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Old Gastrointestinal Cards > GI Worms Protozoa Diarrheals & Hepatitis > Flashcards

GI Worms Protozoa Diarrheals & Hepatitis Flashcards

1
Q

Entamoeba Histolytica: Transmission

A

Fecal oral route by contamination of food or water with infective cysts

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2
Q

Entamoeba Histolytica: Clinical disease

A

Commonly asymptomatic (carrier state). Acute disease it can present as severe dysentery with numerous small stools containing blood, mucous and shreds of necrotic mucosa. Disseminated infections occur when not detected early. Primarily spreads to the liver (lung and brain possible) and is more common in immunocompromised host

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3
Q

Entamoeba Histolytica: Morphology (shape, # of nuclei, #of flagella, cytoplasmic appearance)

A

Trophozoites have ameboid shape, ground glass cytoplasm, a solitary nucleus, no flagella and often RBC inclusion bodies. Cysts are spherical with 1-4 nuclei and might contain chromatoid bodies (sausage shaped)

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4
Q

RBC inclusion bodies are often seen in what organsim

A

Entamoeba Histolytica

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5
Q

Acanthamoeba: Transmission

A

Direct contact (as with the contact lense epidemic) or inhalation

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6
Q

Acanthamoeba: Clinical disease

A

Immunocompromised: More common, causes pneumonitis (lung inflammation), dermal ulceration, and slowly progressive but fatal encephalitis. Healthy individuals: Can cause ulcerative keratitis (eats the cornea) resulting from contaminated contact lenses.

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7
Q

This organism was responsible for the keratitis outbreak in schools after kids started sharing their color contacts

A

Acanthamoeba

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8
Q

Naegleria fowleri: Transmission

A

Swimming in warm bodies of fresh water, such as ponds, lakes, rivers, and hot springs. Enters brain via olfactory route (cribriform plate)

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9
Q

Naegleria fowleri: Clinical disease

A

Affects healthy and immunocompromised individuals by causing primary amebic meningoencephalitis, a rapidly progressing and almost invariably fatal disease (the case fatality rate is estimated at 98%)

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10
Q

Infection with this organsim almost always results in death (98% mortality rate)

A

Naegleria fowleri

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11
Q

Giardia Lamblia: Transmission

A

Ingestion of infected water or by anal/oral sexual contact

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12
Q

Giardia Lamblia: Clinical disease

A

Trophozoites coat villi of small intestine, interfering with the absorption of fat, and fat soluble nutrients such as vitamin B12, carotene, and folate. Symptoms: epigastric pain and non-bloody diarrhea (steatorrhea)

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13
Q

Giardia Lamblia: Morphology (shape, # of nuclei, #of flagella, cytoplasmic appearance)

A

Trophozoite is pear shaped with sucking disk, 2 nuclei that resmble eyes and 4 pairs of flagella. Cyst is football shaped with 2-4 nuclei and axonemes

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14
Q

Infection with which organism is the most common (in the USA) of the intestinal protozoan infections

A

Giardia Lamblia

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15
Q

Trichomonas vaginalis: Transmission

A

Sexual contact, contaminated towels, wash cloths, and clothing (can survive on fomites up to 24 hours)

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16
Q

Trichomonas vaginalis: Clinical disease

A

Trophozoites feed on the mucosal surface of the vagina resulting in inflammation, vaginal irritation, burning, and purulent discharge. Infection in males may be asymptomatic and harder to detect. Prostatic inflammation is most common symptom

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17
Q

Trichomonas vaginalis: Morphology (shape, # of nuclei, #of flagella, cytoplasmic appearance)

A

Trophozoite is oval or pear shaped with 1 nucleus. Has 4 flagella, and a characteristic undulating membrane. Its axoneme appears to protrude from the posterior but is actually covered by membrane

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18
Q

Cryptosporidium parvum: Transmission

A

Ingestion of infected water or by anal/oral sexual contact

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19
Q

Cryptosporidium parvum: Clinical disease

A

Immunocompromised: An opportunistic infection seen in AIDS patients that causes chronic life threatening infection with profuse watery diarrhea. Immunocompetent: Profuse watery diarrhea that is self-limiting.

