Enterics 1

Front 1

Gram negative causing GI infections. They are straight rods, ferment glucose, and oxidase negative?

Back 1

shigella sp.; salmonella sp.; Yersinia sp.; Escherichia coli; ETEC; EIECl EPEC; EHEC/STEC; EAEC

Front 2

Gram negative bacteria causing GI infections. These are tiny gull-shaped rods, microaerophilic and oxidase +?

Back 2

Campylobacter jejuni

Front 3

Gram negatives causing GI infections. tiny, curved rods, microaerophilic urease +?

Back 3

Helicobacter pylori

Front 4

These gram negatives cause gastrointestinal infections and are comma shaped rods, ferment glucose, and are oxidase +?

Back 4

V. cholera; V. vulnificus; V parahaemolyticus

Front 5

What distinguishes inflammatory diarrhea from secretory diarrhea?

Back 5

PMNs in the stool

Front 6

What is hemorrhagic colitis?

Back 6

bloody diarrhea with or without inflammation

Front 7

Shigella and salmonella (DO or DON’T) ferment lactose?

Back 7

DON’T

Front 8

Enterobacteriaceae (DO or DON’T) test positive for oxidase?

Back 8

DON’T

Front 9

What are the four groups of shigella (different serotypes of same species)?

Back 9

S. dysenteriae; S. flexnerii; S. boydii, S. Sonnie

Front 10

Which class of Shigella is most common in developing countries?

Back 10

Shigella Flexnerii

Front 11

Which shigella is most common in the US?

Back 11

Shigella sonnei

Front 12

What are the two complications of shigella disease?

Back 12

hemolytic uremic syndrome (for shiga producing strain); Reiters syndrome

Front 13

A patient comes in with fever, tenesmus, abdominal pain, and bloody stools. Exam revelas fecal leukocytes in the stool, low volume. Cultures reveal growht on McConkey agar, with no lactose fermenting, and negative oxidase?

Back 13

Shigella disease

Front 14

What cells in the gut does shigella destroy (cause apoptosis)?

Back 14

Shigella

Front 15

What are the two types of diarrhea?

Back 15

Secretory (profuse, watery, no WBC, no blood, no fever) and Inflammatory (neutrophils, sometimes blood, fever)

Front 16

This bacteria invades through the M cells and uses host cytoskeletan to move from cell to cell (intracellular) and between cells (paracellular)?

Back 16

Shigella

Front 17

What are the two classic causes of secretory diarrhea?

Back 17

ETEC and Cholera

Front 18

T/F shigella can cause ulcer formation?

Back 18

TRUE;

Front 19

What is the hallmark finding of hemorrhagic colitis?

Back 19

blood in stool; PMN variable

Front 20

Which bacteria produce hemmorrhagic colitis?

Back 20

EHEC;E coli 0157; STEC

Front 21

Shigella spreads intracellularly or extracellularly?

Back 21

Intracellular (humoral immunity NOT effective)

Front 22

Do all shigella produce shiga toxin?

Back 22

No; only shiga dysenteriae type 1

Front 23

Why do shiga toxin only express virulence factors @ 37 degrees?

Back 23

Because that is the temperature of the gut and it conserves energy outside

Front 24

What does shiga toxin inhibit and how?

Back 24

Protein synthesis; N-glycosidase removes a residue on the 60s ribosome

Front 25

What does the B subunit of shiga toxin bind to ?

Back 25

glycolipid Gb3 on glomeruli (hemolytic uremic syndrome)

Front 26

Shigella (human specific or zoonotic)?

Back 26

Human specific

Front 27

Shigella (low infectious dose or high infectious dose)?

Back 27

Low (highly infectious and passes easy)

Front 28

How can shigella be easily transmitted (four F)?

Back 28

feces; fingers; fomites; flies

Front 29

Airplanes, cruiships, and engineering mistakes causing pipeline confusion in hotel resorts?

Back 29

Shigella

Front 30

What is PFGE?

Back 30

pulse field gel electrophoresis (used for outbreaks; restriction enzymes cut and compare strains between cases)

Front 31

Shigella (motile or nonmotile)?

Back 31

Non motile (although uses actin to propel between cells)

Front 32

What two tests on stool could you perform to diagnose inflammatory diarrhea?

