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29 Cards in this Set

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Gastroenteritis
Inflammation of the stomach and intestine
Diarrhea
Increase in number of stools w/decreased form
Diarrhea
(pathology)
(1) Electrolyte imbalance
(2) Osmotic factors (i.e. abnormal digestion, lactase insufficiency)
(3) Disorders of gut motility
Viral Infections of the GI tract
(2 patterns of infection)
Replication/disease in GI tract
Replication at GI but disease elsewhere
What GI viral infections result in disseminated disease?
Enteroviruses and adenoviruses
What is the most common cause of severe diarrhea worldwide?
Rotavirus
Bacterial infections become more important in developing countries
Important GI-tract Viral Families
"Cause poop to RACE through you"
Reoviridae
Caliciviridae
Astroviruses
Enteric Adenoviruses
Reoviridae
CROO
(coltivirus, orthoreovirus, orbivirus, rotavirus)
Non-enveloped
Double layer capsid
Segmented dsRNA (enables reassortment)
Name origin: Respiratory/Enteric Portals with no-associative symptoms ("Orphan")
Rotaviruses
Genera of Reoviridae (non-enveloped, dsRNA, double-layer capsid)
Most common origin of viral gastroenteritis
Rotavirus
(classification)
7 types based on VP6 (core) variation
A/B/C infect humans
Serotypes determined by outer capsid proteins (VP4/7)
What antigen determines Rotavirus groups?
VP6 (core) antigen
7 groups, A- G (but only A/B/C infect humans)
What antigen(s) determines Rotavirus serotype?
VP4/7
Group A Rotavirus
Single most important agent of diarrhea in very young (>90% serotype (+) by 3!)
Rotavirus
(pathogenesis)
Fecal-oral route (via fomites)
Short incubation period (2 days)
Virus shed in stool > week
Rotavirus
(clinical manifestation)
Infants/children
Vomiting, diarrhea, abdominal cramping, fever, dehydration (may need to be rehospitalized for rehydration therapy)
Rotavirus
(diagnosis)
Rapid Antigen Test
ELISA stool/rectal swap
Detects VP6, group A variant
Rotavirus
(Management/Prevention)
Rehydration
Vaccine? Earlier form pulled from market, new vaccine available for 6 - 32 week/old infants
Caliciviridae
Of "RACE"
Causes gastroenteritis
Importnant points:
CANNOT CULTURE
Non-enveloped
(+) ssRNA
Noro/Sapoviruses
Norovirus
Of Caliciviridae ((+)ssRNA, non-enveloped and cannot culture)
LEADING CAUSE OF ACUTE GASTROENTERITIS IN OLDER CHILDREN/ADULTS
What is the leading cause of gastroenteritis in children? In adults?
Children: rotavirus (of Reoviridae)
Adults: norovirus (of Caliciviridae)
Norovirus
(pathogenesis)
Transmission via contaminated food/water or person-to-person spread (aerosolized vomitus!)
Norovirus
(susceptibility to infection?)
Strain-dependent binding to blood group antigens
Norovirus
(Spectrum of symptoms)
Inocculate patients w/same virus and get a broad spectrum of symptoms
Astroviruses
Cause Gastroenteritis
(cause poop to RACE through you)
non-enveloped; ssRNA
World-wide distribution (therefore, majority are sero (+) by 5)
Generally affects infants/young children and problem w/institutional outbreaks
Enteric Adenoviruses
Cause gastroenteritis (cause poop to RACE through you)
Non-enveloped, dsDNA (think, aDenoviruses)
Serotypes 40/41 associated with diarrhea
Longer incubation period (10 days)
What are the two leading causes of gastroenteritis in infants?
Rotavirus (of Reoviridae family) and Enteric Adenoviruses
Which Enteric Adenoviral Serotypes are associated with diarrhea?
Serotypes 40 and 41
ORT
Oral Rehydration Therapy
(treating infants with serve dehydration). NOTE: the WHO makes distinct recommendations between world-wide vs. US ORT. Why? b/c the [salt] is TOO HIGH in the world solution
Q: Why is American ORT different from world-wide ORT?
The world solution has too much salt