Week 10 Flashcards

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1
Q

which hepatitis can be vacinated agaisnt

A

A and B

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2
Q

Which Hepatitis are transmited enterically

A
  • A and E (“Vowels in the Bowels”)
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3
Q

Which genus is hepatitis A from

A

Hepatovirus

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4
Q

Which family is Hepatitis A in

A

Picornavirus (like rhinoviruses)

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5
Q

What are main impacts of Hepatisis A

A

acute but self-limiting inflammation of the liver

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6
Q

What characteristic of hepatitis A virus is critical in fecal-enteral transmission?

A

lack of lipid envolope (HAV and HEV is stable in bile)

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7
Q

What allows hepatitis A and E to have large outbreaks

A

direct route to outside (anal transmission) allows for large outbreaks

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8
Q

Hepatitis A - incubation period

A

15-45 days for replication

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9
Q

Hepatitis A - why it causes symptoms abrubpty

A

virus is present in blood and shed in stools within a few days of exposure

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10
Q

Hepatitis A - onset of symptoms is…

A

abrupt

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11
Q

Hepatitis A - serum markers of infection (3)

A
  • ALT and AST (liver serum transaminases) increases
  • bilirubin increases
  • IgM antibody for HAV
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12
Q

Prevention of Hepatitis A

A

Vaccine

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13
Q

Symptoms of Hepatitis A (9)

A
  • fever, malaise, anorexia, N/V, RUQ pain
  • dark urine, light clay coloured stools, frank icterus
  • jaundice
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14
Q

Hepatitis A - risk factors (4)

A
  • close contact with an active case
  • sexual behaviour
  • food and water borne transmission
  • visiting developing countries
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15
Q

Hepatitis A - recovery (3)

A
  • always acute, complete recovery is the rule
  • does not cause chronic hepatitis/carrier state
  • lifelong immunity
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16
Q

Hepatitis A - age as a factor

A
  • under 2 = rarely diagnosed with hepatitis
  • under 6 = asymptomatic
  • over 40 = risk of hepatic failure –> transplant
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17
Q

Hepatitis A - who gets immunization (3)

A
  • international travellers
  • homosexually sexually active men
  • illicit drug users
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18
Q

Hepatitis E - genus of virus

A
  • calcivirus
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19
Q

Hepatitis E - incubation period

A

40 days

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20
Q

Hepatitis E - pregnant women

A

cause fatality in 15-20% of cases in women infected during third trimester of pregnancy (fulminant hepatitis = hepatic failure)

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21
Q

Hepatitis E - where do outbreaks occur

A

typically developing countries

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22
Q

Hepatitis E - diagnositis

A
  • HEV-IgG antibody
  • absence of markers for other hepatis viruses
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23
Q

Which Hepatitis vaccines are RNA based

A
  • Hepatitis A, C, D, E, G
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24
Q

Hepatitis E - vaccination?

A

China has produced a vaccine but it is not availiable globally

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25
Q

Hepatitis B - family

A

Hepadnaviridae

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26
Q

Hepatitis B - acute infection severity

A
  • asymptomatic to fulminant hepatitis
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27
Q

Hepatitis B - types of infection

A

Acute and Chronic

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28
Q

Hepatitis B - amount of chronic infections globally

A

350 million with chronic infection

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29
Q

Hepatitis B - complications are associated with which type of infection

A

Chronic infection

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30
Q

Hepatitis B - pathogenesis

A

cell-mediated immune response of the host

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31
Q

Which Hepatitis strains are DNA based

A

Hepatitis B

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32
Q

Chronic Hepatitis B - potential complications (2)

A

1) HBV –> cirrhosis –> cancer
2) hepatitis D development

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33
Q

Hepatitis B - incubation period

A

50-150 days (more serious health problem)

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34
Q

Hepatitis B - marker of infectivity

A
  • HBSAg - first marker (before elevation in AST and ALT serum transaminases)
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35
Q

Hepatitis B - marker of recovery

A

HBSAb - immunity and recovery

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36
Q

Hepatitis B - what if both markers are absent (period between recovery and infectivity)

