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43 Cards in this Set
- Front
- Back
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The top 4 microbe infections in the US are due to, EXCEPT:
a. Salmonella b. Shigella c. Campylobacter d. Clostridium e. E. coli |
Salmonella, Shigella, Campylobacter, E. coli
NOT colstridium |
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Who is NOT susceptible to GI infection?
a. children b. 6 month old weaned off breastfeeding c. child living in poor hygiene conditions d. 20y/o who washes hands frequently |
almost everyone is susceptible especially children, while washing hands helps prevent spread; and remember neonates have a decreased immunity, while children have contact with other children and they often fail to wash their hands
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A child <4y/o is most likely to be affected with
a. Salmonella b. Shigella c. Campylobacter d. E. coli |
Salmonella
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What state has the highest incidence of CAmpyLobacter?
a. Illinois b. California c. Georgia d. Colorado |
CALifornia = CAmpyLobacter
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Which state has the highest incidence of Salmonella?
a. Illinois b. California c. Georgia d. Colorado |
Georgia = Salmonella
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Which state has the highest incidence of ST E.COLi 0157
a. Illinois b. California c. Georgia d. Colorado |
COLarado = E.COLi 157
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What do migrants, travelers, refugees, and immigrants have in common?
a. live in poor conditions b. share cultural habits c. fail to wash their hands d. have a high degree of GI infections |
have a high degree of GI infections probably because of their living conditions/water supply, ocean/desert/swamp, travel practices, and urban/rural
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What is the most common GI infection isolated via mouth, often seen in the summer months of July-Aug, commonly seen in Gerogia?
a. Salmonella b. E.Coli c. Campylobacter d. Shigella |
Salmonella = Summer = Georgia
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What is the most common isolated gut infection isolated in the winter months of Jan -Feb, common in California?
a. Salmonella b. E.coli c. Campylobacer d. Shigella |
CAmpyLobacter = winter = CALifornia
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What is the MOST important host factor of personal hygiene that determines risk of GI infection?
a. gut sterility b. pathogens you ingest c. abundant, uncontaminated water supply and good sanitary facilities d. pathogens you spread |
abundant, uncontaminated water supply and good sanitary facilities
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What is NOT a physical barrier, or host factor that decreases risk of GI infections?
a. gut sterility b. gastric acid stomach c. skin d. mucus membrane integrity |
gut sterility is an age host factor often seen in young children increasing their risk of rotavirus
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Why is motility important as a host factor during GI infections?
a. decreases susceptibility to botulism b. absroption of fluids c. gastric acid barrier d. mucus membrane integrity |
absorption of fluid and removal of non-indigenous organisms
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Immunocompromised pts are susceptible to GI infections, while breast fed babies acquire IgA passively to increase their immunity. What lymphocyte often effective against gram negative organisms?
a. macrophage b. Tcells c. Bcells d. neutrophiles (PMN's) |
neutrophiles (PMN's)
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Loss of microflora can lead to increased levels of what organisms in flora, EXCEPT/
a. E.coli b. Pseudomonas c. Klebsiella d. Clostridia |
Pseudomonas, Klebsiella, Clostridia, and Candida
NOT E.coli |
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what is the protective role of intestinal flora to prevent GI infections:
a. competition b. production of inhibitory f.a's c. bacteriocins d. stimulation of immune system |
. competition
b. production of inhibitory f.a's c. bacteriocins d. stimulation of immune system and vitamin production |
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What bacteria causes >90% duodenal and 80% gastric ulcers?
a. campylobacter b. E.coli c. H.pylori d. Shigella |
H.pylori (urease positive used as a diagnostic)
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Why are ABO blood type pts susceptible to ulcers?
a. often use increased NSAIDs b. H.pylori adherence c. risk for PUD gene d. damaged EP |
Lewis b blood group antigen is part of O antigen, this where H.pylori adhere
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H.pylori has urease as a protective mechanism from acidic envrionment resultin in increased bicarbonate and NH4+, but what other protein funciton can lead to ulcers.
a. increased destruction of cells b. increased cell replication c. inhibit acid secretion d. increase acid secretion |
inhibit acid secretion via another protein
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children are often infected with H.pylori after parents kiss them, what are the risk factors of gastric ulcer disease with H.pylori.
a. increase in dissemination b. increase in sepsis c. increased risk for gastric CA and MALT lymphoma d. increased risk for carcinoid |
increased risk for gastric CA and MALT lymphoma
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What are 3 diagnostic measures for H.pylori identification?
a. biopsy with rapid urease test b. gemisa test c. 13C urea breath test d. serology IgG |
biopsy with rapid Urease test
13C urea breath test serology IgG |
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What test can determine H.pylori eradication?
a. biopsy b. rapid urease test c. 13C urea bread |
rapid urease test
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What are 2 optional treatment options for H.pylori?
a. 2-PCN + PPI b. 1- PCN c. 2 PCN + H2RA and bismuth d. 1 PCN + H2RA |
2 PCN + H2RA and bismuth
remember ONE PCN is never enough |
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Antibiotic use can increase your risk of infections with what two organisms?
a. Salmonella and E.coli b. Salmonella and Campylobacter c. Salmonella and Clostridium d. Salmonella and Shigella |
Salmonella and Clostridium
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How was the specific Salmonella organism identified during the outbreak of Salmonella infection due to antibiotic use?
a. antimicrobial resistance and plasmid profile b. antimicrobial resistance and endotoxin c. toxin and plasmid profle d. toxin and resistance |
antimicrobial resistance and 3 plasmid profile (was unique)
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What is the most identifiable cause of antibiotic associated diarrhea and pseudomembrane collitis ?
