Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
419 Cards in this Set
- Front
- Back
|
What is the commentest cause of morbidity and mortality?
|
GIT infections
|
|
|
What microbes are located in the GIT prenatally?
|
No microbes are located in the GIT prenatally, it is sterile.
|
|
|
What are the first microbes to appear in the GIT after birth?[2]
|
E. coli
Streptococci |
|
|
When does Streptocci appear in the GIT flora?
|
Immediately after birth
|
|
|
When does E. coli appear in the GIT flora?
|
Immediately after birth
|
|
|
What is the affect of Bifidobacterium in the GIT?
|
Creates a reducing enviroment
|
|
|
When is the GIT created into a reducing environment?
|
4 days after birth
|
|
|
What microbes are responsible for creating a reducing environment in the GIT?[3]
|
Bifidobacterium
Bacteroides Clostridium |
|
|
What is the result of breast feeding on Clostidium in the GIT?
|
Clostridium declines
|
|
|
What is the affect of breast feeding on Bifidobacterium in the GIT?
|
Bifidobacterium remains high
|
|
|
What microbe is prominent in the child who is fed formula?
|
Lactobacilli
|
|
|
What is the affect on weaning a child from breast feeding on E. coli in the GIT?
|
E. coli increases to normal
|
|
|
What is the affect on weaning a child from breast feeding on Streptococci in the GIT?
|
Streptococci increases to normal
|
|
|
What is the affect on weaning a child from breast feeding on Clostrium?
|
Clostridium increases to normal
|
|
|
What is the affect of breast feeding on E.coli in the GIT?
|
E.coli is reduced
|
|
|
What is the affect of breast feeding on Streptococci in the GIT?
|
Streptococci is reduced
|
|
|
What is the affect of breast feeding on Bacteroides in the GIT?
|
Bacteroides is reduced
|
|
|
At what point is the GIT flora of the breast fed baby similar to the GIT flora of the formula fed baby?
|
When the breast fed baby is weaned from breast feeding
|
|
|
What microbes in the breast fed baby metabolize proteins?
|
Bifidobacteria
|
|
|
What microbe is found in the feces of the formula fed infant which metabolizes sugar?
|
Lactobacilli
|
|
|
What type of bacteria are seen in the GIT flora?[2]
|
Gram (+)
Anaerobic |
|
|
What is the gram negative bacteria which is found in the GIT?
|
Bacteroides
|
|
|
How long does it take for the infant GIT flora to resemble adult flora?
|
2 years after weaning onto solid food
|
|
|
What is the microbial count of the mouth?
|
>500 different bacterial species
|
|
|
How are bacteria integrated into the mouth?
|
Biofilm on the teeth and gums
|
|
|
Describe the bacteria that are found in the mouth.[2]
|
Anaerobes
Facultative anaerobes |
|
|
What is the microbial count in the stomach?
|
0 the stomach is sterile
|
|
|
What is the reason that the bacterial microbe count is 10^5-10^7 in the stomach?[2]
|
Achlorhydria
Malabsorption |
|
|
What happens to the bacterial numbers when progressing down the GIT and away from the stomach?
|
Bacterial numbers increase
|
|
|
What happens to the bacterial numbers when progressing up the GIT and towards from the stomach?
|
Bacterial numbers decrease
|
|
|
Are there any Coliforms in the duodenum?
|
No
|
|
|
Are there any Bacteroides in the duodenum?
|
No
|
|
|
What is the bacterial count in the duodenum?
|
0 to 10^4.5
|
|
|
What are some of the microbe located in the duodenum?[5]
|
Aerobic Sterptococci
Staphylococci Lactobacilli Yeasts Anaerobic Streptococci |
|
|
What is the bacterial count in the jujenum and illeum?
|
10^5 to 10^7
|
|
|
Are there any Coliforms in the jujenum?
|
Yes
|
|
|
Are there any Bacteroides in the duodenum?
|
Yes
|
|
|
What is the bacterial count at the illeo-cecal junction?
|
10^6 to 10^8
|
|
|
What bacteria can be seen in the jujenum and the illeum?[7]
|
Enterobacteria
Streptococcus Staphylococcus Lactobacillus Bacteroides Bifidobacterium Clostridium |
|
|
What is the microbial count of the Colon?
|
10^10 to 10^12
|
|
|
How many species can be isolated from the colon?
|
>400
|
|
|
Are the flora of the colon aerobic or anaerobic?
|
Anaerobic
|
|
|
What are the bacteria of the colon?[5]
|
Bacteroides
Bifidobacterium Clostridium Eubacterium Peptostreptococcus |
|
|
What are the two factors that affect microbial composition of the GIT flora?
|
Allogenic
Autogenic |
|
|
What are allogenic factors?
|
Those that originate outside of the GIT
|
|
|
What are autogenic factors?
|
Thos e that arise from within the GIT
|
|
|
What are the allogenic factors?[5]
|
Diet
Age Geographic location Antibiotic therapy Surgery |
|
|
How does the nature of a meal influence bacterial composition?
|
Diet affect the nature of gastric emptying
|
|
|
What is the composition of the GIT flora in a western diet (meat)?[2]
|
Increased Bacteroides
Decreased Enterococci |
|
|
What is the composition of the GIT in a vegetarian diet?[2]
|
Decreased Bacteroides
Increased Enterococci |
|
|
How do antibiotics affect the GIT flora?
|
Disturbs or removes normal flora
|
|
|
What is the result of removal of normal GIT flora?
|
Increased susceptibility to pathogenic microbes
|
|
|
What are the autogenic factores?[2]
|
Environment
Activities of the microorganisms |
|
|
What are the environmental factors which affect GT flora?[6]
|
pH
Paristalsis Shedding of the epithelium Mucus Conjugated bile salts IgA |
|
|
How is pH a factor in GIT flora?