A
  • IgM antibody
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37
Q

Hepatitis B - transmission

A

infected blood or serum, body secretions (oral/sexual contact)

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38
Q

Hepatitis B - at risk populations (5)

A
  • people with multiple partners
  • men who have sex with men
  • healthcare worksers
  • injection drug users
  • mother to child
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39
Q

Chronic Hepatitis B - common symptoms (3)

A
  • nonspecific/mild
  • lack of energy
  • malaise
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40
Q

Chronic Hepatitis B - symptoms w hen immune complexes are present

A
  • myalgias
  • arthralgias skin rash
  • glomerulonephritis
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41
Q

Chronic Hepatitis B - unnoticed (2)

A
  • can be slow to notice symptoms
  • may be unnoticed until cirrhosis and end-stage liver disease is present
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42
Q

Chronic Hepatitis B - serum qualities

A
  • persistent HBSAg
  • failure to develop HBSAb for 6 months
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43
Q

Chronic Hepatitis B - recovery

A
  • 1% per year become spontaneously immune
  • no known cure
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44
Q

Hepatitis B - Prevention

A
  • vaccine with HBSAg antigen
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45
Q

Hepatitis B Vaccine - populations (5)

A
  • all people with lifestyle risk factors
  • medical personel
  • lots of sexual partners
  • houshold contacts of HBV carriers
  • infants of HBV carrier mothers
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46
Q

Hepatitis C - family

A

Flavivirus

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47
Q

Hepatitis C - pathology

A
  • slowly progressive liver disease that is asymptomatic until the late development of liver disease/liver cancer
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48
Q

Hepatitis C - symptom prevelance

A

only 5% of cases

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49
Q

Hepatitis C - potential for chronic infection

A

70% develop chronic infection

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50
Q

Hepatitis C - potential for spontaneous recovery

A

40%

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51
Q

Hepatitis C - diagnosis

A
  • increased serum transaminases
  • confirmed with HCV Ab (marker of infection)
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52
Q

Hepatitis C 0 risk factors (4)

A
  • intravenous drug abuse (in the remote past sometimes after a single episode)
  • 60-90% of IV drug abusers have Hep C
  • exposure to untested/non heat treated blood products
  • some sexual transmission (0-5%)
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53
Q

Hepatitis C - incubation period

A

2-26 weeks

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54
Q

Hepatitis C - symptoms (6)

A
  • asymptomatic
  • nonspecific (fatigue, malaise, anorexia, weight loss)
  • typically not jaundice or fulminant hepatitis
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55
Q

Hepatitis C - serious consequences

A
  • progressive liver fibrosis –> cirrhosis
  • end stage liver disease
  • hepatocellular liver cancer
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56
Q

Hepatitis C - risk factors for progressive liver fibrosis (5)

A
  • age of aquisition over 40
  • male sex
  • alcohol consumption over 50g/day
  • immunocompromised state
  • genotype of the virus
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57
Q

Hepatitis D

A

-

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58
Q

Hepatitis C - genotypes of the virus

A
  • many (6+)
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59
Q

Hepatitis D - Genotype number

A

3

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60
Q

Hepatitis D transmission

A
  • blood borne
  • rarely sexual and perianal transmision
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61
Q

Hepatitis D and Hepatitis B

A
  • can be acquired at the same time
  • Hepatitis B must be present for Hepatitis D to infect
  • Hepatitis D can make Hepatitis B worse
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62
Q

Hepatitis D - vaccination?

