Micro Nath Digestive System Infections & Hepatitis

Front 1

Cause of nausea, vomiting (onset < 6 hr) after eating cold cuts, orpotato salad, or mayonnaise, or custards implicated. TOW?

Back 1

Staphylococcus aureus

Front 2

Staphylococcal food poisoning is mediated by what?

Back 2

Enterotoxin

Front 3

Tx of staphylococcal food poisoning

Back 3

Rehydration

Front 4

Cause of nausea and vomiting, +/- diarrhea (onset < 6 hr) after
eating reheated rice. TOW?

Back 4

Bacillus cereus

Front 5

What makes bacterial spores resistant to heat

Back 5

dipicolinic acid core

Front 6

Cause of nausea, vomiting, watery diarrhea w/ rapid onset (6-12 hr)
after eating reheated meat or gravy implicated. TOW?

Back 6

Clostridium perfringens

Front 7

Persistent dyspepsia in those not receiving NSAIDs is tested for
what?

Back 7

Helicobacter pylori

Front 8

Increased risk of gastric adenocarcinoma and MALT lymphoma.

Back 8

H. pylori colonization

Front 9

Indications to treat H. pylori-associated PUD

Back 9

Presence of organism

Front 10

Standard first line treatment for PUD due to H. pylori is what?

Back 10

PPI + clarith + amox

Front 11

Hx of acute onset of diarrhea with rice-water stools, vomiting,
dehydration in a pt during travel to South America. TOW?

Back 11

Vibrio cholerae

Front 12

Sx and Sn of cholera are due to what?

Back 12

A-B toxin causes increase cAMP

Front 13

Cholera pathogen is isolated from stool by culture on thiosulfate-citarate-buffered sucrose (TCBS) agar. Why sucrose (and not glucose)?

Back 13

Differential fermentation (+)
by V. cholerae on sucrose

Front 14

The comma-shaped cholera organisms are microscopically similar
to

Back 14

Campylobacter

Front 15

Tx of cholera involves

Back 15

Rehydration (tet in severity)

Front 16

Secretory diarrhea, fever and vomiting during travel are caused by

Back 16

Enterotoxic E. coli

Front 17

Secretory diarrhea w/ fatty, foul-smelling stools in campers, hikers;
also day-care outbreaks are caused by

Back 17

Giardia lamblia

Front 18

Following ingestion of 15-25 cysts and excystation, trophozoites
with flat ventral surface adhere at brush border of enterocytes and
contribute to malabsorption. TOW?

Back 18

Giardiasis

Front 19

Dx of giardiasis is confirmed by

Back 19

Stool antigen (+)

Front 20

Specific Rx of giardiasis involves

Back 20

Metronidazole

Front 21

Protracted, secretory diarrhea w/ large fluid loss in AIDS is caused
by (clue: acid-fast organisms)

Back 21

Cryptosporidium >>
Cyclospora > Isospora

Front 22

Frank bloody diarrhea, after eating undercooked meats or drinking
fruits drinks, is caused by prepared foods or water, contaminated w/

Back 22

E. coli O157:H7

Front 23

Mechanism of blood loss in hemorrhagic enterocolitis involves

Back 23

Shiga toxin (a cytotoxin)

Front 24

Complication of hemorrhagic enterocolitis in children

Back 24

hemolytic uremic syndrome

Front 25

Profuse diarrhea, fever, vomiting, and dehydration in infants is
caused by

Back 25

Rotavirus

Front 26

Mechanism of rotaviral diarrhea involves

Back 26

Villus destruction

Front 27

Infantile watery diarrhea and fever are caused by

Back 27

Adenovirus 40,41

Front 28

Outbreak of nausea, vomiting, fever in adults is caused by

Back 28

Norovirus

Front 29

Cause of nausea/vomiting, abdominal cramps, diarrhea +/- bloody
8-48h after eating eggs or poultry or peanut butter?

Back 29

Non-typhoidal Salmonella

Front 30

Primary gastroenteritis progressing to chronic carrier state of
Salmonella in bile ducts is common due to

Back 30

Abx use

Front 31

Abx used to treat septic phase salmonella gastroenteritis is

Back 31

ciprofloxacin

Front 32

Cause of fevers (>103°) abdominal pain, headaches; little diarrhea;
macular rose-colored spots (rash). PE: bradycardia;
hepatosplenomegaly (+/-) in a pt with hx of travel (to tropics)?

Back 32

Salmonella typhi

Front 33

Cause of occult-bloody diarrhea, abdominal cramping and fever, 2d
after ingestion of salad from meat-contaminated cutting-boards?

Back 33

Campylobacter jejuni

Front 34

Abx for campylobacter enteritis with prolonged, high fevers in
pregnancy, and HIV is

Back 34

Erythromycin

Front 35

Cause of dysentery-like illness with fever + abdominal cramps,
tenesmus + blood & mucus in children?

Back 35

Shigella sonnei

Front 36

Tx of dysentery due to Shigella flexneri or S. dysenteriae in elderly
involves

Back 36

ciprofloxacin

Front 37

Cause of dysentery-like illness in the northern region after eating
cheese; pseudoappendicitis or pseudo-crohn syndrome?

Back 37

Yersinia enterocolitica

Front 38

Cause of dysentery-like illness in a patient on broad-spectrum abx?

Back 38

Clostridium difficile

Front 39

Diarrhea due to Clostridium difficile is mediated by

Back 39

Toxin A (enterotoxin) + toxin
B (cytotoxin).