|
Influences colonization in the stomach
|
|
|
How is parastalsis a factor in GIT flora?
|
Influences the time that flora can remain in one location
|
|
|
How does shedding of the epithelium influence GIT flora?
|
Shedding prevents colonization
|
|
|
How is mucous a factor in GIT flora?
|
Mucous is antimicrobial
|
|
|
What are the activities of the microorganims which influence GIT flora?[5]
|
Nutritional and attachment site
Bacterial inhibitors Toxic metabolic end products H2S production Maintenance of low oxidation-reduction potentials |
|
|
What are the oral diseases caused by microbes?[3]
|
Dental caries
Gingivitis Periodonitis |
|
|
What are dental caries?
|
Infectious disease resulting in localized dissolution and destruction of the calcified tissues of the teeth
|
|
|
Infectious disease resulting in localized dissolution and destruction of the calcified tissues of the teeth
|
Dental carries
|
|
|
What are the microbes involved in Dental caries?[5]
|
S.mutans
S.sanguis Lactobacilli Actinomyces naeslundii A. odontolyticus |
|
|
What is Peridontal disease?
|
Infections affecting supporting structures of the teeth
|
|
|
Infections affecting supporting structures of the teeth
|
Peridontal disease
|
|
|
What is Gingivitis?
|
Inflammation of the gims
|
|
|
Inflammation of the gums
|
Gingivitis
|
|
|
What are the possible disease that can result from systemic infection from the mouth flora?[2]
|
Endocardidtis
Pneumonia |
|
|
What are the commonest pathogens associated with ingestion of food?[5]
|
Campylobacter jejuni
Salmonella Shigella E.coli O157:H7 Yersinia enterocolytica |
|
|
What are important questions to ask a patient when suspecting a GIT infection from ingested food?[8]
|
What food in the past 24-48 hours?
Any Raw/partially cooked food? Any unpasteurized milk? Any juices? Any shellfish? Visited a farm? Any foreign travel? Been camping? |
|
|
What do you have to recognize when trying to determine the etiology of a GIT infection?[3]
|
Incubation period
Duration of symptoms Most prominent symptoms |
|
|
What disease is caused by Bacillus cereus?[2]
|
Diarrheal food borne infection
Emetic food-poisoning |
|
|
What is the onset and duration of Diarrheal food borne infection with Bacillus cereus?
|
8-16 hrs onset
12-24hrs duration |
|
|
What are the Sx of Diarrheal food borne disease caused by bacillus cereus?[3]
|
Watery diarrhea
Cramps Occasional vomiting |
|
|
What foods cause Diarrheal food borne disease caused by bacillus cereus?[4]
|
Meat
Soups Sauces Vegetables |
|
|
What is the mode of contamination of food that cases Diarrheal food borne disease caused by bacillus cereus?
|
Soil/dust
|
|
|
What is the onset and duration of emetic food poisoning caused by Bacillus cereus?
|
1-5 hrs onset
6-24 hrs duration |
|
|
What are Sx of emetic food poisoning caused by Bacillus cereus?[4]
|
Nausea
Vomiting Sometimes Diarrhea Sometimes Cramps |
|
|
What are the typical foods that cause emetic food poisoning caused by Bacillus cereus?[2]
|
Cooked rice
Sometimes pasta |
|
|
how is food contaminated in emetic food poisoning caused by Bacillus cereus?
|
Soil/dust
|
|
|
What bacteria causes Botulism?
|
Clostridium botulinum
|
|
|
What is the onset and duration of Botulism?
|
12-36 hrs onset
Months in duration |
|
|
What are the Sx in Botulism?[5]
|
Fatigue
Weakness Double vision Slurred speech Respiratory failure |
|
|
Can botulism cause death?
|
Yes
|
|
|
What foods can cause type A & B botulism?[5]
|
Vegtables
Fruits Meat Fish Poltury |
|
|
What food can cause type E botulism?
|
Fish
|
|
|
What contaminates the food in Type A & B botulism?
|
soil/dust
|
|
|
What contaminates the food in Type E botulism?
|
Water and sediments
|
|
|
What causes botulism in the infant?
|
Clostridium botulinum
|
|
|
What are the Sx of botulism in the infant?[3]
|
Constipation
Weakness Respiratory failure |
|
|
Can botulism in the infant cause death?
|
Yes
|
|
|
How is botulism contracted in the infant?
|
Ingestion of spores from the soil
|
|
|
What causes Campylobacteriosis?[2]
|
Campylobacter jejuni
C.coli |
|
|
What is the onset and duration of Campylobacteriosis?
|
3-5 days onset
2-10 days duration |
|
|
What are the Sx for Campylobacteriosis?[5]
|
Diarrhea
Abdominal Pain Fever Nausea Vomiting |
|
|
What are typical foods causing Campylobacteriosis?[3]
|
Chicken
Raw Milk Pork |
|
|
What causes Cholera?
|
Vibro cholerae
|
|
|
What is the onset and duration of Cholera?
|
2-3 day onset
1 week duration |
|
|
What are the Sx for cholera?[3]
|
Profuse water diarrhea
Vomiting (sometimes) Dehydration |
|
|
Is Cholera fatal
|
Yes if untreated
|
|
|
How is cholera transmitted?
|
Food and water that is contaminated by the feces of infected individuals
|
|
|
What is the onset and duration of Food-borne infection caused by Clostridium perfringes?
|
8-24 hrs onset
<24hr duration |
|
|
What is the Sx for Food-borne infection caused by Clostridium perfringes?[4]
|
Watery diarrhea
Cramps RARE nausea RARE vomiting |
|
|
What is the typical food that causes Food-borne infection caused by Clostridium perfringes?[2]
|
Cooked meat
Meat Gravy |
|
|
What does ETEC stand for?
