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Name three things that can cause esophagitis?
Candida, CMV, HSV.
What are three non-invasive tests to diagnose H. pylori?
Urea breath test, serology, stool antigen test.
What are three invasive tests to diagnose H. pylori?
Endoscopic: Culture, histology, biopsy urease test.
What is the first line treatment for H. pylori?
- Two antibiotics: Metronidazole, clarythromycin
- One PPI: Omeprazole.
What is the measured fecal osmolality in osmotic diarrhea?
Less than 2.
What does STEC stand for?
Shiga-toxin producing E. coli - (0157:H7).
What is an unusual feature of E. coli 0157:H7, what medium is used to culture?
- Does not ferment sorbitol
- Sorbitol-MacConkey medium (SMAC): clear colonies are 0157.
What are some characteristics of Salmonella?
Gram negative, flagellated, non-encapsulated, facultative anaerobic bacillus.
Where is salmonella typhi found, where does it multiply in the body, what are some risk factors?
- Poor sanitation areas
- Mononuclear phagocytic cells
- HIV, decreased gastric pH.
What are the four most common symptoms of typhoid?
- Fever, weakness, anorexia, headache
- Less common: abdominal pain, diarrhea, constipation.
What are some characteristics of Shigella dysenteriae?
- Gram-negative, rod shaped
- fecal-oral transmission
- greatest reservoir is humans
- affects mostly age 1-5
- invades host cells.
What is a complication of shigellosis?
HUS: Hemolytic-uremic syndrome.
What do campylobacter bacteria look like?
Motile and curves S-shape, or spiral rod.
What are some clinical features of Yersinia enterocolitica?
- fever, diarrhea, abdominal pain (RLQ)
- Rectal bleeding, ileum perforation
- Reactive polyarthritis
- Erythema nodosum
- Exudative pharyngitis.
What are three characteristics of Yersinia enterocolitica?
Gram negative, Non-lactose fermenter (NLF), bacilli.
What is the most common health-care associated diarrhea?
What are three characteristics of C. difficile?
- Gram + bacilli
- Spore Forming.
What are the three reserviors for C. difficile?
Soil, environment, colonized people.
When does C. difficile infection usually occur?
After course of broad-spectrum antibiotics (killing normal intestinal flora).
What is a characteristic of its pathogenesis?
Forms a pseudomembrane on the colon (pseudomembranous colitis - PMD).
What is one severe complication of CDAD (C. difficile Associated Disease)?
What are four diagnostic methods for C. difficile?
- Cytotoxin assay
- Immunoassay (ELISA) for toxin
- Stool culture
What are the two toxins released by C. difficile?
- Toxin A: enterotoxin, causes tissue damage, fluid secretion, inflammation (not necessary for virulence)
- Cytotoxin B: 1000x more potent than A, activate release of cytotoxins from monocytes.
What are some characteristics of CMV?
- Largest genome of all herpes viruses (betaherpesvirus)
- most cases sub-clinical.
What are some clinical features of CMV infection?
- Mononucleosis-type syndrome
- Interstitial pneumonia
What stain is used to visualize Cryptosporidium?
Modified Kinyoun acid-fast stain -- red sphere.
What are some clinical manifestations of Cryptosporidia infection?
- Voluminous, watery diarrhea - without blood or leukocytes -- associated with cramps, fatigue, anorexia
- Can be fulminant and rapidly fatal in HIV or immunocompromised patients.
What can infect that is found in raspberries?
What stain is used to visualize cyclospora?
- Acid Fast
- Should be done several times - low excretion.
What is a characteristic of Microsopidiosis?
Caused by 6 different genera of obligate intracellular, monocellular parasites.
What stain is used in the stool examination to diagnose microsopidiosis?
Weber's chromatrope-based stain.
Name two liver flukes?
How do you diagnose liver flukes?
- Ultrasound of liver
- Examination of stools for eggs.
In who do most cases of spontaneous bacterial peritonitis present?
Patients with ascites from chronic liver disease.