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AAW - GI > Week 4 - Wed - Fri > Flashcards

Week 4 - Wed - Fri Flashcards

1
Q

In which - UC or CD - do you get pseudopolyps

what are they

A

in UC

they are actually just left over segments of gut epithelial cells that are not ulcerated

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2
Q

crypt architectural distortion means what - acute or chronic IBD

A

chronic

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3
Q

antibody tests that can differentiate UC from CD

A

CD: ASCA positive

UC: pANCA positive

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4
Q

quiescent colitis

A

damaged crypt architecture without inflammation

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5
Q

patients with chronic watery diarrhea and a normal colonoscopic exam

A

microscopic colitits

if nothing on biopsy then irritable bowel syndrome

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6
Q

what are you thinking if you see intraepithelial lymphocytes

what other cells are you looking for

A

microscopic colitis - lymphocytic colitis type

also see increased plasma cells

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7
Q

what are you thinking if you see eosinophilic tissue right under the epithelium on colon biopsy

A

microscopic colitis - collagenous colitis type

it’s a collagen band

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8
Q

colonic cells with enlarged nuclei and with normal cytoplasm

A

radiation colitis

if there was less cytoplasm, higher chance of it being cancer

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9
Q

intestinal segments that are particularly susceptible to ischemic damage

A

splenic flexure (SMA and IMA watershed zone)

sigmoid colon and rectum (IMA, pudendal artery, and iliac arter watershed zone)

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10
Q

smudgy hyalinized appearance to LP and atrophic crypts

A

ischemic colitis

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11
Q

hematochezia in an older patient with tortuous dilation of vessels

what is it
where in the GI system

A

angiodysplasia

most often found in cecum, terminal ileum, and ascending colon

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12
Q

smooth muscle proliferation between the crypts

A

characteristic of a “solitary rectal ulcer”

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13
Q

the majority of foodborne illness outbreaks are caused by what

A

norovirus

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14
Q

gram positive rod that can produce biofilms and spores, and adheres to invasive medical devices

found in rice and can survive cooking

A

bacillus cereus

B. Cereus = Box Car appearance

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15
Q 
gram pos
bacilus
non-fastiduous
flagellated, motile
non spore forming
oxidase -
A

Listeria Monocytogenes

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16
Q 
gram neg
curved rod
faculative anaerobe
flagellated, motile
oxidase pos
A

Vibrio spp

inc vibrio cholera

also grows in alkaline media (she didn’t mention it, but its in FA)

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17
Q 
gram pos
bacili
spore-forming
obligate anaerobe
non-motile
A

clostridium perfringens

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18
Q

which bacteria produces an enterotoxin that binds to receptors in endothelial cell junctions and generates pores in the host mucosa cells

A

clostridium (perfringens, botulinum, difficile)

it’s called alpha toxin (lecithinase)

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19
Q

bacteria she wanted us to remember assc with cafeterias and will not normally cause fever or vom

A

c. perfringens

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20
Q 
gram -
bacili (spiral)
microaerophilic
motile
cold sensitive

in what aninals?

what agar?

what possible complication

A

campylobacter jejuni

poultry

karmali agar - charcoal based

guillain-barre

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21
Q

karmali agar

A

used to culture campylobacter jejuni

has vanco for the gram positives, cefoperazone, and cyclohexamide

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22
Q

guillan-barre linked to what bacteria

A

campylobacter jejuni

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23
Q

what bacteria can generate H2S and cause an iron sulfide precipitate

A

salmonella enterica

24
Q

salmonella found it what pets

A

turtles

i like turtles

25
Q

what is more likely to cause bloody diarrhea - campylobacter, Staph a.

A

campyobacter

26
Q

common food poisoning thing that causes projectile vom, low grade fever, diarrhea

A

noravirus

27
Q

tests you can do to definitively diagnose noravirus

A

PCR assay on stool or vom samples

28
Q

vibrio parahaemolyticus enterotoxin

A

TDH (thermostable direct hemolysin) and/or TRH

forms pores in RBCs, gut epithelial cells

foodborne

29
Q

is cholera food borne?