|
Enterotoxic E. coli
|
|
|
What is the onset and duration of Food-borne infection caused by ETEC
|
10hrs-3 days onset
3-5 days duration |
|
|
What are the Sx for Food-borne infection caused by ETEC?[4]
|
Profuse watery diarrhea
Sometimes cramps Nausea Vomiting |
|
|
What are typical foods to cause Food-borne infection caused by ETEC
|
Raw food
|
|
|
What does EIEC stand for?
|
Entroinvasive E.coli
|
|
|
What is the onset and duration of Food-borne infection caused by EIEC?
|
18hr onset
Uncertain duration |
|
|
What are the Sx of Food-borne infection caused by EIEC?[4]
|
Cramps
Diarrhea Fever Dysentery |
|
|
What does EHEC stand for?
|
Enterohemorragic E. coli
|
|
|
What are the onset and duration of Food-borne infection caused by EHEC?
|
3-8 days onset
2-9 days duration |
|
|
What are the Sx for Food-borne infection caused by EHEC?[2]
|
Watery than bloody diarrhea
Kidney failure |
|
|
What are teh typical foods that cause Food-borne infection caused by EHEC?[3]
|
Raw or undercooked beef
Raw milk Unpasteurized fruit juices |
|
|
What causes Listerosis?
|
Listeria monocytogenes
|
|
|
What is the onset for Listerosis?
|
3-70 days for onset
|
|
|
What are the Sx of Listerosis?[4]
|
Meningo-encephalitis
Still Births Streptacemia in the newborns Meningitis in the newborns |
|
|
What is the typical food that causes Listerosis?[4]
|
Raw milk
Cheese Processed meat Vegetables |
|
|
What causes Salmonellosis?
|
Salmonella spp
|
|
|
What is the onset and duration of salmonellosis?
|
5hrs-3days for onset
1-4 days duration |
|
|
What are the Sx for salmonellosis?[6]
|
Diarrhea
Abdominal Pain Chills Fever Vomiting Dehydration |
|
|
What are the typical foods that cause salmonellosis?[4]
|
Raw or undercooked eggs
Raw or undercooked meat Raw or undercooked poultry Raw milk |
|
|
What causes Shigellosis?
|
Shigella spp
|
|
|
What is the onset and duration of Shigellosis?
|
12hr-4 day onset
4-7 day duration |
|
|
What are the Sx of Shigellosis?[5]
|
Diarrhea
Fever Nausea Sometimes vomiting Sometimes cramps |
|
|
What are typical foods that cause Shigellosis?
|
Raw foods
|
|
|
What toxin causes Staphylococcal food poisoning?
|
ST enterotoxin of S. aureus
|
|
|
What is the onset and duration of Staphylococcal food poisoning?
|
1-6hrs onset
6-24hrs duration |
|
|
What are the Sx of Staphylococcal food poisoning?[4]
|
Vomiting
Nausea Prostration Watery diarrhea |
|
|
What are typical foods that cause Staphylococcal food poisoning?[6]
|
Ham
Meat Poultry Cram-filled pastries Whipped butter Cheese |
|
|
What is the onset and duration of food borne infection caused by V paraheamolyticus?
|
12-24hrs onset
4-7 days duration |
|
|
What are the Sx of food borne infection caused by V paraheamolyticus?[6]
|
Diarrhea
Cramps Sometimes nausea Vomiting Fever Headache |
|
|
What are typical foods to cause food borne infection caused by V paraheamolyticus?
|
Fish and seafood
|
|
|
What is the duration of food borne infection caused by V. Vulnificus?
|
1 day duration
|
|
|
What is unique about people with food borne infection caused by V. Vulnificus?
|
High serum iron
|
|
|
What are the Sx of food borne infection caused by V. Vulnificus?[3]
|
Fever
Chills Prostration |
|
|
What is prostration?
|
Extreme exhaustion or lack of energy or power.
|
|
|
Extreme exhaustion or lack of energy or power.
|
Prostration
|
|
|
Can Food borne infection with V.vulnificus cause death?
|
Yes
|
|
|
What foods typically cause food borne infection with V. vulnificus?[2]
|
Raw Oyseters
Raw Clams |
|
|
What causes Yersinioisis?
|
Y. enterocolytica
|
|
|
What is the onset and duration of Yersinoisis?
|
3-7 days onset
2-3 weeks duration |
|
|
What are the Sx of Yersiniosis?[4]
|
Diarrhea
Abdominal pain (mimics appendicitis) Fever Vomiting |
|
|
What causes Hepatitis in GIT?
|
Hep A
|
|
|
What is the onset and duration of Hep A?
|
15-50 days onset
Weeks-months duration |
|
|
What are the Sx of Hep A?[4]
|
Fever
Weakness Nausea Jaundice |
|
|
What food typically causes Hep A?[3]
|
Raw or Undercooked shellfish
Sanwiches Salads |
|
|
What causes Viral gastroenteritis?[3]
|
Norwalk
Nrowalk-like virus Rotavirus |
|
|
What is the onset and duration of Viral gastroenteritis(Norwalk)?
|
1-2 days onset
1-2 days duration |
|
|
What are the Sx of viral gastroenteritis(Norwalk)?[6]
|
Nausea
Vomiting Watery Diarrhea Abdominal pain Headache Mild fever |
|
|
What are typical foods that cause viral gastroenteritis (Norwalk)?[3]
|
Raw or Undercooked shellfish
Sanwiches Salads |
|
|
What is the onset and duration of Viral gastroenteritis(Rotavirus)?
|
1-3days onset
4-6 days duration |
|
|
What are the Sx of viral gastroenteritis(Rotavirus)?[2]
|
Watery Diarrhea
Dehydration |
|
|
What are typical foods that cause viral gastroenteritis (Rotavirus)?
