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27 Cards in this Set

  • Front
  • Back
which type of toxins are normally preformed?
neurotoxins (--> immediate infection) N/V/D
features of neurotoxins in GI
stimulate receptors --> secretory diarrhea
which common bacteria produce neurotoxins
Staph aureus
C. botulinum
which bacteria produce enterotxins
cholera
some strands of E. coli
how does cholera toxin --> dz
subunit B binds gangliosides on epi cell membrane, releases toxic A2 substance
stim cAMP and fluid secretion
which E. coli toxin is similar to cholera toxin
heat labile (LT) toxin
how does heat stable toxin work in E. coli
activates cGMP and stimulates NaCl absorption and Cl secretion
what are the 3 main types of enteric infx?
non-inflammatory
inflammatory
invasive
how is infx caused in noninflammatory GI dz?

clinical features of dz

location

stool exam
superficial invasion or attachment

watery diarrhea, might have n/v, pain fever

small bowel

no PMNL
inflammatory GI dz- clinical features

location

stool exam
dysentery w blood, mucous, small volume diarrhea, fever, can have systemic toxicity

colon

moderate # of polys
how is infx caused in systemic GI dz?

clinical features of dz

location

stool exam
penetration through mucosa to regional nodes and beyond

enteric fever, mild diarrhea, or no sx

distal small bowel

non-specific
examples of noninflammatory orgs
cholera
c. perfringens
ETEC
norovirus
ex of inflammatory orgs
Shigella
salmonella enteritidis
c. diff
e. histolytica
ex of systemic org
salmonella typhii
y. enterocolitica
when should a stool exam be done
only if + for WBC
immunocompromised, elderly, prolonged diarrhea
what in stool sample indicates inflammatory diarrhea
polys in stool
when is endoscopy done to evaluate GI infx
in immunocompromised pts
dx c. diffpseudomembranous colitis
sx of GI staph aureus
toxin (preformed?)
time to onset
duration of sx
vomiting, diarrhea, abdominal cramps
preformed
1-6 hrs
24-48 hrs
sx of norovirus
time to onset
duration of sx
inflammatory?
abrupt onset of N/V, watery diarrea, cramps, sometmes fever
24-48 hrs (takes time to get to high levels)
48-72 hrs
noninflammatory
sx of ETEC
time to onset
duration of sx
anorexia, cramps, explosive diarrhea, no blood or mucous in stool
4-14 days of arrival
1-5 days
when should stool culture be done in ETEC
if no response to ABx
evidence of colitis
look for parasites
sx of C. enteritis
toxin (preformed?)
time to onset
watery, bloody or minimal dairrhea, cramps
1-6 wks of ABx use
toxins in C diff
toxin A and B --> mucosal injury
clinical course of typhoid fever
feer develops in 1-3 weeks following ingestion
occurs when org has spread beyond regional LN in Peyer's patches
fever, abdominal pain, hepatosplenomegaly
altered MS
rash and pneumonia
dx of typhoid fever?
stool cultures can be -, but blood and bone cultures usually +
complications of typhoid fever
intestinal perforation
bleeding
hepatitis
in small bowel diarrhea, is glucose transport intact?
yes, so if glucose and salt solution are made, water can be absorbed