Back 32

Methylene Blue stain; Lactoferrin

Front 33

What are the two main types of salmonella?

Back 33

Typhoidal and non-typhoidal

Front 34

S typhi and S. paratyphi (human specific or zoonosis)?

Back 34

human specific

Front 35

S. enteriditis, S. typhymurium, S. heidelberg (human-specific or zoonosis)?

Back 35

Zoonoses

Front 36

What are the two typhoidal salmonella?

Back 36

S. typhi; S. paratyphi A B C

Front 37

Whata re the three major non-typhoidal salmonella?

Back 37

S. enteridits; S. typhirium; S. heidelburg

Front 38

Is diarrhea common in enteric fever?

Back 38

Typically it is constipation early then later it can be bloody diarrhea

Front 39

A patient comes in with naseua, vomiting, and diarrhea with low fever. He just came from a petting zoo where they had baby ducks and chickens about a day ago. Blood cultures are negative, and stool culture reveals gram negative straight rods, lac(-), oxidase (-) and H2S +. What bacteria is the culprit?

Back 39

Salmonella (non-typhoidal)

Front 40

Which salmonella type can cause sustained bacteremia and sometimes septicemia in the old and immunocompromised (typhoidal or non-typhoidal)?

Back 40

Non-typhoidal

Front 41

Non-typhoidal salmonella (invades epithelial cells or doesn't)?

Back 41

Invades

Front 42

Non-typhoidal salmonella colonizes what part of the gut?

Back 42

SI

Front 43

A patient with fever and endocarditis, played with turtle?

Back 43

Non-typhoidal salmonella (sustained bacteremia/septicemia)

Front 44

What aspect of developed nations has led to multiple salmonella outbreaks?

Back 44

centralized food processing

Front 45

Salmonela can be found on produce T/F?

Back 45

TRUE; (jalapeno)

Front 46

What is the most common source of non-typhoidal salmonella?

Back 46

Eggs

Front 47

What animals carry non-typhoidal salmonella?

Back 47

turtles, reptiles, baby ducks, and chickens

Front 48

Salmonella (motile or nonmotile)?

Back 48

Motile (also NLF, and H2S +)

Front 49

Describe the pathogenesis of Typhoid fever?

Back 49

ingestion of food/water > Small intestine colonized > Peyers patches via M cells (no apoptosis) > use macros to travel bloodstream

Front 50

A patient comes in with fever and several weeks of pain in flank, RUQ, early constipation followed by bloody diarrhea. She is confused, has bone pain, and inflamed parotid. What gram negative bacteria could she have gotten. Is this contamination from animals or from humans?

Back 50

typhoid fever (salmonella); Human specific

Front 51

Is there a virulence plasmid in S. typhi?

Back 51

NO (there is in shigella)

Front 52

What is the most important virulence factor of S.. Typhi and S. Paratyphi?

Back 52

Capsule (Vi antigen); inhibits C3B deposition

Front 53

What does the capsule (vi entigen) do for the bacteria?

Back 53

protects from complement mediated killing (also a component of 3 vaccines)

Front 54

Enterocolitis, Enterocolitis w/ immunocomprimised, sustanied bacteremia, Extra-intestinal infection, Enteric fever (which one do you NOT treat)?

Back 54

Enterocolitis

Front 55

T/F Both typhoidal and non-typhoidal salmonella can produce extra-intestinal infections?

Back 55

TRUE; (non-typhoidal in immunocomprimised can lead to bacteremia and extraintestinal infections)

Front 56

NLF, grows well in 4 degrees, contaminated produce and undercooked chitterlings; Highest incidence in Europe and Scandinavia, zoonoses?

Back 56

Yersinia pseudotuberculosis, Yersinia enterocoltica

Front 57

Screening blood supplies is important for this bacteria?

Back 57

Yersinia (grows at 4c)

Front 58

These are the major complications of Yersinia infections?

Back 58

Enterocolitis (inflammatory diarrhea); Reiters syndrome; Mesenteric lymphadenitis; Extraintestinal infections (septicemia, endocarditis)

Front 59

Infection with this bacteria frequently mimics appendicitis?

Back 59

Yersinia