|
Raw or mishandled food
|
|
|
What is the duration of short acting food poisoning caused by wild mushrooms?
|
<2 hrs
|
|
|
What are the symptoms of short acting food poisoning caused by wild mushrooms?[3]
|
Severe nausea
Vomiting Diarrhea |
|
|
What is the duration of long acting food poisoning caused by wild mushrooms?
|
4-8hrs
|
|
|
What are the symptoms of short acting food poisoning caused by wild mushrooms?[2]
|
Diarrhea
Abdominal cramps |
|
|
Can long acting food poisoning by ingestion of wild mushrooms be fatal?
|
Yes
|
|
|
What is food poisoning?
|
Arises from ingestion of food containing toxins
|
|
|
Arises from ingestion of food containing toxins
|
Food poisoning
|
|
|
What microbe produce toxins that cause food poisoning?[3]
|
C.botulism
S.aureus B.cereus |
|
|
What are food associated infections?
|
Arise from ingestion of food containing a causative organism
|
|
|
Arise from ingestion of food containing a causative organism
|
Food associated infections
|
|
|
Enteritis
|
Inflammation of the intestinal mucosa
|
|
|
Inflammation of the intestinal mucosa
|
Enteritis
|
|
|
Gastroenteritis
|
Inflammation of the stomach and the intestinal linings
|
|
|
Inflammation of the stomach and the intestinal linings
|
Gastroenteritis
|
|
|
Colitis
|
Inflammation of the large intestine
|
|
|
Inflammation of the large intestine
|
Colitis
|
|
|
Enterocolitis
|
Inflammation of the small and large intestine
|
|
|
Inflammation of the small and large intestine
|
Enterocolitis
|
|
|
Dysentery
|
Inflammation of the GI tract with blood and pus in feces
|
|
|
Inflammation of the GI tract with blood and pus in feces
|
Dysentery
|
|
|
Diarrhea
|
Frequent and fluid stool (>3 loose stools)
|
|
|
Frequent and fluid stool (>3 loose stools)
|
Diarrhea
|
|
|
What is the primary symptom of Gastroenteritis?
|
Vomiting(Fever and/or diarrhea may be present)
|
|
|
What is non-inflammatory diarrhea?
|
Watery diarrhea without fever/dysentery
|
|
|
Watery diarrhea without fever/dysentery
|
Non-inflammatory diarrhea
|
|
|
Inflammatory Diarrhea
|
Grossly bloody stool with or without fever
|
|
|
Grossly bloody stool with or without fever
|
Inflammatory diarrhea
|
|
|
What microbes cause inflammatory diarrhea?[7]
|
Shigella
Campylobacter Salmonella V. parahaemolyticus Y. enterocolytica EIEC EHEC |
|
|
What are the bacterial agents that cause gastroenteritis?[3]
|
S. aureus
B. cereus C. botulinum |
|
|
What are the fungal agents that cause gastroenteritis?[2]
|
Mushrooms
Aspergillus |
|
|
What causes gastroenteritis?
|
Ingestion of toxins
|
|
|
Does the growth of an organism result in gastroenteritis?
|
No
|
|
|
Is there fever with gastroenteritis?
|
No
|
|
|
Is there fecal leukocytes with gastroenteritis?
|
No
|
|
|
What microbes release toxins which affect the CNS?[3]
|
C. botulinum
S. Aureus B. cereus |
|
|
What microbes release toxins which affect the intestines?[2]
|
S. Aureus
B. cereus |
|
|
Describe S. Aureus[4]
|
Gram (+)
Aerobic or facultative Coagulase (+) Catalase (+) |
|
|
Is S. Aureus considered normal flora in humans?
|
Yes, ~50% of humans have S. Aureus as their normal flora
|
|
|
What are the exotoxins produced in food, by S. Aureus?[8]
|
A
B C1 C2 C3 D E H |
|
|
What exotoxins from S. aureus are most frequently implicated in outbreaks of gastroenteritis?[2]
|
A
D |
|
|
Describe ST Enterotoxin and what microbe is it from?[4]
|
Heat stable
Water soluble Low molecular weight S. Aureus |
|
|
What is the infective dose of ST enterotoxin from S. aureus
|
1 microgram by 100000 bacteria per gram of food
|
|
|
What is the neurologic effect of S. areus enterotoxin?
|
Vomiting
|
|
|
What is the enteric effect of S. aureus enterotoxin?
|
Diarrhea
|
|
|
Is there stimulation of Adenylate cyclase with enterotoxin from S. aureus
|
No
|
|
|
What are the symptoms of S. aureus enterotoxin?[7]
|
Vomiting
Nausea Abdominal Cramps Watery Diarrhea Headaches Muscular Cramping Prostration |
|
|
Describe Bacillus cereus.[4]
|
Gram (+)
Arranged in chains Aerobic or facultative Spore forming |
|
|
What kind of disease is caused by Bacillus cereus?[2]
|
Emetic
Diarrheal |
|
|
By what mechanism does Bacillus cereus cause disease?
|
Exotoxin (ST neurotoxin)
|
|
|
What are incriminating foods to cause Food poisoning by Bacillus cereus?
|
Boiled rice stored inappropriately
|
|
|
What medium is used to identify B.cereus?
|
Non-selective medium (such as Blood Agar) with polymyxin to suppress gram (-)
|
|
|
Describe Clostridium botulinum.[4]
|
Gram (+)
Anaerobic Spore forming Produces exotoxins |
|
|
T/F Clostridium botulinum is susceptible to penicillin.
|
True
|
|
|
Characterized by descending symmetrical paralysis.
|
Clostridium botulinum
|
|
|
What is the most common from of botulinum in the US?
