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GI > Helicobacter, etc > Flashcards

Helicobacter, etc Flashcards

1
Q

Gram -

A

H. pylori

C. jejuni

Bacteroidea fragilis

Prevotella melaninogencia

Vibrio

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2
Q

Gram +

A

Clostridium

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3
Q

Route of transmission:

H. pylori

C. jejuni

Vibrio

Bacteroides

Prevotella

A

H. pylori - fecal-oral; gastric secretions

C. jejuni - undercooked poultry; unpasteurized milk; contaminated water

Vibrio - seafood

Bacteroides - overgrowth

Prevotella - overgrowth

Clostridium - spores

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4
Q

Which enteric bacteria infects nearly 100% of patients in developing countries? How many patients in developed countries are infected with this organism?

A

H. pylori

10-50%

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5
Q

List the three enteropathic Vibrio species.

A

V. cholera

V. parahemolyticus

V. vulnificus

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6
Q

How is C. jejuni diagnosed? Treated?

A

Culture with media containing Abx to kill off enteric bacteria

Usually self-limiting; give erythromycin if prolonged

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7
Q

Which two organisms are microareophilic? What the crap does that mean?

A

H. pylori, C. jejuni

Must be grown under low O2 tension

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8
Q

A patient presents to your clinic in southern Louisiana. She has a one day history of mild watery diarrhea and recalls eating oysters at a party two days ago. How do you treat?

A

Don’t - self-limited

(Seafood-associated watery diarrhea that isn’t extreme in quantity with onset 24 hours after exposure = think V. parahaemolyticus)

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9
Q

A patient presents with 3 day history of watery diarrhea that now is bloody. She recalls eating chicken, pasta salad, and oysters at a picnic about 10 days ago. She complains of abdominal pain and back pain. Vitals are 38C, 102/80, 90, 18. Dx?

A

C. jejuni infection

(Incubation time of 1 week; watery diarrhea that becomes dysentery; appendicitis-like pain; fever; undercooked poultry)

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10
Q

What are the two serogroups of V. cholera?

A

O1

O138

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11
Q

Two virulence factors of clostridium

A

Exotoxins

Secreted hydrolytic enzymes

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12
Q

What two organisms causing enteropathic infections are gram - coccobacilli?

A

Bacteroides fragilis

Prevotella melaninogencia

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13
Q

Name 3 steps in management of C. diff

A
  1. D/C antibiotics
  2. Metronidazole if acute
  3. Enema
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14
Q

Name 4 diseases caused by H. pylori

A
  1. Duodenal ulcers (95% of these)
  2. Gastric ulcers (70% of these)
  3. Gastric adenocarcinoma
  4. Gastric lymphoma
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15
Q

List 3 infections caused by C. perfringens

A
  1. Gas gangrene
  2. Food poisoning
  3. Cellulitis
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16
Q

Mechanism of C. botulinum

A

AB toxin cleaves V &/or T-snares preventing release of ACh

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17
Q

Which organism is present in the environment as spores?

A

Clostridium (difficile, botulinum, perfringens, tetani)

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18
Q

AB neurotoxin

A

C. tetani

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19
Q

Capsule

A

Bacteroides fragilis

Prevotella melaninogencia

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20
Q

What organism is usually found in seawater in warm months?

A

Vibrio

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21
Q

Describe the toxins of C. diff

A

Toxin A - enterotoxin - diarrhea

Toxin B - cytotoxic - inflammation

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22
Q

A patient presents with fever, a watery diarrhea, and elevated white count with 90% polys. What is the most likely organism?

A

C. jejuni

(This is the most common GI infection caused by bacteria, indicated by the high polys)

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23
Q

What two ways can V. vulnificus be transmitted?

A

Seafood

Wound contamination (cellulitis)