a. Salmonella b. E.coli c. campylobacter d. Clostridium difficile |
clostridium difficile (gram positive, obligate anaerobe, spore) resistant to multiple antibiotics
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Although any antibiotic can result in AAC (antibiotic associated Colitis), these 3 are primarily associated?
a. clindamycin b. tetracyclins c. cephalosporins d. fluoroquinolones |
clindamycin, cephalosporins, and fluoroquinolones
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What is the major cause of AAC (colitis)?
a. toxin A (fluid secretion) toxin B (cytotoxic) b. alters GI cells via adherence c. inhibits acid secretion locally d. increases susceptibility for E.coli infection |
toxin A (fluid secretion) toxin B (cytotoxic) and increased use antibiotics alter intestinal flora allowing overgrowth of C.difficile
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32y/o male presents with profuse, watery or mucoid, green foul smelling diarrhea. Complaining of cramping, abdominal pain and tenderness. After a gualac + test and some leukocytes in stool. What culture will you use to isolate the suspected organism?
a. chocolate b. cycloserin-cefoxitin-fructose (CCFA) c. Thayer meyer d. MacKonkey |
CCFA: cycloserin-cefoxitin-fructose (CCFA)
can also rapid Ag detection via latex agglutination or immunochromatographic assays (to verify diagnosis) |
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What is an optimal treatment for AAColitis?
a. d/c antibiotic b. supportive care (fluids, electrolytes) c. metronidizole, oral vancomycin d. vaccine |
NO vaccine, all others are effective
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what is a common cause of viral gastroenteritis in infants and young children?
a. rotavirus b. noroviruses c. adenovirus d. rhinovirus |
rotavirus
while in adults it is norovirus |
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what is a common cause of viral gastroenteritis in adults?
a. rotavirus b. noroviruses c. adenovirus d. rhinovirus |
norovirus
while in children it is rotavirus |
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3y/o girl presents with symptoms of watery diarrhea, headache, with abdominal cramping. This is often distinguished from bacterial infeciton due to ?
a. dysentary b. watery diarrhea c. fever d. abdominal cramps |
viral infection (rotavirus) is often watery diarrhea, while in bacterial infection is often bloody diarrhea
treat with fluids (rehydration) and prevent via washing hands, disinfecting surfaces, and washing soiled clothing and diapers |
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rotavirus presents as the "stomach flu" or "24h flu" with a wheel like appearance EXCEPT:
a. envelope b. triple layer capsid w/spikes c. dsRNA (11 segments) d. group A predominates in humans |
no envelope
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Rotavirus often infects Epithelial cells of the small intestine causing SEVERE diarrhea, transmitted via fecal oral route, prevalent in Nov-April. The virus disrupts tight junctions, microvillar, mf networks, EXCEPT:
a. evokes intestinal secretions b. loss of brush border enzymes c. infiltration of lamina propria w/mononuclear cells d. delay in gastric emptying |
NO DELAY in gastric emptying (often associated with norovirus)
a. evokes intestinal secretions b. loss of brush border enzymes c. infiltration of lamina propria w/mononuclear cells |
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3y/o boy presents with watery diarrhea and vomiting for the past 3-8days. In addition to fever and abdominal pain. As you may suspect this can lead to severe dehydration, what can you do to verify diagnosis?
a. rapid antigen detection b. stool sample c. ELISA d. serology |
rapid antigen detection or PCR ofen presents with mild --> severe symptoms (the mild symptoms often seen in adults)
remember treat with rehydration NO vaccine at this time the one that was out Rotashiled was pulled from the market due to intusscusception |
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What is a common cause of intussusception, presenting as excessive crying spells, and dysentary (bloody diarrhea) cramping of abdomen.
a. Rotavirus b. Norovirus c. RotaShield d. PCN |
intussusception is telescoping of small intestine caused via RotaShield vaccine that was pulled from the market in 1998
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Treatment for rotavirus is often reHYDRATION, while prevention is
a. washing hands b. disinfecting contaminated surfaces c. washing soiled clothing d. vaccine |
all of the above: vaccines include Rotaris (RV1) and **RotTeq (RV5)** pentavalent 3 doses at 2,4,6 months
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Norovirus is a small virus resistant to freezing, higher T, acid, steaming, ether, and up to 10ppm Cl-, described as
a. ss+RNA b. major VP2 c. envelope d. cultivated |
ss+RNA (YES)
major VP1 capsid protein not able to cultivate no envelope |
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Up to 50% of foodborne gastroenteritis are due to
a. Rotavirus b. Norovirus c. adenovirus d. astrovirus |
norovirus (common OUTBREAKS!!) because only need a small amount and highly contagious due to increased shedding clinical is often asymptomatic
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Two city hospitals suddenly got visits from crowds of people complaining of vomiting and diarrhea, some had fever. Mucus was negative for blood and there were NO leuckocytes in fecal material. What is you next step for diagnosis
a. RT-PCR b. rapid Ag detection in stool c. PCR |
norovirus often a OUTBREAK!!
RT PCR remember Kaplan criteria: 1) vomit >50% of persons 2) mean incub period 24-48h 3) mean duration 12-60hrs 4) no bacterial pathogen isolated |
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Permanent immunity develops to norovirus
a. true b. false |
immunity develops to norovirus, BUT not permanent
false |
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Norovirus is often treated with rehydration and vaccine
a. true b. false |
partially true (treated with rehydration, but NO vaccine)
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3y/o presents with gross blood/mucus in stool, including leuckocyts on fecal smearl (Wright stain). After talking with parent they recently returned from their grandparents farm in Durango, MX.
a. viral b. non-viral |
non-viral
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