|
Infant botulinum
|
|
|
What Exotoxins are produced by clostridium botulism?[8]
|
A
B C1 C2 D E F G |
|
|
What exotoxins from Clostridium botulinum are usually the cause of human infection?[4]
|
A
B E F(Rare) |
|
|
What is the action of Clostridium botulinum toxin?
|
Prevents the release of Acetyl Choline across the synaptic cleft
|
|
|
Which of the botulinum toxins is most potent?
|
Toxin A
|
|
|
What is the dosage required of botulinum Toxin A to kill a human?
|
10^ -8 g
|
|
|
What are the types of human disease that can be caused by Clostridium botulinum?[3]
|
Food poisoning
Wound botulism Infant botulism |
|
|
What is the incubation period for infection of clostridium botulinum causing food poisoning?
|
12-36hrs
|
|
|
Is botulinum reportable?
|
Yes
|
|
|
What indications can lead to a presumptive diagnosis of botulinum poisoning?[2]
|
Symmetrical descending paralysis
History of ingestion of food which has been home canned |
|
|
What test is used to confirm botulinum toxin?
|
Mouse toxin-neutralization test
|
|
|
Is infant botulism a food poisoning?
|
No
|
|
|
What is the pathogenesis of infant botulism?
|
Ingestion of spores
Germination of the GIT Vegitative cells replicate Release toxins in the intestines (Toxins A & B) |
|
|
What toxins are implicated in Infant botulism?[2]
|
Toxin A
Toxin B |
|
|
What are the symptoms of infant botulism?[5]
|
Lethargy
Suck and gag reflex deminished Dysphagia Flaccid paralysis Respiratory arrest |
|
|
What toxins cause short acting fungal food poisoning?[6]
|
Museinol
Muscarine Psilocybin Coprius Artemetaris Ibotenic Acid |
|
|
What toxin causes long acting fungal food poisoning?
|
Amantia
|
|
|
What species produces aflatoxins?
|
Aspergillus flavus
|
|
|
What toxins do aspergillus flavus produce?
|
Aflatoxins
|
|
|
What is the result of ingestion of aflatoxins?[3]
|
Acute necrosis
Cirrhosis Carcinoma |
|
|
What food is associated with Ciguatera poisoning?
|
Ingestion if contaminated fish
|
|
|
Does cooking denature Ciguatoxin?
|
No
|
|
|
What microbe causes Ciguatera poisoning?
|
Gambieriscus toxicus
|
|
|
What toxin causes Ciguatera poisoning?
|
Ciguatoxin
|
|
|
What is the incubation period for Ciguetera poisoning?
|
mins-30hrs
|
|
|
What is the duration of ciguatera poisoning?
|
1-2 weeks
|
|
|
What are the symptoms of ciguatera poisoning?[8]
|
Watery Diarrhea
Nausea Abdominal cramps Muscle aches Burning sensation Extremity paresthesia Severe puritis Hot/Cold temp reversal |
|
|
What is known a Non-allergic histamine fish poisoning?
|
Scromboid poisoning
|
|
|
What is the pathogenic mechanism of Scromboid poisoning?
|
Bacteria(Stenotrophomonas maltophilia, Morganella morgani) convert histadine into histamine in fish which accumulates
|
|
|
What is the action of scrombotoxin?
|
Converts histadine to histamine
|
|
|
What bacteria cause scromboid poisoning?[2]
|
Stenotrophomonas maltophilia
Morganella morgani |
|
|
What is the incubation period for Scromboid poisoning?
|
mins-3hrs
|
|
|
What is the duration of scromboid poisoning?
|
3hrs-several days
|
|
|
What are the symptoms of scromboid poisoning?[8]
|
Watery diarrhea
Nausea Vomiting Burning sensation in the mouth Urticaria Facial flushing Puritis Paresthesias |
|
|
What are the Bacterial agents that cause Non-inflammatory diarrhea?[4]
|
E. coli (ETEC,EPEC)
V.cholera Clostridium perfringes Bacillus cereus |
|
|
What are the viral causes of non-inflammatory diarrhea?[3]
|
Rotavirus
Norovirus Adenoviruses |
|
|
Describe E.coli[3]
|
Gram(-)
Facultative anaerobes Produce toxins |
|
|
What are the pathogenic subspecies of E. coli?[6]
|
Enterotoxigenic (ETEC)
Enteropathogenic (EPEC) Enteroadhesive (EAEC) Enterohemmorhagic (EHEA) Enteroinvasive (EIEC) Diffusely-adherent (DAEC) |
|
|
What is the pathogenic mechanism infection and disease caused by ETEC?
|
Ingestion
Colonization with CFA (colonization factor antigen) Release of plasmid encoded Enterotoxins |
|
|
Ingestion followed by Colonization
followed by Release of plasmid encoded Enterotoxins. |
ETEC
|
|
|
What are the types of enterotoxins that are seen in ETEC?[2]
|
Heat Labile (LT)
Heat Stable (ST) |
|
|
What is the action of LT enterotoxin from ETEC?
|
Activation of adenylate cyclase
|
|
|
What is the action of ST enterotoxin from ETEC?
|
Activation of guanylate cyclase
|
|
|
Is ETEC infection fatal?
|
No it is self limiting
|
|
|
What are the symptoms of LT and ST enterotoxins from ETEC?[3]
|
Watery diarrhea
Nausea Vomiting |
|
|
What is the duration of ETEC infection?
|
3-5 days
|
|
|
What is the incubation period for ETEC infection?
|
10 hrs - 3 days
|
|
|
What does EPEC stand for?
|
Enteropathogenic E. coli
|
|
|
T/F EPEC contain LT and ST enterotoxins as well as CFAs.
|
False, EPEC does not contain any of these virulence factors
|
|
|
What does EPEC use to attach to the epithelial cells of the intestine?
