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65 Cards in this Set
- Front
- Back
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microbial flora in intestines provide us with
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butyrate as energy for colonic epithelial cells, vit K, assitance in reabsorption and conservation of estrogens and androgens in bile, resist colonization by invading pathogens
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mucositis
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superficial ulcerations of the mucosa of the entire GI tract; seen in ppl receiveing ionizing radiation or chemotherapy
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what bacteria are resistant enough to bile to grow in the gallbladder
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gram neg typhoid bacillus and gram-pos enterococci
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circumstanses that predispose to intestinal infectious disease
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anatomic alterations, changes in stomch pH, normal flora alterations, encounter with pathogens
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what causes signs and symptoms of GI infections
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toxins, local inflammation, deep tissue invasion, perforation
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specific defenses of the mouth
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nonpathogenic resident flora, mechanical actions of saliva and tongue, antimicrobial constituents of saliva (antibodies and lysozyme)
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what is lysozyme effective against
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mainly gram-pos bacteria
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dental pellicle
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coating of sticky macromolecules, mainly proteins that bacteria of the mouth adhere to
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microbial metabolism in plaque
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transforms dietary sugar into acids, mainly lactic acid, which is responsible for dental caries
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Ludwig angina
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polymicrobial infection of sublingual and submandibular spaces that arises from a tooth; cellulitis-inflammation of submucosal/subQ CT that can progress rapidly, press against airway, and threaten with ashyxiation
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predominant bacteria found in stomach
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gram pos like lactobacillus, peptostreptococcus, Staphlococcus, and streptococcus
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hallmark of cholecystitis
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pain upper R quadrant of abdomen-may beuild up to crescendo and then subside, only to recur rapidly (biliary colic)
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other symptoms of cholecystitis
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nausea, vomiting; shaking chills, high spiking fever, jaundice, tenderness over gallbladder
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Charcot triad
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biliary colic, jaundice, and chills and spiking fever
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ascending cholangitis
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spread of infection from biliary ducts to the liver
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emphysematous cholecystitis
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rapid clinical onset, extensice gangrene, presence of gas in the gallbladdder wall, high mortality rate; occurs in patients with compromised arterial supply to gallbladder wall (diabetes or elderly)
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most frequent microbes infecting gallbladder
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from GI tract-E coli; 40% mix of facultative and strictly anaerobic flora that ascend from duodenum; Typhoid bacilli
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bacterial overgrowth syndrome
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large microbial biomass in absorptive small intestine(usually Bacteroides); leads to competition for certain vitamins and malabsorption of fats
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result of bacterial overgrowth syndrome
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increased fecal fat (steatorrhea); B12, vit A, and vit D deficiency; diarrhea (osmotic);
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dysentery
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distinctive syndrome involving colon-brisk inflammatory response results in abdominal pain and small-V stools consisting of blood, pus, and mucus
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what usually causes dysentery
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Shigella species
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E coli causing dysentery in children and elderly is also associated with
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formation of platelet-fibrin thrombi in the glomeruli or brain; produce toxins related to shigella dysenteriae type 1; new and emerging infectious disease; foodborne outbreaks
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Cholera typical diarrhea
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rice-water appearance; no fecal, bloody, or bilious appearance
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culture of cholera
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TCBS agar (thiosulfate-citrate-bile salt sucrose)
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shigella infection under light microscope (stool sample)
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sheets of neutrophils
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rotavirus symptoms
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vomit, low-grade fever, mild upper respiratory symptoms with cough, nasal discharge, and pharyngitis, watery diarrhea without blood or leukocytes
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microangiopathic hemolytic anemia
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erythrocyte fragments characteristic of RBC damage secondary to endothelial cell damage
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how is campylobacter jejuni transmitted
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by poultry
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waterborne or shellfish associated outbreaks with what organisms
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Aeromonas hydrophila and Plesiomonas in recent years; Cryptosporidium (protozoan-waterborne)
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microsporidia can cause chronic diarrhea in what group
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AIDS patients (enterocytozoon bieneusi and septata intestinalis)
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agents of viral diarrhea
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adenovirus, astrovirus, norovirus, rotavirus, others
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Where is Cl cholerae found