A

no vaccine is availiable for D but hep B vaccine will prevent it

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63
Q

What is diarrhea

A
  • passage of more than 300 grams of stool per day
  • due to excretion of excess fecal water (60-90%)
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64
Q

What is acute diarrhea

A
  • diarrhea lasting 2 weeks or less
  • often associated with infectious causes
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65
Q

What is acute gastroenteritis

A
  • less than 2 weeks of vomitting and diarrhea
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66
Q

Infectious entercolittis - pathogenic mechanisms (3)

A
  • ingestion of preformed toxins in contaminated foods
  • infection by toxigenic organism proliferating in the gut lumen producing an enterotoxin
  • infection by enteroinvasive organisms that proliferate in the lumen and invade/destroy mucosal epithelial cells
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67
Q

Rotavirus - type of genetic material

A

RNA viruses

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68
Q

Rotavirus - belongs to which family

A

Reoviridae

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69
Q

Rotavirus - serogroups

A
  • A, B, C
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70
Q

Rotavirus - group A serotypes

A

1, 2, 3, 4

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71
Q

Rotavirus - common age group

A
  • children under 5
  • most severe in ages 3-24 months (hospital)
  • under 3 months protected by transplancental antibodies
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72
Q

Rotavirus - transmission

A
  • fecal oral route
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73
Q

Rotavirus - impact on intestine

A
  • localizes in duodenum and proximal jujenum
    -destruction of villous epithelium
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74
Q

Rotavirus - portal of exit

A
  • virus shed before and for days after clinical illness (very few infectious ririons are needed to cause disease in susceptible host)
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75
Q

Rotavirus - common complication

A
  • malabsorption complication is common, takes 3-8 weeks to resolve
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76
Q

Rotavirus - diagnosis (3)``

A
  • electron microscopy of stool
  • detection of antigen via latex agglutination
  • enzyme immunoassay
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77
Q

Rotavirus - therapy

A

supportive, primarily oral rehydration

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78
Q

Rotavirus - prevention

A

oral vaccine is avaliable and may be given in infancy

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79
Q

Norovirus - family

A

caliciviridae

80
Q

Norovirus - serotypes

A

at least 4

81
Q

Norovirus - age group

A
  • common in older children and adults
82
Q

Norovirus - outbreaks

A

can cause large outbreaks
- 50% of adults are seropositive by 5th decadef

83
Q

Norovirus - incubation period

A

10-51 hours

84
Q

Norovirus - illness duration

A

1-2 days

85
Q

Norovirus - symptoms

A

abrupt onset of vomiting and diarrhea

86
Q

Norovirus - diagnosis

A

electron microscopy of stool

87
Q

Norovirus - treatment

A

supportive treatment

88
Q

Norovirus - portal of exit

A

viral shedding continues for 3-4 days after onset of illness

89
Q

Norovirus - breaking chain of transmission

A

good hygeine (transmission is fecal-oral)

90
Q

Listeria Monocytogenes - causes what disease

A

Listeriosis

91
Q

Listeria Monocytogenes - gram status

A

gram positive

92
Q

Listeria Monocytogenes - shape

A

rod shapped

93
Q

Listeria Monocytogenes - oxygen?

A

anaerobic

94
Q

Listeria Monocytogenes - mobility

A

flagella

95
Q

Listeria Monocytogenes - resevoir location (6)

A
  • soil –> vegetable contamination
  • animal carriers
  • stream water
  • sewage
  • plants
  • food
96
Q

Listeria Monocytogenes - how can it be given to humans (6)

A
  • uncooked meats, uncooked veggies, fruits (cantalope/apples), milk, foods made from milk, processed foods
  • NOTE: pasturization and cooking kill Listeria, but contamination can occur after
97
Q

Listeria prevention

A
  • effective sanitation of food contact surfaces
  • keeping foods in home refrigerated below 4 degrees Celcius
  • pasturizing dairy products
  • cooking all meets to safe internal temp
98
Q

Listeria - susceptible hosts (4)

A
  • pregnant women
  • newborns
  • adults with weakened immune systems
  • elderly
99
Q

Listeria - pregnant woman complications (4)

A
  • fetal death
  • premature delivery
  • birth of a fetus that dies shortly after birth
  • spontaneous abortion
100
Q

Listeria - pregnant woman - preventing complications (2)

A
  • avoid unpasteurized dairy and cheeses as well as deli means
101
Q

Clostridium Botulism - gram status

A

gram positive

102
Q

Clostridium Botulism - oxygen

A

anaerobic

103
Q

Clostridium Botulism - causes the following diseases (4)

