Infectious Diarrhea

Question 1

Causative organisms of salmonellosis?

Answer 1

Salmonella bongori, salmonella enterica

Question 2

Reservoirs of salmonellosis?

Answer 2

poultry (MC)

pet reptiles- turtles

Question 3

Salmonellosis is associated with?

Answer 3

reactive arthritis - can’t see, can’t pee, can’t climb a tree

Question 4

Causative organisms of Shigellosis?

Answer 4

Shigella dysenteriae (most aggressive)
Shigella sonnei- developed nations, milder disease
Shigella flexneri- less developed nation

Question 5

Reservoirs of Shigellosis?

Answer 5

rapidly spreads in close quarters- military example
contaminated H20
food
produce grown where sewage used as fertilizer

Question 6

Causative organisms of Campylobacter species?

Answer 6

Campylobacter jejuni

Question 7

Reservoirs of Campylobacter species?

Answer 7

poultry (MC)- raw/uncooked animals and livestock
raw milk
chicken pate
domestic dogs and cats

Question 8

Complications of Campylobacter species?

Answer 8

Guillain-Barre syndrome (ascending paralysis)

Question 9

Reservoirs of enterohemorrhagic e. coli (EHEC)?

Answer 9

Cattle cows (MC)

Question 10

Enterohemorrhagic e.coli (EHEC) is capable of producing what?

Answer 10

Shiga toxin-producing e. coli (STEC)

Question 11

Reservoirs of Yersinosis?

Answer 11

Pigs

Question 12

Infants and children w/ Yersinosis may progress to?

Answer 12

Necrotizing eterocolitis

Question 13

Clinical manifestations of Yersiniosis?

Answer 13

mesenteric lymphadenitis-RLQ pain

Mimics appendicitis

Question 14

Causative organisms pseuromembranous colitis?

Answer 14

clostridium difficile (c.diff)

Question 15

Pseudomembranous colitis is usually associated with what antibiotics?

Answer 15

Clindamycin (MC)
Ampicillin
Cephalosporins (2nd and 3rd generation)
Fluoroquinolones

Question 16

A severe case of Pseudomembranous colitis can result in?

Answer 16

Toxic megacolon
greenish, foul-smelling watery diarrhea
profuse diarrhea >30 x a day

Question 17

What stool study is used for Pseudomembranous colitis?

Answer 17

Nucleic acid amplification test (PCR assay) for TcdB toxin-higher sensitivity

Question 18

Lab findings for Pseudomembranous colitis?

Answer 18

Leukocytosis >30,000

Question 19

Tx for Pseudomembranous colitis?

Answer 19

Metronidazole - 1st line for mild-moderate disease (caution w/ etoh intake)
Vancomycin (PO only NOT IV) - >2 occurrences, good for leukocytosis
Fecal transplant - if everything else false

Question 20

Causative organisms of Amebiasis?

Answer 20

Entamoeba histolytica

Question 21

Transmission of Amebiasis?

Answer 21

Anal-oral or fecal-oral

Question 22

Geographic distribution of Amebiasis?

Answer 22

worldwide, more common in tropics and developing nation

Question 23

Morphology of Amebiasis?

Answer 23

Tropozoite - motile, bulls-eye shape nucleus w/ RBC in the cytoplasm
RUQ pain

Question 24

Tx for Amebiasis?

Answer 24

Metronidazole (1st line-definitely for liver abscesses)

Question 25

Is norovirus contagious?

Answer 25

Extremely contagious; causes 1/5 of all cases of viral gastroenteritis worldwide.
- no blood in stool

Question 26

MC outbreak location of norovirus?

Answer 26

Cruise ships

Question 27

Rotavirus is the MCC of what?

Answer 27

pediatric diarrhea (age: 6-24 mos)

Question 28

Transmission of staphylococcal food poisoning?

Answer 28

fecal-oral transmission
mayonnaise (big one)
meats
dairy
bakery products

Question 29

Transmission of Enterotoxigenic e.coli (ETEC)?

Answer 29

AKA: travelers diarrhea
Fecal-oral route
contaminated foods, drinking water, or ice

Question 30

Tx for Enterotoxigenic e.coli (ETEC)?

Answer 30

supportive (most important)
Azithromycin-given prior to travel esp. to Southeast Asia
Pepto-bismol

Question 31

Causes of Bacillus cereus?

Answer 31

fried rice

Question 32

A subtype of clostridium perfringens can lead to what?

Answer 32

Jejunal hemorrhagic necrosis- uncommon in US

Question 33

Causative organisms of cholera?

Answer 33

AKA: blue death

vibrio cholerae

Question 34

Clinical manifestation of cholera?

Answer 34

voluminous “gray/white” fluid diarrhea w/ flecks of mucus

rice water diarrhea

Question 35

Causative organisms of vibriosis?

Answer 35

vibrio parahaemolyticus: mud bugs

vibrio vulnificus

Question 36

Vibrio bacteria are commonly found in?

Answer 36

marine, brackish waters, swamps—-> shellfish (MC crayfish)

Question 37

List the 2 manifestations of vibriosis?

Answer 37

GI disease and soft tissue infection

Question 38

Clinical manifestations of GI disease caused by Vibriosis?

Answer 38

vibrio parahaemolyticus MC

watery diarrhea- shortly after eating raw shellfish

Question 39

Clinical manifestations of soft tissue infection caused by Vibriosis?

Answer 39

vibrio vulnificus MC - very bad
recent swimming in marine or brackish waters
cellulitis-may spread rapidly

Question 40

The highest risk after consumption of infected shellfish?

Answer 40

Septicemia

Question 41

The causative organism of Giardiasis?

Answer 41

Giardia lamblia

Question 42

Transmission of Giardiasis?

Answer 42

fecal-oral

hikers drinking pond water (beaver pee)

Question 43

Giardiasis is the MC what?

Answer 43

Intestinal parasite disease in the US

Question 44

Clinical manifestation of Giardiasis?

Answer 44

foul-smelling, greasy diarrhea, abdominal gassy distention

Question 45

Tx for Giardiasis?

Answer 45

Metronidazole (1st line)

Question 46

What is tenesmus?

Answer 46

continued inclination or feeling the need to evacuate the bowels

Question 47

Another name of clostridium perfringens?

Answer 47

Gas gangrene

Question 48

Severe complications of shigellosis?

Answer 48

Shiga toxin

Question 49

Does EHEC have fevers or no?

Answer 49

No fevers!

Question 50

Causative organisms of Yersiniosis?

Answer 50

Yersinia enterocolitica