|
Bundle-forming pilus
|
|
|
What is the pathogenic mechanism of EPEC?[4]
|
Attachement (Bundle-forming pilus)
Effacement of the microvilli Osmotic imbalance Watery diarrhea |
|
|
What is the symptom of EPEC?
|
Watery diarrhea
|
|
|
Describe vibro cholerae.[4]
|
Gram (-)
Motile Non-Spore forming Oxidase (+) |
|
|
What is the mechanism of diease with infection of vibro cholera?
|
Release of AB enterotoxin
|
|
|
What is the pathogenisis of infection with vibro cholerae?
|
Colonization of the SI
Release of Enterotoxin Enterotoxin activates Adenylate cyclase |
|
|
What is the incubation period for vibro cholerae?
|
2-3 days
|
|
|
What is the duration of disease caused by vibro cholerae?
|
Up to 1 week
|
|
|
What are the complications associated with cholera?[4]
|
Dehydration
Hypovolemia Hypokalemia Metabolic acidosis |
|
|
What is the cause of death in cholera?
|
Death from uremia
|
|
|
What causes metabolic acidosis in cholera?
|
Loss of bicarbonate
|
|
|
What is the best management for cholera?[2]
|
Replacement of ion and fluid loss
Tetracycline |
|
|
What does screening of stools entail when looking for virbro cholerae?
|
Presence of oxidase activity
|
|
|
What is the agar used to diagnose vibro cholerae?
|
Thiosulphate-citrate-bile salts-sucrose
|
|
|
What is the differential agent in TCBS agar?
|
Sucrose
|
|
|
Describe Clostridium perfringes.[4]
|
Gram (+)
Rods Spore forming Anaerobic |
|
|
Why does clostridium perfringes form spores after ingestion?
|
Response to environmental stress
|
|
|
What toxins are produces by clostridium perfringes?[2]
|
C. perfringes enterotoxin (CPE)
Beta-toxin |
|
|
What is the incubation period for Clostridium perfringes?
|
8-24 hrs
|
|
|
What is the duration of disease caused by clostridium perfringes?
|
24 hrs
|
|
|
What are the symptoms of disease causes by Clostridium perfringes?[2]
|
Watery diarrhea
Severe abdominal pain |
|
|
Does Clostridium perfringes cause Fever?
|
No
|
|
|
Does Clostridium perfringes cause Nausea?
|
No
|
|
|
Does Clostridium perfringes cause Vomiting?
|
No
|
|
|
Is disease caused by clostridium perfringes fatal?
|
No
|
|
|
How is Clostridium perfringes diagnosed?[5]
|
Case history
Symptoms Spores in stool Vegetative cells in contaminated food Enterotoxins in stool |
|
|
What are the forms of gastroenteritis that are caused by Bacillus cereus?[2]
|
Emetic
Diarrheal |
|
|
What is the pathogenisis of Bacillus cereus Diarrheal gastroenteritis?
|
LT enterotoxin activates andenylate cyclase
|
|
|
What is the incubation period of Bacilliun cereus?
|
8-16 hrs
|
|
|
What is the duration of disease caused by Becillius cereus?
|
12-24 hrs
|
|
|
What are the symptoms of disease caused by Bacillius cereus?[2]
|
Watery diarrhea
Abdominal pain |
|
|
What are the viral causes of Non-inflammatory diarrhea?[6]
|
Rotavirus
Norovirus Adenovirus Astrovirus Torovirus Hep A&E |
|
|
What family does Rotavirus belong to?
|
Reoviridae (Respiratory Enteric Orphan)
|
|
|
What does "reo" stand for in reoviridae?
|
Respiratory
Enteric Orphan |
|
|
Describe rotavirus.[2]
|
ds RNA
Double layered capsid |
|
|
When do outbreaks of Rotavirus occur in developed countries?
|
Winter
|
|
|
When do outbreaks of Rotavirus occur in developing countries?
|
Year long (predominantly in the summer)
|
|
|
What is the route of transmission for the Rotavirus?
|
Feco-oral
|
|
|
What is the incubation period for Rotavirus?
|
1-3 days
|
|
|
What is the duration of disaease caused by Rotavirus?
|
4-6 days
|
|
|
What causes diarrhea with infection with Rotavirus?
|
Blunting of the villi
|
|
|
What are the symptoms of infection with rotavirus?[2]
|
Watery diarrhea
Vomiting (sometimes) |
|
|
Is there a vaccination for rotavirus?
|
Yes (Rotashield, RotaTeq)
|
|
|
How is rotavirus detected?[4]
|
Virus in the stool:
Latex agglutinations ELISA Electron Microscopy |
|
|
When does the amount of virus in stool peakwith rotavirus?
|
3-4 days of diarrhea
|
|
|
To what virus family does Norwalk virus belong?
|
Colciviridae
|
|
|
Describe Norwalk virus[2]
|
ss(+) RNA
Non-enveloped |
|
|
What season is common for Norwalk outbreaks?
|
Winter
|
|
|
What is the incubation period for Norwalk virus?
|
1-2 days
|
|
|
What is the duration of diesease caused by norwalk virus?
|
1-2 days
|
|
|
What are the symptoms of Norwalk virus infection?[7]
|
Abdominal cramps
Myalgia Malaise Headache Nausea Low grade fever 1-2 days of diarrhea |
|
|
What is the route of tranmission of norwalk virus?[3]
|
Food-borne
Water-borne Horizontal |
|
|
In what setting is there a lot of outbreaks of norwalk virus?
|
Resteraunt
|
|
|
To what viral family does adenovirus belong?
|
Adenoviridae
|
|
|
Describe adenovirus.[2]
|
dsDNA
Icosohedral capsid |
|
|
What does adenovirus infect?[3]
|
Epithelial cells of the pharynx
Conjunctiva Small intestine |
|
|
What are the intestinal symptoms of adenovirus infection?