A
  • botulism
  • tetanus
  • gas gangrene
  • pseudomembranous colitis
104
Q

Adult botulism - route of transmission

A

1) spores float in air and land on food
2) f food is cooked thoroughly, spores will dies
3) if food is not cooked then placed in anaerobic environment (glass jar, freezer bag), bacteria grows and synthesizes neurotoxin

105
Q

Adult botulism - at risk foods

A
  • smoked fish or home-canned vegetables
106
Q

Infant botulism - route of transmission/ pathogenesis (3)

A
  • infants ingest food contaminated with spores
  • spores germinate and bacteria colonizes infants intestinal tract
  • from this location botulism toxin is released
107
Q

Infant botulism - at risk food

A
  • honey (don’t give to children under 1 years of age)
108
Q

Campylobacter - shape

A

slender spiral

109
Q

Campylobacter - gram status

A

gram negative

110
Q

Campylobacter - movement (3)

A
  • single polar flagellum
  • corkscrew motion
    -moves through fluids faster than other bacteria
111
Q

Campylobacter - oxygen

A
  • microareophillic and capnophillic (will not grow in air)
112
Q

Campylobacter - common disease cause

A
  • most common cause of acute enteritis in developed countries
113
Q

Campylobacter - complications (3)

A
  • bacteremia
  • pseudoappendicitis
  • rarely peripheral poloneuropathy (Guillain-Barré)
114
Q

Campylobacter - at risk foods (5)

A
  • raw or undercooked poultry, meat, fish, shellfish
  • raw milk (fecal contaminating)
115
Q

Campylobacter - transmission

A
  • consumption of undercooked foods
  • handling raw meat
  • cross contamination of foods
116
Q

Campylobacter - disease progression

A
  • most strains produce a cholera-like enterotoxin and one or more cytotoxins –> explosive diarrhea
117
Q

Campylobacter - incubation period

A

1-7 days

118
Q

Gastrointestinal

A
  • explosive diarrhea
  • febrile prodrome (fever over 38 degrees)
119
Q

Campylobacter - antibiotic treatment? (2)

A
  • rarely required
  • severely effected = fluroquinolones or erythromycin used
120
Q

E. coli - location in the body

A

endemic to intestines of healthy people and animals

121
Q

E. coli - gram status

A

gram negative

122
Q

E. coli - oxygen

A

faculative anaerobic

123
Q

E. coli - shape

A

rod shapped

124
Q

E. coli - role in the body?

A
  • normal
  • helps digest food
125
Q

E. coli - pathonogenic symptoms

A
  • diarrhea
  • stomach pain
  • cramps
  • low-grade fever
126
Q

difference between normal E. coli and pathogenic E. coli

A
  • different strains of E. coli can cause diseases
127
Q

E. coli - number of diarrhea causeing strains

A
  • 6 known strains
128
Q

How does E. coli strain cause diarrhea - pathogenesis

A
  • produce a toxin called Shiga
  • this toxin damages lining of small intestine and causes diarrhea
  • aka Shiga toxin-producing E. coli (STEC)
129
Q

E. coli - at risk food (4)

A
  • meats (contaminated during slaughterin process when E. coli in animal intestines get onto cuts of meat, meat from more than one animal is ground together), then eating this undercooked meat
  • drinking raw milk
  • unpasteurized apple cider or juices
  • soft cheese made from raw milk
  • fruit and veggies (growing near animal farms)
130
Q

E. coli - people at greatest risk

A
  • very young newborns/children
  • elderly
  • people with weakened immune systems
  • people who travel to certain countries
131
Q

E. coli (STEC strain) infection symptoms (6)

A
  • stomach pain/cramps
  • diarrhea (watery to bloody)
  • fatigue
  • loss of appetite/nausea
  • vomiting
  • low fever
132
Q

Shigella - infects where

A
  • intestinal infection
133
Q

Shigella - main symptom

A
  • diarrhea, which is often bloody
134
Q

Shigella - gram status

A
  • gram negative
135
Q

Shigella - oxygen?

