Week 3: The Small and Large Intestine

Question 1

What kind of diarrhea does ETEC cause?

Answer 1

watery

Question 2

What is the shiga-toxin producing strain of E. coli?

Answer 2

EHEC
Bloody diarrhea
hemolytic uremic syndrome (6-9% of cases)

Question 3

What are 3 possible outcomes of a salmonella typhi infection?

Answer 3

• gastroenteritis (diarrhea OR constipation)
• typhoid fever (bacteria invade mucosa, can lead to perforation)
• asymptomatic carriage, esp. in gall bladder

Question 4

Salmonella, campylobacter and E. coli reservoirs

Answer 4

Humans and poultry and cows

Question 5

Of salmonella, campylobacter and E.coli infection, which ones do you treat with antibiotics?

Answer 5

Treat Salmonella, leave the other two alone in otherwise healthy patients.

Question 6

What are the symptoms of giardia? How is it diagnosed

Answer 6

diarrhea, sometimes steatorhea, gas
No fever or leukocytes in stool because no invasion.
Diagnosed on stool O&P

Question 7

What causes amebic dysentry? What are the symptoms?

Answer 7

Enamoeba histolytica
Causes bloody diarrhea, liver abscess (1% of infections) and chronic disease mimicking IBD.
If amoeba is seen on stool O&P, need to do another test (serology, EIA or PCR) to differentiate E. histolytica and E. dispar

Question 8

Treatment for E. histolytica

Answer 8

Metronidazole (kills trophozoites) followed by ioqoquinol/paromomycin (kills cysts)

Question 9

Symptoms of cryptosporidium infection

Answer 9

Diarrhea (NVD), stomach cramps, fever, 2-10 days long

Question 10

Symptoms and complications of C. diff

Answer 10

Foul smelling diarrhea and mild abdominal pain
Pseudomembranous colitis
Toxic megacolon

Question 11

How do you test for C. diff?

Answer 11

A stool antigen test

Question 12

What are the causes of lactic acidosis?

Answer 12

• lack of O2 in muscle (hypoxia, ischemia)
• excessive glycolysis (e.g. seizure, malignant hyperthermia)
• impaired gluconeogenesis (liver failure, genetic)
• ETC disorder