5.2.2

Perforated visous
mixed intestinal fora
presents as acute abdomen
diagnosed clinically
tx is surgical & antibiodics

Perforation and localization: appendix, diverticulae, biliary tract, pancreas, surgery
Sites: rlq, llq, or other
Mixed intestinal flora especially anaerobes
Manifestations: fever, chills, night sweats, localized abd. pain (may be mild), symptoms may be masked in seriously ill Pt's.

Organisms that will not grow in the presence of oxygen

______ are normal flora that invade with trama and reduced blood flow (trauma allows infection).
They are usually not transmitted person to person, and infections usually occur and progress slowly.

Name the type of infection based on the following.
Insidious onset of dz
cantiguous to mucosal surfaces
foul smell (about half the time)
severe tissue necrosis
gas in tissue
gram stain appearance of multiple organisms

____ causes 95% of peptic ulcers, most people are exposed to it in childhood, and most importantly has strong urease activity, which help protect it in the gastric envorinment and plays a role in how it invades and causes dz.
It also causes 50-70% of gastric uclers and has a possible association with dyspepsia and gastric carcinoma.

What is a very common illness (although consequences are minor in US), is the most common cause of death word-wide; and what causes the acute manifestations of this illness?

What type of pathogenic mechanism is associated with n/v, large volume-water diarrhea?

What pathogenic mechanism is associated with tenesmus, fever, pain, bloody small volume diarrhea?

What pathogenic mechanism is assocaited with n/v and abdominal pain soon after ingestion?

What are 3 important things to think of when evaluating the severity of diarrhea?

What clues help you determine the likely pathogen?

Name 5 important culture parameters for stool samples.

What are the 3 most common things to look for in a stool culture?

What would you look for in a stool culture with:
a) bloody stool sample
b) like appendicitis
c) recent use of antibiotics
d) recent exposure to shellfish/water

With what pathogens would you
a) perform a toxin assay?

b) What about a antigen assay?

c) What about an acid fast or antigen detection?

Inhabitants of lower GI
Survive readily in nature
increased colonization of these organisms in hospitalized Pt's

Over whelming number of serotypes -- outbreaks are due to new serotype in a community.
Normal flora of reptiles, and birds (also found in humans, livestock, mammals and snakes)
Gastroenteritis related to improper food handling (poultry and eggs are a common vector)
highest incidence in children less than 5 and adults older than 70.
Peak incedence in summer and infection requires a high inoculum

Name the pathogen:
Invasive -- invades mucoas and peyer's patches and then enters blood circulation
Can be found in blood culture (the only cause of diarrhea with this characteristic)
Antacids make one more usceptible to infections
Sx begin 24-48 hrs afer ingestion of contimanated food or water.
n/v, cramping, large volume diarrhea
Resolves spontaneously in 3-4 days
Fever in 50%

Similar to E coli
non-lactose fermenter
4 species -- name the most severe
NOT NORMAL FLORA EVER
Transmitted via feces, fingers, food flies
Only 200 organsims can cause dz
High rates of secondary attacks
Mostly a ped. dz in US (day-care centers)

Pt comes in with abdominal cramps, tenesmus, fever and bloody, mucoid small volume stools. The pathogen is known to destroy the villi and epithelial cells on the surface of large intestine mucosa -- what is it?

What effect does Bismuth Subsalicylate have on the tongue and stools?

On what receptor is loperamide thought to act? Why isn't it associated with sedation, respiratory depression or euphoria?