A

faculative anaerobic

136
Q

Shigella - movement:

A

non motile

137
Q

Shigella - shape

A

rod shapped

138
Q

Shigella - how it survives in the body (2)

A
  • genetically close to E. coli
  • able to survive the proteases and acids of intestinal tract (easy to cause infection)
139
Q

Shigella - why is it so contagious

A
  • survives intestinal tract
  • only 10 cells needed to cause infection
140
Q

Shigella - pathogenesis (4)

A
  • penetration of colonic mucosa
  • degredation of epithelium
  • acute inflammatory colitis
  • leakage of blood, inflammation int the colon, mucus into intestinal lumen
141
Q

Shigella - routes of transmission

A
  • touching your mouth (washing hands)
  • eating contaminated food (sewage)
  • swallowing contaminated water
142
Q

Shigella - risk factors (4)

A
  • being a child (under 5)
  • living in group housing/participating in group activities
  • living or traveling in areas that lack sanitation
  • men who have sex with men
143
Q

Yernisa Enterocolitca - gram status

A
  • gram negative
144
Q

Yernisa Enterocolitca - shape

A

spherical (Coccus)

145
Q

Yernisa Enterocolitca - oxygen

A

faculative anaerobes

146
Q

Yersiniosis - at risk foods

A
  • raw or undercooked pork
  • contaminated milk-
  • untreated water
  • contact with infected animals or their feces
  • (rarely) person to person
147
Q

Yersiniosis - symptoms (4)

A
  • depend on age
  • CHILDREN = fever, abdominal pain, diarrhea (bloody)
  • ADULT = right-side abd pain
148
Q

Yersiniosis - onset of symptoms

A

4-7 days after exposure

149
Q

Yersiniosis - duration of symptoms

A

1-3 weeks or longer

150
Q

Yersiniosis - complications

A
  • rash
  • join pain
  • sepsis
151
Q

Salmonella Typhi - location of infection

A

intestinal tract and blood

152
Q

Salmonella Typhi - causes which infection

A

typhoid fever

153
Q

Salmonella Typhi - prevelent where

A
  • developing countries
  • areas where sewage and water treatment systems are poor
154
Q

Salmonella Typhi - route of transmission

A

fecal-oral

155
Q

Salmonella Typhi - shape

A

rod shapped

156
Q

Salmonella Typhi - movement

A

flagellated

157
Q

Salmonella Typhi - gram status

A

gram negative

158
Q

Salmonella Typhi - pathogenic mechanism

A
  • endotoxins cause damage
  • inactivated by gastric acids (large inoculum required)
159
Q

Salmonella Typhi - at risk foods

A
  • consuming contaminated food or drink
  • consuming food prepared by someone who is infected or a carrier of an illness
160
Q

Helminths

A
  • intestinal worms
161
Q

Helminths - catagories (3)

A
  • Nematodes (roundworms)
  • Cestodes (tapeworms)
  • Trematodes (flukes)
162
Q

How are Helminths transmitted (2)

A
  • soil transmitted (hookworms, whipworms, roundworms, tapeworms)
  • oral ingestion of larval-infected tissue (undercooked meats)
163
Q

Enterobius vermicularis - what

A

a roundworm (helminth)

164
Q

Enterobius vermicularis - mode of transmission

A
  • nocturnal pruitus ani when females migrate to perianal skin to lay eggs
    (when infected person sleeps, female pinworms leave intestine through anus and deposit eggs on surrounding skin, causing itching around anus leading to difficulty sleeping and restlessness)
165
Q

Enterobius vermicularis - common symptoms

A
  • itching around anus
  • difficulty sleeping and restlessness
  • symtoms usually mild
166
Q

Enterobius vermicularis - population

A
  • school aged and pre-school aged children
  • institutionalized persons
  • household members/caretakers of persons with pinworm infection
167
Q