A

no

30
Q

leading cause of death with food borne illness

A

listeria

31
Q

how to test for listeria

A

look for the bacteria in a normally sterile site like blood or CSF

don’t look in the stool because it can be there and not cause Sx

32
Q

which bug can cause infection initiating in the GI tract but resulting in neurological symptoms including slurred speech and muscle weakness?

A

clostridium perfringens, gram pos, spore forming

this was one of her example questions

33
Q

diarrhea (often bloody)
fever
stomach cramps

was passed through feces and not food

A

shigella spp.

34
Q

most mild shigella spp

A

shegella sonnei

35
Q 
gram -
bacillus
faculative anaerobe
nonmotile
non sporeforming
mainly lactose negative
oxidase negative
A

shigella spp

36
Q

what bacteria use actin in the cells to move around because they don’t have flagella

A

shigella spp

37
Q

shigella toxin

A

shiga toxin

aka AB5 toxin

binds to Gb3 receptors on the colonic epithelial cells.

the A subunit is what enters the cell, inactivates the ribosome 60s by removing adenosine from rRNA

get dysentery, enhanced cytokine release, hemolytic uremic syndrome

38
Q

STEC
VTEC
EHEC

what kind of toxin

A

shigalike

39
Q

ETEC vs EHEC (STEC)

which has bacterial penetration

A

EHEC has penetration

40
Q

EHEC (STEC) genes with toxins

A

stxA, stxB

they are italicized when genes

stx1 and stx2 are the toxins themselves

41
Q

what bacterial infections of the gut do you not generally treat with antibiotics

A

EHEC (STEC)

because of bacterial lysis/aggravation leading to HUS`

42
Q

examples of high inoculum organisms

A

v. cholerae, c. perfringens

as opposed to STEC which can be only 100 organisms

43
Q

GI bacterial infecition that is gram variable

A

C. diff

44
Q

pseudomembranous colitis

A

C. diff

45
Q

Mech of nitazoxanide

used for what

A

interferes with pyruvate::ferredoxin oxidoreductase enzyme dependent electron transfer (not in mammals - we have NADH-producing pyruvate dehydrogenase), essential to anaerobic energy metabolism protein

primarly luminal

used for cryptosporidium

46
Q

what antiparasite interferes with thyroid tests and causes loss of visual acuity

A

iodoquinol - a luminal amebicide

47
Q

paromomycin

class?
tox?

A

aminoglycoside

tox - ototox, nephrotox

(it is a luminal antiparasitic and doesn’t have an many SE as other animoglycosides)

48
Q

Tx for cyclospora (food borne outbreak)

A

bactrim

49
Q

anal pruritis and intestinal infection symptoms.

a worm - name?
Dx?
Tx?

A

enterobius vermicularis (pinworm)

Dx - scotch tape test

Tx - bendazoles

50
Q

barrel shaped appearance of eggs

Sx

A

trichuris trichiura

Sx - bloody diarrhea, anemia, finger clubbing the best indicator of severity

51
Q

mech of pyrantel pamoate and levamisole

A

selectively opens a restricted subgroup of nematode acetylcholine receptor ion channels in nematode nerve and muscle. depolarization, entry of Ca, spastic contraction, worm can’t move and is swept away.

52
Q

tape worm in:

pork
fish
dogs

A

pork - taenia solium - cysticercosis, neurocysticercosis - Tx is praziquantel, albendazole for neurocysticercosis

fish - diphyllobothrium latum - vit b12 deficiency - macrocytic anemia - Tx is praziquantel

dogs - echinococcus granulosus - hydatid cysts in liver, causing anaphylaxis if antigens released (surgeons preinject with ETOH to kill cysts before removal - Tx is albendazole

53
Q

proglottids in stool

A

its a tape worm (not specific to which)

54
Q

common treatment for flukes (and also tapeworms)

A

praziquantel

flukes are Schistosoma (in snails, cause liver and spleen granulomas, can lead to squamous cell of the bladder) and clonorchis sinensis (biliary tract inflammation –> pigmented gall stones, assc with cholangiocarcinoma)

55
Q

we put up an immune response to what life cycle stage of schistosoma

A

egg

56
Q

swimmers itch is causes by what type of organisms

A

flukes

57
Q

3 parasites you are most likely to find in the us

A

giardia
crypto
pinworm (enterobius vermicularis)

AAW - GI (7 decks)

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