E coli pathogenesis

A

Invasion in LI
Enters via endocytosis
Inhibits protein synthesis
Dead wbc, rbcs, mucosal cells in stool

96
Q

3 types of clinical sx of salmonella

A

Gastroenteritis (s. typhimurium, s. enteritidis, s. newport)
Septicemia (s. cholerasuis)
Enteric Typhoid fever

97
Q

Review chart in ipad for Salmonella (bookmarked)

Enteroinvasive vs septic vs typhoid

98
Q

Where does Salmonella replicate

A

pyers patches

99
Q

Where does salmonella infect

A

Columnar epithelial cells of the small intestine

100
Q

What is most at risk for carrying enterocolitis

101
Q

Highest incidence of salmonella

A

Serotype enteritidis

102
Q

What besides food carries salmonella

103
Q

Enteric fever characteristics

A

Only found in travelers from asia mexico india

S. typhi

104
Q

What is one weird fruit that carries salmonella typhi

A

Mamey fruit pulp

105
Q

Diagnosis of salmonella

A

Macconkey agar

106
Q

General characteristics of salmonella

A 
Motile 
Gram - rod 
No fermentation lactose 
H2S production 
Gas from glucose 
serotype
107
Q

Clinical diagnosis of salmonella

A

Hx of travel
Rose colored spots on abdomen
Examine blood for absece of eosinophils
Positive widal reaction

108
Q

Characteristics of campylobacter

A 
Gram - 
non sporing 
microaerophilic 
Does not ferment CH2O 
Catalase +
109
Q

Epi of campylobacter compared to h pylori

A

Campylobacter- Spike in summer

H pylori same level each season

110
Q

What is the #1 food borne disease

A

Campylobacter

111
Q

Pathogenesis of campylobacter

A

Invasion
Toxin: Endo/entero (watery diarrhea)
Cytotoxin: Verotoxin similar to shiga

112
Q

Clinical sx of campylobacter

A

sx after 3-5 days of ingestion
Profuse diarrhea sometimes Green
Fever
Prostration

113
Q

Campylobacter lab

A

Culture: Spreading, grey color
Catalase/oxidase definitive diagnosis
Microscopy: gram- (presumptive diagnosis)

114
Q

Characteristics of yersinia

A

Psychrotroph- facultative psychrophile

common in children < 7

115
Q

What is the toxin released by yersinia

A

ST enterotoxin

Increases cGMP

116
Q

How long does yersinia last

A

14-21 days

117
Q

What is a complication related to yersinia

A

Reactive arthritis

Induced polyclonal T cell stimulation (toxin)

118
Q

Lab diagnosis of yersinia

A

MacConkey look for pinpoints

Specialized media for yersinia

119
Q

General characterisitc of non cholera vibrio

A

Not agglutinated
Halophilic organisms
Coastal waters

120
Q

Vibrio parahaemolyticus

A

Eat raw seafood
look out for sushi
Watery diarrhea

121
Q

Vibrio vulnificus

A

Diarrhea
INfection of cuts
Skin lesions

122
Q

Diagnosis of non vibrios

A

Screen stool for oxidase
TCBS agar
Sucrose: differentiating agent
Sucrose - : v. parahaemolyticus, v. vulnificus

123
Q

Pathogenesis of EAEC

A
  1. Initial adherence to intestinal mucosa (fimbriae)
  2. enhanced mucus production- biofilm
  3. cytotoxin production - damage to intestinal cells
124
Q

Prognosis of EHEC

A

Life threatening
Haemorrhagic colitis
Uremic syndrome: renal failure

125
Q

Toxin for EHEC

A

Phage encoded cytotoxin verotoxin
VT1: biochem structure similar to shiga toxin
VT2: B toxin bound to receptor allows for subunit A into cell. Activates 28 rna

126
Q

Pathogenesis of EHEC

A

No invasion

Attaches via fimbrae

127
Q

Diagnosis of e coli

A 
Pink colonies on mac conkey agar 
Sortibol macconkey agar 
ETEC 
ELISA 
DNA probe
128
Q

What are the antibiotics associated with C diff

A

ampicillin
Cephalosporins
clindamycin
Amoxicillin

129
Q

Toxins in C diff

A

Toxin A: Enterotoxin

Toxin B: cytotoxin

130
Q

Clinical sx of c diff

A

Varies
watery diarrhea
non bloody
hyposlcumineia, leukocytosis

131
Q

Diagnosis of c diff

A

presence of pseudomembrane

132
Q

Tx of c diff

A

Discontinue antibiotics

Tx w/ vancomycin, metronidazole

133
Q

Gastric cancer w. H. Pylori seen with

A

Low acid production

Pan gastritis

134
Q

Peptic ulcer w. h. pylori seen with

A

high acid production

antral predominant gastritis

135
Q

What allows for h. pylori to survive at low pH

136
Q

Virulence factor for H. pylori

A

cagPAI

VacA cytoxin

137
Q

Non invasive tests for h pylori

A

Breath (rapid presumptive)

Serology (definitive)

138
Q

Invasive tests for h pylori

A

Urease (rapid presumptive)
Culture (definitive)
Histo (definitive)

139
Q

Tx for h pylori

A

Triple/quadruple therapy

140
Q

Gastrointestinal abscess pathogenesis general

A

Reduced O2 tension/ oxidation reduction potential
Impaired blood supply
Provides anaerobic environment

141
Q

Common cause of peritonitis

A

Primary: e coli, tb, n. gonorrhoeae, c. thrachomatis
secondary: Spillage of bacteria from GI into peritoneal cavity

142
Q

Common cause of diverticulitis

A

bacteroides

Ecoli enterococci

143
Q

Common cause of pancreatic absces

A 
e coli
Klebsiella 
Enterobacter 
enterococci
streptococci
144
Q

Diagnosis of abscess

A

location of pain
WBC count
imagining

145
Q

Treatment of abscess

A

improve vascular perfusion
eliminate source of infection
Aspirate infected exudate
Treat complications

146
Q

Anaerobes are resistant to what

A

penicillins
cephalosporins
Amino glycosides

147
Q

Non toxic b. fargils promotes what

A

Mucosal health

148
Q

Toxic b fragilis causes what

A

inflammatory diarrhea coloniziation

Toxins 1-3

Micro (14 decks)

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