Enterobius vermicularis - transmission

A

fecal-oral route (eggs from anus to someones mouth either directly or indirectly

168
Q

Enterobius vermicularis - diagnosis

A

identifying the worm or its eggs (seen on skin near anus or on underclothing 2-3 hours after falling asleep)

169
Q

Enterobius vermicularis - common name

A

pinworm

170
Q

Roundworm example - ascaris lumbricoides - number

A

one billion infected worldwide

171
Q

ascaris lumbricoide 0 mode of transmission

A
  • females produce enourmous numbers of eggs that become inefective until 2-3 weeks in soil
172
Q

ascaris lumbricoide - complication

A
  • migration of adult worms
  • hypersensitivity to larvae in lungs
173
Q

Roundworm example: hookworms (2)

A
  • ancylostoma duodenale
  • necator americanus
174
Q

Hookworms - mode of transmission

A
  • soil transmission
  • often in areas where human feces are used as fertilizer/defacation onto soil happens
  • infected person defecates eggs onto soil, grows into larvae that can penetrate skin of human
  • human barefoot walks on soil = transmission
  • also ingestion of worm too
175
Q

Hookworms - s/s of infection (8)

A
  • itching and localized rash
  • mild infection = no symptoms
  • diarrhea
  • loss of appetite
  • weight loss
  • fatigue
  • anemia
  • physical/cognitive decline in children
176
Q

Hookworms - severe infection symptoms

A
  • pulmonary symptoms (wheezing, blood tinged sputum, sputum with eosinophilla) occur when larvae migrate to lungs
177
Q

Hookworms - diagnosis

A
  • stool sample (microscope to look for presence of eggs)
178
Q

Cestodes example

A

tapeworm

179
Q

Tapeworm - what

A

flat segmented worms

180
Q

Tapeworm - resevoir

A

live in intestines of some animals (infection due to grazing in pastures or drinking contaminated water)

181
Q

Tapeworm - transmission to humans

A
  • eating raw or undercooked meat
  • 6 types of tapeworms that infect people: identified by animal they come from (pork, beef, etc)
182
Q

Tapeworm - life cycle

A

1) egg
2) imature larva
3) adult that can make more eggs

183
Q

parts of Tapeworm (3)

A

-head, neck, chain of segments called proglottids

184
Q

Tapeworm - intestinal infection - pathogenesis

A
  • tapeworm head adheres to intestinal wall
  • proglottids grow and produce eggs
  • adult tapeworms can live up to 30 years in a host
  • usually only one or two adult tapeworms
  • invasive larval infections are mroe severe
185
Q

Tapeworm - s/s of infection (9)

A
  • nausea
  • weakness
  • loss of appetite
  • abdominal pain
  • diarrhea
  • dizziness
  • salt craving
  • weight loss
  • inadequate absorption of nutrients from food
186
Q

Trematodes example

A

flukes

187
Q

Flukes - what

A

parasites that can infect humans

188
Q

Flukes - at risk foods

A
  • raw/undercooked fish, crabs, crayfish
189
Q

Flukes infection - symptoms (4)

A
  • indegestion
  • abd pain
  • diarrhea
  • constipation
190
Q

Flukes - where do they infect in the body (4)

A
  • blood vessels
  • gastroointestinal tract
  • lungs
  • liver
191
Q

Giardia - causes what illness

A
  • giardiasis
192
Q

Giardia - parasite found where (4)

A
  • surfaces
  • soil
  • food
  • water
193
Q

Giardia - protection

A
  • outer shell that allows it to survive outside the body for a long time and makes it tolerant to chlorine disenfection
194
Q

Giardia - transmission (6)

A
  • swallowing Giardia picked up from surfaces that contain feces from infected person/animal
  • drinking water/ice where Giardia lives
  • swallowing water while swimming where Giardia lives (lakes, rivers)
  • uncooked food containing Giardia
  • contact with someone ill with Giardia
  • travelling to countries where Giardia lives
195
Q

Giardia - symptoms (7)

A
  • diarrhea
  • gas
  • greasy stool that can float
  • stomach or abdominal cramps
  • upset stomach/nausea
  • dehydration
  • weight loss