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20
Q

This organism is acid fast and resistant to chlorination

A

Cryptosporidium parvum

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21
Q

This organism is similar to Cryptosporidium parvum except its larger. It is also acid fast.

A

Cyclospora cayetanensis

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22
Q

Cyclospora cayetanensis: Transmission

A

Contaminated fruit

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23
Q

Which three infection-causing protozoans of the GI tract are acid fast

A

Cryptosporidium parvum, Cyclospora cayetanensis, Isospora belli

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24
Q

Isospora belli: Clinical disease

A

Similar to Cryptosporidium. Causes acute, non-bloody diarrhea with crampy abdominal pain, which can last for weeks and result in malabsorption and weight loss. In immunodepressed patients, and in infants and children, the diarrhea can be severe.

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25
Q

This organsim is the only known ciliate to cause human disease and has a major reservoir in swine

A

Balantidium coli

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26
Q

This organism is similar to Entamoeba Histolytica except for what difference

A

Balantidium coli except it very rarely invades beyond the gut wall (no disseminated infection)

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27
Q

Watery (no blood or mucous) diarrhea sans fever and minimal local inflammatory response occuring 1-8 hrs after ingestion of contaminated food is caused by what two organisms [and is it pre-formed toxin, toxin, or organism mediated]

A

Bacillus Cereus or Staph Aureus [Pre-formed toxin]

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28
Q

Watery (no blood or mucous) diarrhea sans fever and minimal local inflammatory response occuring 18-36 hrs after ingestion of contaminated food is caused by what four organisms [and is it pre-formed toxin, toxin, or organism mediated]

A

Enterotoxigenic E. Coli, Vibrio cholera, Clostridium Perfingens, or Bacillus Cereus [Toxin produced in GI tract]

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29
Q

Dysentery and fever occuring 2-4 days after ingestion of contaminated food is caused by what four organisms [and is it pre-formed toxin, toxin, or organism mediated]

A

Campylobacter jejuni, Salmonella, Shigella, or Enteroinvasive E. Coli

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30
Q

Various GI symptoms occuring 7-10 days after ingestion of contaminated food is caused by what three organisms [and is it pre-formed toxin, toxin, or organism mediated]

A

Giardia, Cryptosporidium, or Entamoeba

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31
Q

How does cholera toxin work

A

It migrates across membrane of small bowel mucosa cell to stimulate adenylate cyclase which stimulates cyclic AMP which stimulates secretion of electrolytes into bowel lumen

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32
Q

Which 5 organisms cause dysentery (partially invade gut)

A

Shigella, Campylobacter Jejuni, Clostridium difficile, Invasive E. Coli, and Entamoeba Histolytica

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33
Q

Which 2 organisms fully invade the gut

A

Salmonella typhi and Yersinia

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34
Q

This diarrhea-causing organism is an aerobic, curved gram-negative rod. Infection is associated with salt water exposure

A

Vibrio cholera

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35
Q

This diarrhea-causing organism is the most common bacterial cause of diarrhea

A

Campylobacter jejuni

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36
Q

This diarrhea-causing organism is a microaerobic, curved gram-negative rod. Infection is associated with chickens and unpasteurized milk

A

Campylobacter jejuni

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37
Q

This diarrhea-causing organism is a non-spore-forming aerobic gram negative rod. Infection is associated with chickens, turkeys, cows, pigs, pets, and unpasteurized milk

A

Salmonella

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38
Q

This kind of E. Coli causes watery diarrhea in travellers

A

Enterotoxigenic (or enteroaggregative)

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39
Q

This kind of E. Coli causes watery diarrhea in children

A

Enteropathogenic (or enteroaggregative)

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40
Q

This kind of E. Coli causes febrile severe diarrhea particularly in developing cultures

A

Enteroinvasive

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41
Q

This kind of E. Coli causes afebrile, gross blood, associated with hemolytic/uremic syndrome

A

Enterohemorrhagic

42
Q

What Diarrhea-causing virus is a Reovirus (segmented double stranded RNA, icosahedral virion, double capsid, and no envelope)