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24
Q

List the 4 virulence factors of H. pylori and the function of each

A
  1. VacA - creates holes (ulcers) in organs
  2. CagA - rearranges cytoskeleton of cells
  3. PAI-assc. Type III secretion system - allows injection of virulence factors
  4. Urease - cleave urea into ammonia which neutralizes enviornment
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25
Dented cans
Botulism
26
What causes the "gas" in gas gangrene?
Carb fermentation by C. perfringens
27
Name 4 bacteria with AB toxins.
Diphtheria V. cholera C. tetani C. botulinum (Note: C. difficle has an A and a B toxin but not an AB toxin)
28
How would you treat an infection with this organism?
Omeprazole + metronidazole + clarithromycin
29
Rice water stools
V. cholera
30
What is the most common anaerobic infection?
Bacteroides fragilis
31
Most toxic bacterial exotoxin
C. botulinum AB toxin (! gram could kill 1 million people)
32
Vibrio is (G+, G-) \_\_\_\_-shaped (cocci, rod)
G- Curve Rod
33
Risus sardonicus
C. tetani
34
A college student presents to the ER with breathing difficulty, diarrhea, dry mouth and reports his arms feel "really tired". Upon questioning, you elicit that he frequently buys discounted food items to save money. Treatment?
Botulinum anti-toxin Mechanical ventilation (Botulism = descending paralysis, diarrhea, nausea, dry mouth, respiratory failure)
35
Describe the appearance of C. jejuni.
G- spiral-shaped rods that pair up end-to-end "Gull wing appearance"
36
HTIG
Treatment of C. tetani (Human tetanus immunoglobulin)
37
Watery diarrhea that can become bloody
Campylobacter jejuni Clostridium difficle Enterohemorrhagic E. coli
38
Which enteric organism is resistance to beta lactams?
C. jejuni
39
Oxidase +
Vibrio
40
Describe the appearance of H. pylori. Which other organism does it resemble?
Curved, G- rod Campylobacter jejuni
41
Most common nosocomial infection?
C. diff
42
Boxcar appearance
C. perfringens
43
PAI-encoded pilus
V. cholera (TCP)
44
List 3 diseases caused by bacteroides fragilis
1. Abscesses (think intraabdominal) 2. PID 3. Pulmonary infections (think alcoholic aspirating)
45
20% fatality rate
V. vulnificus in immunocompromised/chronic liver disease patients
46
A patient presents to your clinic with dysuria and frequency. You prescribe amoxicillin for a presumed UTI. Two days later she comes back complaining of abdominal pain and diarrhea. T 38.2, BP 120/70, P 88, RR 18. How can you definitively diagnose her condition?
RADT of toxin A and/or B in stool Endoscopy for pseudomembranes Detection of toxin B activity on tissue cells (should kill the cells) (C. diff)
47
What organism are associated with worse infection in immunocompromised patients and patients with chronic liver disease? What are these complications?
V. vulnificus Septicemia, bullae
48
Why do anaerobic infections stink?
They ferment carbs and breakdown amino acids, the products of which stink
49
Tdap vs. Dtap
Dtap for \< 7 yo Tdap for 10-64 yo
50
List two infections caused by prevotella melaninogencia
Periodontal abscess Pulmonary abscess
51
You saw a patient in clinic 10 days ago with watery diarrhea that had become bloody, prompting him to seek medical attention. You reassured the patient that his likely condition is self-limiting. Now he presents with ascending paralysis. How would you definitively diagnose his condition?
Culture on media containing Abx to kill off enteric flora (Likely **C. jejuni**; watery diarrhea followed by dysentery then Guillian-Barre = C. jejuni)
52
Descending paralysis? Ascending paralysis?
Botulism GBS (Campylobacter)
53
How is gas gangrene acquired?
C. perfringens spore contamination of wound
54
20 liters of watery diarrhea per day
V. cholera
55
List the two virulence factors of vibrio.
AB toxin TCP pilus
56
Which two classes of drugs shouldn't be used to treat a bacteroides overgrowth? Why not?
Penicillin - developed resistance Aminoglycosides - don't work in anaerobic conditions
57
3 ways in which to get C. botulinum infection
Contaminated food Wound contamination Inhalation of spores (infants)
58
Tx of tetanus
HTIG = soaks up toxin (tetanospasmin)
59
Is C. diff part of most people's GI flora?
No; only ~5% of population
60
Why are anaerobic infections generally not cultured from stool/sputum?
They're always present in GI tract, so wouldn't be useful
61
A 3 month old's limbs and head go limp when his mother lifts him from his crib. Sherushes him to the ER where she recalls to the physician that the baby had not been eating well that day and had not had a soiled diaper. Diagnosis?
Botulism (Floppy baby syndrome; infants inhale/ingest spores from carpets; constipation, poor muscle tone, poor feeding)
62
Only endospore-forming anaerobe
Clostridium
63
Two ways to diagnose V. cholera
TCBS agar MacConkey agar
64
Pseudomembranous colitis
C. diff (Ulcerative lesions in colon)
65
3rd most common food-borne illness in US
C. perfringens
66
List 2 ways in which to diagnose H. pylori infection. How could you monitor recurrence?
1. Urea breath test 2. Endoscopy Serology (only tells you if you've ever had H. pylori so not good diagnostically, only for recurrence)
67
A patient presents to your clinic during a DWB trip to Ghana. He reports a 5 day history of severe watery diarrhea and dehydration. He has also been vomiting. When did he contract the causative organism?
7-8 days ago (V. cholera symptoms [profuse watery diarrhea with vomiting] begins 2-3 days after exposure)
68
Appendicitis-like pain
C. jejuni
69
What is the function of V. cholera's A toxin?
ADP ribosylates GTP-binding protein --\> activates adenylate cyclase --\> causes efflux of Na+, Cl-, and H2O into small intestine lumen
70
First sign of tetanus
Trismus (lockjaw)
71
What are the two subgroups of V. Cholera O1?
El tor and classical
72
A patient presents to your urgent care facility with a few hours diarrhea and abdominal pain. She doesn't have a fever and denies vomiting. She reports eating meatloaf the night before. Dx? Tx?
C. perfringens food poisoning Nothing - resolves within 24 hours (Onset 8-24 hours after exposure; no fever or vomiting!)
73
Associated with poor sanitation
V. cholera
74
Bullae
V. vulnificus in patient with immunocompromise &/or chronic liver disease
75
Why does V. cholera require a high infectious dose?
It is transmitted mainly through contaminated water and food, so most of it it killed by acidic stomach environment
76
Honey
Botulism in infants
77
Tx of V. vulnificus? V. parahaemolyticus? V. cholera?
V. vulnificus - doxy V. parahaemolyticus - self-resolving V. cholera - ORT (Na+, glucose, water)
78
What is TCBS agar? When is it used?
Thiosulfate, citrate, bile salts, sucrose Diagnose V. cholera
79
List 3 factors influenced by our gut microbiome.
Weight, CV health, tendency to develop TIIDM
80
Periodontal abscess
Prevotella melaninogencia
81
Anaerobes lacks ____ and \_\_\_\_
SOD Catalase
82
Mechanism of C. tetani
Tetanospasmin, an AB neurotoxin, cleaves V-snare, preventing release of GABA and glycine = prevents postsynaptic inhibition of spinal motor reflexes

GI (10 decks)

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