|
Watery diarrhea
|
|
|
Is there vomiting with infection of adenovirus?
|
No
|
|
|
To what viral family does Astrovirus belong?
|
Astroviridae
|
|
|
Describe Astrovirus.[2]
|
ss(+)RNA
Non-enveloped |
|
|
Where is type 1 astrovirus present?
|
UK
|
|
|
Where is type 2 astrovirus present?
|
Mexico
|
|
|
Where is type 6 astrovirus present?
|
Japan
|
|
|
What are the symptoms for a torovirus infection?[2]
|
Increased bloody diarrhea
Decreased vomitting |
|
|
Who is at risk for infection with torovirus?[3]
|
Immunosupressed
Aged Hospitalized |
|
|
Describe HAV.[3]
|
ss(+)RNA
Nonenveloped Icosahedral |
|
|
What is the route of transmission for HAV?[2]
|
Feco-oral
Horizontal |
|
|
At what point is HAV shed in the stool?
|
10-14 days before onset of symptoms
|
|
|
Describe HEV.[3]
|
ss(+)RNA
Nonenveloped Icosahedral |
|
|
What is the incubation period for HEV?
|
6 weeks
|
|
|
Is Clostridium Defficile associated with Food borne diease?
|
No
|
|
|
What conditions are associated with clostridium defficile?[2]
|
Antibiotic associated diarrhea
Antibiotic associated colitis |
|
|
What are the etiological agents inflammatory diarrhea?[9]
|
Shigella
EIEC Salmonella Campylobacter V. parahaemolyticus V. vulnificus Yersinia EHEC EAEC |
|
|
What is the general pathogenisis of inflammatory diarrhea?[3]
|
Ingestion
Colonization Invasion |
|
|
What organisms cause inflammatory diarrhea without invasion?[2]
|
EHEC
EAEC |
|
|
What are the symptoms of inflammatory diarrhea?[2]
|
Bloody Diarrhea
Fever (sometimes) |
|
|
What are the virulence factors for Shigella?[2]
|
Exotoxin
NAD glycohydrolase |
|
|
What is the action of the shigella exotoxin?[2]
|
Neurotoxin
Causes ulceration |
|
|
What is the action of NAD glycohydrolase? What organism is it associated with?
|
Destroys NAD and shuts down metabolism
Shigella |
|
|
What are the clinical manifestations of Shigellosis?[2]
|
Watery diarrhea
Dysentery |
|
|
What is the route of transmission for shigella?
|
Feco-oral
|
|
|
What is the pathogenisis of shigella?[5]
|
Invasion of the large intestine
Invasion of the cells Multiplication Spread to adjacent cells Cause cell death by apoptosis |
|
|
How long does shigella remain in the stool after symptoms have subsided?
|
30 days
|
|
|
What causes Bacillary dysentary?
|
Shigella dysenteriae
|
|
|
What is the method by which Shigella dysenteriae produces disease?
|
Cytotoxin know as shiga toxin
|
|
|
What is the action of shiga toxin?
From what organism does shiga toxin come from? |
Inhibition of protein synthesis
Shigella dysenteriae |
|
|
What species of shigella is found in young children?
|
Shigella sonnei
|
|
|
In what population is shigella sonnei seen?[2]
|
Chidren under 5
Travellers |
|
|
What shigella species is seen in sexually active gay men?
|
Shigella flexneri
|
|
|
In what population is shigella flexneri seen?
|
Sexually active gay men
|
|
|
What mediums can be used to culture shigella?[2]
|
MacConkey's agar
Salmonella-shigella agar |
|
|
Describe shigella
|
Gran (-) rod
|
|
|
What does EIEC stand for
|
Enteroinvasive E. coli
|
|
|
What are the actions of Shiga toxin?[5]
|
Inhibits protein synthesis
Induces diarrhea Inhibits sugar absorption Inhibits amino acid absorption Neurotoxin |
|
|
To what diseas is EIEC similar and how is it different?
|
Shigellosis
Less severe |
|
|
What are the clinical presentations of salmonellosis?[3]
|
Gastroenteritis
Septicemia Enteric (typhoid) Fever |
|
|
What is the incubation of gastroenteritis caused by Salmonella?
|
8-48 hrs
|
|
|
What is the incubation of Septicemia caused by Salmonella?
|
Variable
|
|
|
What is the incubation of Enteric fever caused by Salmonella?
|
7-20 days
|
|
|
What is the onset of gastroenteritis caused by Salmonella?
|
Abrupt
|
|
|
What is the onset of Septicemia caused by Salmonella?
|
Abrupt
|
|
|
What is the onset of Enteric fever caused by Salmonella?
|
Insidious
|
|
|
What is the fever of gastroenteritis caused by Salmonella?
|
Low
|
|
|
What is the fever of strptacemia caused by Salmonella?
|
Rapid rise
|
|
|
What is the fever of Enteric fever caused by Salmonella?
|
Gradual with a high plateau
|
|
|
What is the duration of gastroenteritis caused by Salmonella?
|
1-4 days
|
|
|
What is the fever of septicemias caused by Salmonella?
|
Variable
|
|
|
What is the fever of enteric fever caused by Salmonella?
|
Several weeks
|
|
|
What are the GI symptoms of gastroenteritis caused by Salmonella?[3]
|
Nausea (at onset)
Diarrhea (at onset) Vomiting (at onset) |
|
|
What are the GI symptoms of septecemia caused by Salmonella?
|
None
|
|
|
What are the GI symptoms of enteric fever caused by Salmonella?
|
Early constipation
|
|
|
What are the Blood cultures of gastroenteritis caused by Salmonella?
|
Negative
|
|
|
What are the Blood cultures of septecemia caused by Salmonella?
|
Positive during the high fever
|
|
|
What are the Blood cultures of Enteric fever caused by Salmonella?