A

Rotavirus

43
Q

What Diarrhea-causing virus is a Calicivirus (positive sense single stranded RNA, icosahedral virion with no envelope)

A

Norovirus

44
Q

What is the incubation period of Rotavirus

A

24-72 hours

45
Q

This virus is icosahedral, lacks an envelope, and has linear double-stranded DNA genome

A

Adenovirus

46
Q

Which Serotypes of the Adenovirus cause acute viral gastroenteritis in infancts that is often associated with concurrent respiratory tract infection

A

40, 41, and 42

47
Q

What is the incubation period of Norovirus

A

6-24 hours

48
Q

Who does Rotavirus usually infect

A

Infants <2 yrs

49
Q

Who does Norovirus usually infect

A

School age children and adults

50
Q

Diphyllobothrium latum: Transmission and Intermediate/difinitive host

A

Transmission: Ingestion of undercooked cooked freshwater fish containing the infective pleurocercoid. Intermediate host: Copepod and freshwater fish Difinitive host: Humans

51
Q

Which organism causes the following clinical disease: Pretty minor, digestive upset, abdominal discomfort, weight loss, and weakness. Pernicious anemia can develop in cases where worms attach in the upper small intestine (out competes for B12)

A

Diphyllobothrium latum

52
Q

This is the largest tapeworm in humans

A

Diphyllobothrium latum

53
Q

Taenia Solium: Transmission and Intermediate/difinitive host

A

Transmission: Ingestion of undercooked pork infected with cysticercus causes GI infection. Fecal/oral ingestion of eggs can cause intermediate host infection of brain (cysticercosis). Intermediate host: Pigs. Difinitive host: Humans

54
Q

Cysticersosis is caused by infection with what organsim

A

Taenia Solium

55
Q

Taenia Solium: Morphology (# of suckers, # of hooks, # of uterine branches)

A

Scolex with 4 suckers, double row of hooks, gravid proglottids <12 uterine branches

56
Q

Taenia Saginata: Transmission and Intermediate/difinitive host

A

Transmission: Ingestion of undercooked beef infected with cysticercus causes GI infection. Intermediate host: Cows. Difinitive host: Humans

57
Q

Taenia Solium & Taenia Saginata: Clinical disease

A

Few symptoms including abdominal discomfort, mild irritation of the intestinal mucosa from adult worm, and discomfort of the proglottids crawling out of the anus

58
Q

Taenia Saginata: Morphology (# of suckers, # of hooks, # of uterine branches)

A

Scolex with 4 suckers, no hooks, gravid proglottids >12 uterine branches

59
Q

The clinical disease of this organism includes: Cutaneous-little reaction. Repeat infection can cause allergic response. Pulmonary effects include coughing, shortness of breath, wheezing. Abdominal effects include pain, diarrhea, indigestion, and nausea possibly mimicking an ulcer. Hyperinfection in immunocompromised patients can lead to disseminated infection that can result in death due to sepsis

A

Strongyloides stercoralis

60
Q

Strongyloides stercoralis: Intermediate (reservoir) host and difinitive host

A

Intermediate (reservoir): Cats and dogs. Difinitive host: Humans

61
Q

This organism can continually autoinfect the human host causing a chronic infection in immunocompromised patients that can last decades

A

Strongyloides stercoralis

62
Q

This organism is microscopic in the adult form and would be found buried in the submucosa of the intestine but is barely ever seen

A

Strongyloides stercoralis

63
Q

Necator americanus & Ancylostoma duodenale: Transmission and life cylce

A

Transmission: Skin contact with soil. Life cycle: Rhabditiform larvae develop into filariform larvae in the soil. Filariform enters skin, is carried to heart and lungs by blood, enters the alveoli, migrates to trachea and is swallowed, matures into adult in the intestine

64
Q

Necator americanus & Ancylostoma duodenale: Clinical disease

A

Cutaneous phase: Ground itch. Pulmonary phase: Pneumonitis. Intestinal phase: Iron deficiency anemia

65
Q

Which organisms are transmitted by penetrating the skin

A

Necator americanus & Ancylostoma duodenale

66
Q

Enterobium vermicularis: Clinical disease

A

Perianal itching, behavioral changes (insomnia and irritability)

