Helico, Vibrio, Campylo, Anaerobes

Question 1

What accounts for 95% of duodenal and 70% of duodenal ulcers?

Answer 1

H. pylori

Question 2

What are the virulence factors of h. pylori?

Answer 2

Gram- rod, curved, microaerophilic
Vac A -vacuolating cytotoxin- punch holes in organelles
PAI encoding Type III secretion system
CagA- rearranges cytoskeleton
Urease

Question 3

How does h. pylori cause ulcers?

Answer 3

Urease: cleave urea, make alkaline, increase gastrin, increase pH

Type III: injects CagA and VacA into our cells to cause vacuolization and cytoskeletal rearrangement

Question 4

VacA does what?

Answer 4

Vacuoles in organelles

Question 5

CagA does what?

Answer 5

Cytoskeletal rearrangement of our cells

Question 6

H. pylori treatment? diagnosis?

Answer 6

urea breath test dx

Tx with omeprazole, metronidazole, clarithromycin

Question 7

What is the most common GI in developed nations?

Answer 7

Campylobacter jejuni, many reservoirs

Question 8

What is shape of campylobacter?

Answer 8

Seagull/moustache

Gram -

Question 9

Presentation: Fever, appendicitis type pain, watery diarrhea becomes bloody

Answer 9

Campylobacter

Question 10

What is the most common antecedent to guillain barre?

Answer 10

Campylobacter–> rising paralysis

X reactibe antibodies to Cj lipooligosaccharides and myelin

Question 11

Tx and diagnosis of campylo?

Answer 11

Dx: antibiotic culture
Tx: erythromycin, fluoros, b-lactam ressitance

SELF LIMITING: 3-7 days diarhea

Question 12

Vibrio characteristics?

Answer 12

Gram - rod
Motile polar flagellum: lives in saltwater
Oxidase positive

Question 13

Shellfish in warm months can have what?

Answer 13

Vibrio: saltwater swimmers

Question 14

Cholera happens due to what?

Answer 14

Poor sanitation

Natural disasters

Question 15

What cholera serogroups are epidemic or pandemic?

Answer 15

O1 (2 subgroups)
El Tor
Classical
O139

> 200 serotypes based on O antigen

Question 16

What kills in cholera?

Answer 16

Dehydration: 20 liters a day of diarrhea

Question 17

Presentation: diarhea progreses to look like rice water

Answer 17

Cholera

Question 18

How long does cholera usually last?

Answer 18

1 week

Question 19

Virulence factors of cholera?

Answer 19

PAI encoded pilus for attachment
Phage encoded toxin:
    AB: 5 B and 1 A subunit
    ADP ribosylation of GTP-binding protein
    adenylate cyclase activation
    cAMP increase: secretory diarrhea

Question 20

Cholera dx? Tx?

Answer 20

Dx: stool culture on TCBS (Thiosulfate citrate bile salts sucrose)
or
MacConkey agar

Tx: HYDRATION (doxy or erythromycin)

Question 21

Rehydration therapy recipe?

Answer 21

8 teaspoons sugar, 1 teaspoon salt, 1 liter water

Question 22

Seafood diarrhea?

Answer 22

Vibrio parahaemolyticus (Japan, US coasts)

Question 23

Seafood and wound infection?

Answer 23

Vibrio vulnificus: cellulitis and bullae

Tx: doxycycline

Question 24

For every one animal cell, how many bacteria cells do we have?

Answer 24

1 to 10!

Question 25

Clostridium form what?

Answer 25

Spores

Question 26

What makes something an anaerobe?

Answer 26

Cant deal with O2 ROS lack superoxide dismutase lack catalase

Question 27

How do anaerobes make energy?

Answer 27

Fermentation

Question 28

What is biggest clue for anaerobes?

Answer 28

STINK: smelly breath or gas

Question 29

Most common anaerobic infection?

Answer 29

Bacteroides fragilis: abcesses, PID, lung aspiration etc.

Question 30

Bacteriodes virulence factors?

Answer 30

Antiphagocytic capsule

Question 31

Aminoglycosides effectiveness against anaerobes?

Answer 31

NOT! need O2 to get inside cells

Question 32

Tx for anaerobes?

Answer 32

Erithromycin, clinda, metronidazole, 3rd gen cephalosporins

Question 33

Shiny black dots on agar?

Answer 33

Prevotella MELANinogenica

Question 34

What is gram + spore forming anaerobe?

Answer 34

Clostridium

Question 35

Large boxcar gram + rods?

Answer 35

clostridium perfringens

Question 36

Gas gangrene and cellulitis?

Answer 36

clostridium perfringens: contamination of wound by spores

Question 37

Virulence factors of clostridium perfringens?

Answer 37

Tissue penetration: Phospholipase Collagenase Protease Fermentation: gas!

Question 38

Gsa gangrene tx?

Answer 38

Surgical debridement Penicillin and protein inhibitors Hyperbaric oxygen chamber

Question 39

C. perfringens also causes what?

Answer 39

Food poisoning: rich meats cooked at low temperatures that do not kill spores

Question 40

Clostridium tetani presentation?

Answer 40

Cut Lock jaw Spasms Light sensitivity

Question 41

Tetanus death?

Answer 41

Exhaustion or respiratory failure

Question 42

Tx for tetanus

Answer 42

Not antibiotics: soak up toxin

Question 43

Kids get what tetanus vaccine?

Answer 43

DTaP | adults get Tdap

Question 44

Clostridium botulinum virulence factors?

Answer 44

TOXINS: prevent Ach release seven antigenic types 1g could kill 1 million people: POTENT Cleave V and T snares

Question 45

Acute symmetric DESCENDING paralysis?

Answer 45

Botulism: respiratory failure

Question 46

Floppy baby?

Answer 46

Infant botulism from carpets, natural honey

Question 47

C. difficile virulence factors?

Answer 47

A and B toxins synergy: A: enterotoxin: diarhea B: cytotoxin: inflammation

Question 48

Watery diarhea?

Answer 48

C. dif C. perfringens V. cholerae

Question 49

Watery then bloody diarrhea?

Answer 49

C. jejuni

Question 50

Persistant infection and symptoms?

Answer 50

H. pylori

Question 51

Seasonal diarhea?

Answer 51

V. cholerae | V. parahaemolyticus

Question 52

Food borne diarrhea?

Answer 52

C. jejuni V. cholerae V. parahaemolyticus C. perfringens

Question 53

Normal flora?

Answer 53

B. fragilis | C. dif

Question 54

Opportunisitic/Nosocomial?

Answer 54

B. fragilis | C. dif

Question 55

Flaccid paralysis

Answer 55

Botulism

Question 56

Lock jaw/stiffness?

Answer 56

Tetani