|
Positive during first and second week
|
|
|
What are the stool cultures of gastroenteritis caused by Salmonella?
|
Positive soon after onset
|
|
|
What are the stool cultures of septicemia caused by Salmonella?
|
Infrequently positive
|
|
|
What are the stool cultures of enteric fever caused by Salmonella?
|
Negative initially
Positive from 2nd week on |
|
|
What is the pathogenisis of salmonellosis?[4]
|
Ingested and reach SI
Penetrate SI Multiply in M cells (within peyer's patches) Released into the lamina propria |
|
|
After entering the lamina propria what is the pathogenisis of septecemia and enteric fever caused by salmonella? [3]
|
Enter lymphatics or blood stream
Multiply in the lymphoid tissue Carried to other organs in the blood |
|
|
What is the pathogenisis of enteric fever caused by salmonella after it has reached the blood?[3]
|
Infects gall bladder
Replicates in the bile Flows from the bile and reinfects the SI |
|
|
What species of salmonella cause gastroenteritis?[3]
|
S.typhimurium
S.enteritidis S.Newport |
|
|
What species of salmonella cause septicemia?
|
S. cholerasius
|
|
|
What species of salmonella cause Enteric fever?
|
S. typhi
|
|
|
Describe Campylobacter
|
Gram (-)
|
|
|
What is the #1 food borne disease in western society?
|
Campylobacterosis
|
|
|
What is the pathogenisis of campylobacter?
|
Invasion of the Large intestine
|
|
|
What are the toxins which are produced by campylobacter?[3]
|
Endotoxin
Enterotoxin Verotoxin |
|
|
What is the incubation period campylobacter?
|
3-5 days
|
|
|
What is the duration of disease caused by campylobacter?
|
2-10 days
|
|
|
What are the symptoms a campylobacter infection?[5]
|
Diarrhea(Profuse, sometimes bloody)
Severe abdominal pain Prostration Pyrexia Vomiting(slight) |
|
|
Pyrexia
|
Fever
|
|
|
What is the course of campylobacter infection?
|
Self-limiting
|
|
|
What are complications to campylobacter infection?[2]
|
Arthritis (knee)
Guillian-Barre syndrome |
|
|
Describe Yersinia enterocolytica
|
Gram (-) rod
|
|
|
What is the pathogenisis of Yersinia enterocolytica?[3]
|
Invasion
Inflammation Infects lymph nodes Heat stable enterotoxin |
|
|
What is the mechanism of action for the enterotoxin of Yersinia enterocolytica?
|
Increases cGMP
|
|
|
What is the incubation period for Yersinia enterocolytica?
|
3-7 days
|
|
|
What is the duration of disease caused by Yersinia enterocolytica?
|
2-3 weeks
|
|
|
What are the symptoms of infection with Yersinia enterocolytica?[3]
|
Abdominal pain
Diarrhea Mild fever |
|
|
What are the complications of Yersinia enterocolytica?
|
Post-infective Reactive arthritis
|
|
|
What media must be used to culture Yersinia enterocolytica?
|
MacConkey agar
Yersinia media |
|
|
What is the #1 cause for food borne infection in Japan?
|
V. parahaemolyticus
|
|
|
What is the pathogenisis of V. parahaemolyticus?[3]
|
Ingested from seafood
Invades gut Reaches lamina propria |
|
|
What are the symptoms of V.parahaemolyticus?[3]
|
Watery diarrhea
Abdominal pain Vomiting |
|
|
What is the treatment for V. parahaemolyticus?
|
Tetracycline
|
|
|
What does EAEC stand for?
|
Enteroaggregative E. coli
|
|
|
What is the pathogenisis of EAEC?[5]
|
Ingested
Attach to gut wall using fimbriae Produce mucus Biofilm with EAEC Cytotoxin production |
|
|
What does EHEC stand for?
|
Enterohemorrhagic E. coli
|
|
|
What are conditions that are caused by EHEC?[3]
|
Hemorrhagic colitis
Hemolytic uremic syndrome Thrombotic Thrombocytopenia pupra |
|
|
What are the symptoms of Hemorrhagic colitis?[2]
|
Bloody diarrhea
Abdominal cramps |
|
|
What is the incubation period for Hemorrhagic colitis?
|
3-8 days
|
|
|
What are the symptoms of Hemolytic uremic syndrome?[4]
|
Bloody diarrhea
Acute renal failure Thrombocytopenia Microangiopathic hemolytic anemia |
|
|
What is the difference between Hemolytic Uremic Syndrome and Thrombotic Thrombocytopenia Purpura?
|
Thrombotic Thrombocytopenia Pupura has neurological symptoms associated with it
|
|
|
What is the pathogenisis of EHEC?[3]
|
Attachment to epithelial cells of LI
Release of verotoxin Verotoxin has toxic affects on the GIT and kidney |
|
|
What is the mechanism of Verotoxin? and what organism is it associated with?
|
AB toxin which inhibits protein synthesis in the gut epthithelial cells (HC) and in the glomuleral cells (HUS)
EHEC |
|
|
Why is E. coli difficult to determine as the pathogenic agent?
|
E.coli is part of the normal gut flora
|
|
|
What is the function of Toxin A from Clostridium defficile?
|
Fluid accumulation in the bowel
|
|
|
What is the function of Toxin B for clostridium defficile?
|
Decreases cell protein synthesis and disrupts cell microfillament system
|
|
|
Describe heliobacter pylori?[2]
|
Gram (-)
Non spore forming |
|
|
What conditions are associated with H. pylori?[3]
|
Stomach ulcers
Duodenal ulcers Stomach cancer |
|
|
How is H. pylori able to survive in the low pH of the stomach?
|
Urease activity results in ammonia formation and an increase in the pH
|