67
Q

This is the world’s most common parasite. It most commonly affects children

A

Enterobium vermicularis

68
Q

This organism can cause bowel obstruction if large number of worms are present (worm ball)

A

Ascaris lumbricoides

69
Q

Ascaris lumbricoides: Transmission and life cylce

A

Transmission: Eggs are ingested. Life cylce: Larvae develop within the egg. When egg is ingested, the larvae penetrate the gut an travel to liver->lung->trache->esophagus. They are swallowed and become adults in the intestine

70
Q

Ascaris lumbricoides: Clinical disease

A

Pneumonitis when larvae migrate through tissue, bowel obstruction (worm ball), abnormal migration is possible and may cause inflammation in affected tissues.

71
Q

Best markers for current acute HBV infection

A

IgM anti-HBc & HBsAg

72
Q

Best markers for past HBV infection

A

IgG anti-HBs & IgG anti-HBc In the absence of HBsAg

73
Q

What markers will be present in an HBV vaccinated individual

A

IgG anti-HBs but no anti-HBc

74
Q

Best marker for chronic HBV infection

A

HBsAg longer than 6 months but no anti-HBs

75
Q

Best markers for HBV infectivity

A

HBV DNA or HBeAg

76
Q

Diagnose: HBsAg: + Anti-HBs: - HBeAg: + Anti-HBe: - Anti-HBc: IgM

A

Acute HBV

77
Q

Diagnose: HBsAg: - Anti-HBs: - HBeAg: - Anti-HBe: + Anti-HBc: IgM

A

HBV Window Period

78
Q

Diagnose: HBsAg: + Anti-HBs: - HBeAg: + Anti-HBe: - Anti-HBc: IgG

A

High infectivity Chronic HBV

79
Q

Diagnose: HBsAg: + Anti-HBs: - HBeAg: - Anti-HBe: + Anti-HBc: IgG

A

Low infectivity Chronic HBV

80
Q

Diagnose: HBsAg: - Anti-HBs: + HBeAg: - Anti-HBe: + Anti-HBc: IgG

A

Recovery from HBV infection

81
Q

Diagnose: HBsAg: - Anti-HBs: + HBeAg: - Anti-HBe: - Anti-HBc: -

A

Immunized against HBV

82
Q

This Hepatitis virus is a Picornavirus

A

HAV

83
Q

This Hepatitis virus is a Hepadnavirus

A

HBV

84
Q

This Hepatitis virus is a Flavivirus

A

HCV

85
Q

This Hepatitis virus is a Delta Virus

A

HDV

86
Q

This Hepatitis virus is a Hepevirus

A

HEV

87
Q

Which Hepatitis virus requires infection with which other hepatitis virus

A

HDV requires HBV infection

88
Q

Which Hepatitis viruses carry a risk of Hepatocellular Carcinoma

A

HBV, HCV, & HDV

89
Q

Which Hepatitis viruses are transmitted by blood or sexual contact

A

HBV, HCV, & HDV

90
Q

Which Hepatitis viruses are transmitted by fecal oral route

A

HAV & HEV

91
Q

Which Hepatitis viruses are naked viruses

A

HAV & HEV

92
Q

When does a Hepatitis superinfection occur

A

When an HBV infected individual is infected with HDV

93
Q

What is the standard treatment option for HBV & HCV

A

Alpha-interferon + Ribovirin

94
Q

What percent of symptomatic HBV infected individuals develop acute vs chronic disease

A

Acute: 90% Chronic: 10%

95
Q

What percent of symptomatic HCV infected individuals develop acute vs chronic disease

A

Acute: 20% Chronic: 80%

96
Q

Which Hepatitis Virus causes high mortality in pregnant women

A

HEV

97
Q

How do liver enzymes ALT and AST compare in viral hepatitis

A

ALT > AST

98
Q

How do liver enzymes ALT and AST compare in alcoholic hepatitis

A

AST > ALT

99
Q

IgM Anti-HAV Indicates what

A

Active HAV infection

100
Q

IgG Anti-HAV indicates what

A

Prior HAV infection and/or HAV vaccination

Old Gastrointestinal Cards (4 decks)

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