Front 40

Clostridium difficile diarrhea is confirmed by

Back 40

EIA for stool toxins

Front 41

Tx of Clostridium difficile diarrhea involves

Back 41

po vanco > metron + ORS

Front 42

Health-care associated spread of Clostridium difficile diarrhea and
protracted outbreak is due to

Back 42

Contact mode of transmission of spores

Front 43

Cause of dysentery involving abdominal pain, tenesmus, stools
with mucus + blood in a patient, who recently traveled to tropics;
CBC: eosinophilia?

Back 43

Entamoeba histolytica

Front 44

Positive stool test using microscopy for trophozoites w/
intracellular RBCs confirms

Back 44

Amebic dysentery

Front 45

Rx of amebic dysentery involves

Back 45

Metronidazole + iodoquinol

Front 46

Abscesses in liver or peritonitis in travelers w/ or w/o hx of amebic
dysentery is confirmed by

Back 46

Serology for E. histolytica

Front 47

Chronic abdominal pain, diarrhea; follows intestinal obstruction;
cholangitis; liver abscess, in children in Southern States. Lab: O &
P (+) for eggs (oval with a thick coarse shell). TOW?

Back 47

Ascaris lumbricides

Front 48

Ova & Parasite test using microscopy for oval eggs (with a thick
coarse shell) in stool confirms what?

Back 48

ascariasis

Front 49

A child has stomach ache, distended abdomen, poor appetite.
“Pearl-colored earthworm”-like organisms in the stool. Major
immune response against this infection?

Back 49

IgE

Front 50

DOC of ascariasis is

Back 50

Mebendazole

Front 51

Vomiting, cramping, diarrhea, epigastric pain, weight loss in an
immigrant from developing country is caused by

Back 51

Strongyloides stercoralis

Front 52

DOC of strongyloidosis is

Back 52

Ivermectin

Front 53

Pt w/ high dose steroids or HIV/AIDS develops pulmonary
infiltrates (+ eosinophilia) and/or gram negative sepsis. TOW?

Back 53

Invasive strongyloidosis

Front 54

Weakness, fatigue, lightheadedness, dyspnea, pruritis; pallor; iron-
deficiency anemia. CBC: elevated eosinophils. TOW?

Back 54

Hookworm infection

Front 55

Fever, periorbital edema, subconjunctival hemorrhages, muscle
weakness, rash, after ingestion of undercooked meat (e.g., pigs,
wild game). Lab: ! CPK, LDH & eosinophilia. TOW?

Back 55

Trichinellosis

Front 56

Vague abdominal pain, bloating, altered appetite after ingestion of
sushi. CBC: megaloblastic anemia (B12 deficiency); eosinophilia
with mild leukocytosis. TOW?

Back 56

Diphyllobothriasis (fish
tapeworm)

Front 57

Dx of tape worm infection is confirmed by

Back 57

proglottids in stool

Front 58

Tx of tape worm infection involves

Back 58

Praziquantel

Front 59

Fever, lymphadenopathy, hepatosplenomegaly in an immigrant
from Africa or Orient; pt recalls an itch within a day of fresh water
exposure. RUQ ultrasound (+); CBC: eosinophilia. TOW?

Back 59

Schistosoma mansoni (Africa)
S. japonicum (Far East)

Front 60

Stool in chronic stage of schistosomiasis yields

Back 60

large eggs with lateral spine.

Front 61

Rx of chronic stage of schistosomiasis involves

Back 61

praziquantel

Front 62

Patient with acute jaundice is HAV IgM (+). What should the
family contact receive for prophylaxis?Inactivated HAV vaccine

Back 62

Inactivated HAV vaccine

Front 63

Patient with jaundice for < 1 week has HBsAg (+), Anti-HBc IgM
(+). TOW?

Back 63

Acute HBV infection

Front 64

Multiple sex partners, IDU, infants born to infected mothers are
risk groups for which hepatitis virus

Back 64

HBV

Front 65

This is an enveloped, double stranded DNA virus w/a ss-break;
transmitted by infective body fluids. TOW?

Back 65

HBV

Front 66

This asymptomatic man has hep serology: HBsAg (-), Anti-HBs
(+), Anti-HBc IgG (+), Anti-HBc IgM (-). TOW?

Back 66

Resolved hepatitis B

Front 67

This man has jaundice and HBsAg (+) > 6 months, Anti-HBs (-),
HBeAg (+), Anti-HBc IgG (+), HBV DNA > 20,000 IU/ml. TOW?

Back 67

Chronic active hepatitis B

Front 68

A pt w/ chronic active hepatitis with evidence of
necroinflammation should receive

Back 68

Peg-IFN" 2a + lamivudine (or cidofovir)

Front 69

This man has no jaundice, but HBsAg (+) >6 months, Anti-HBs (-),
Anti-HBc IgG (+), HBeAg (-), persistently normal ALT. TOW?

Back 69

Inactive HBsAg carrier

Front 70

This man, at the time of annual physical exam, reveals Anti-HBs
(+) and other markers are (-). TOW?

Back 70

HBV vaccination

Front 71

Virologic confirmation of chronic jaundice in a pt w/ IDU or
hemodialysis; vasculitis and glomerulonephritis is based on

Back 71

HCV RNA > HCV IgG

Front 72

Heterogeneous, immune-evasive quasispecies (mutants)generated
during replication of hepatitis C virus in blood causes

Back 72

Chronicity in HCV

Front 73

Fulminant hepatitis in a patient, who has multiple sexual partners
and is HBsAg (+); HBcIgM (-), can be fatal due to what?

Back 73

HDV superinfection.

Front 74

Acute onset of jaundice, nausea, right-upper quadrant pain,
hepatomegaly in pregnant women in India. TOW?

Back 74

HEV infection