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marine organism inhabiting costal waters-lives associated with plankton; shellfish can concentrate
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where is the cholera toxin encoded
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segment of DNA on filamentous bacteriophage called CTX
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shigella infection Y enterocolitica is often transmitted how
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zoonotic-drinking raw milk or consuming undercooked meat like pork
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shigella infection S sonnei is common where
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US-self-limiting watery diarrhea in infants and children in child care centers; rare in dvlping world
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shigella of developing world
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S. flexneri
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diarrhea in children <2 most likely caused by
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virus-rotavirus most common
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rotavirus in temperate regions
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seasonal and produces 'winter vomiting disease'
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malnutrition severe diarrhea associated with
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measles
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proctocolitis due to anal intercourse is due to
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Chlamydia trachmatis, HSV, Neisseria gonorrhoeae, or Treponema pallidum; aka 'gay bowel syndrome'
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viruses that cause death or dysfunction of intestinal epithelial cells
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main agents rotavirus and noroviruses-do not affect cells in crypts
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villus vs crypt cells ion secretion
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villus cells Na+ absorbing and crypt cells Cl- ions
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bacteria that colonize the upper small intestine
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enterotoxigenic E. coli and V. cholerae=diarrhea secondary to toxins
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toxin cause of diarrhea mechanism
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>cAMP, stimulates net Cl- secretion and inhibits Na+ uptake=fluid loss
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food poisoning
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toxins from Bacillus cereus and S. aureus
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reactive arthritis
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immunological phenomenon-organisms usually not found in joint fluid; often possess MHC antigen HLA-B27
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C. jejuni or Y. enterocolitica symptoms
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infect terminal ileum and produce watery, sometimes bloody stool
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dysentery syndrome
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epithelial damage, mucosal inflammation, and bloody diarrhea
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major pathogens that cause dysentery syndrome
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Shigella species and ameba E. histolytica
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tenesmus
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pain worsens with bowel movements
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why are WBCs typically scarse in amebic dysentery
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lysed by toxin produced by amebic trophozoites present in lesions
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bacteria that produce inflammatory illness in terminal ileum
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Campylobacter, salmonella, and yersinia; associated with bloody diarrhea containing leukocytes and occasionally extends to colon resulting in dysentery
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enterohemorrhagic E. coli (EHEC)
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infect large bowel (include shiga toxin producing O157:H7); adhere to colonic epithelium causing characteristic lesion in which brush border is effaced by dramatic change in cytoskeletal structures beneath organism
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hemorrhagic colitis
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diarrhea that appears to be almost pure blood
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Clostridium difficile infection
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adherent pseudomembrane with considerable mucosal inflammation and damage, but without tissue invasion
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kwashiokor
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severe malnutrition due to protein deficiency; can be caused by shigellosis
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Shiga toxins 1 and 2
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cross intestinal mucosa and injure endothelium of intestinal lamina propria, glomeruli, and brain
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Salmonella typhi
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invades gut-associated lymph tissue of small bowel-disseminate to liver and spleen where proliferate
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peritonitis causal organisms
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mix of strict anaerobes like Bacteroides fragilis and facultative gram-neg bacteria of enterobacteriaceae family
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clues that suggest disease requiring specific therapy
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fever, tenesmus, persistent/severe abdominal pain, weight loss, blood in stool, recent antibiotic use, raw seafood meals, male homosexual practices, forgein travel, prolonged duration of symptoms
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culturing stool sample primarily for what pathogens
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E coli )157:H7, Campylobacter, Salmonella, Shigella
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Cholera growth medium
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TCBS agar
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sorbitol-containing MacConkey agar is used for
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E coli 0157:H7; doesn't ferment sorbitol like other E-coli and stands out; doesn't distinguish from non-shiga toxin producing 0157:H7
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anticholinergics and opiates in children with inflammatory diarrhea
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intestinal stasis (toxic megacolon)
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recipe for oral rehydration
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1 L water, .5 tsp salt, .25 tsp bicarb, .25 tsp KCl, 4 tbsp sugar
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