Deck 22: Infectious Diseases Affecting the Gastrointestinal Tract

Question 1

Food moves down the GI tract through the action of

A) cilia.
B) peristalsis.
C) gravity.
D) microorganisms.

Answer 1

Food is moved down the GI tract through the action of peristalsis ( b ). Peristalsis is the muscular contractions of the smooth muscle through the digestive tract which causes the food to move to the stomach.
Cilia line the other parts of the body; however they do not play a role in moving food through the GI tract. For this reason, ( a ) is incorrect.
Gravity plays a role in moving food down the tract; however it is not enough to move the food all the way through the tract. To help gravity, the smooth muscles contract through peristalsis, for this reason, ( c ) is incorrect.
Microorganisms do not play a role in moving food through the tract. Although microorganisms do help with digestion, they do not work physically to transport the food; therefore ( d ) is incorrect.

Question 2

The patient further reports that he has been fully vaccinated against hepatitis as a requirement for his employment and has had no needlestick injuries.
Knowing that the patient has been vaccinated, what hepatitis-causing virus can be eliminated as a cause of this patient's hepatitis

Answer 2

Say you are a clinician and a patient comes in that has hepatitis. He received full vaccination for hepatitis due to work requirements. He also does not have any injuries consistent with using needles. Type C comes from needles or blood contact. Type A and B are well covered with well covered with vaccines. Since A and B are easy to vaccinate, most likely the patient has C. Type C has no vaccination. Blood was shared in a method other than with a needle.

Question 3

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
Regarding food safety,
a. Explain whether there is a greater risk for E. coli O157:H7 infection when consuming a hamburger compared to consuming a steak.
b. Discuss whether or not food poisoning can still occur after consuming a reheated pot of soup known to be contaminated with Staphylococcus aureus.
c. Summarize the microbial risks associated with consuming raw seafood or shellfish today.

Answer 3

Consider food safety.
(a)When cooking food, the safety guidelines give an optimum temperature for the center of a meat product because that means the entire piece has essential killed microbes through heat. A hamburger is generally thin and cooked on a high temperature grill surface at most restaurants.
This means that the optimum internal temperature is easier to achieve. A steak on the other hand is thicker and is offered in varied grades of cooked from rare to well done. Any steak with any purposely left pink is potentially contaminated because the center has not been cooked to a safe level. Therefore a steak would carry a higher risk of contamination than a hamburger.
(b)Take a pot of soup that is contaminated with bacteria. If the pot is reheated it may kill the bacteria but it depends on how well it is reheated. How many times do you reheat something from your refrigerator and the center is still cold? Food poisoning is still possible as long as any part of the food does not reach an appropriate temperature to kill all bacteria for a minimum duration.

Question 4

Diagram the life cycle of Schistosoma mansoni and S. japonicum, and describe the importance of these organisms in world health.

Question 5

Draw or describe the anatomical features of the gastrointestinal tract.

Question 6

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
a. In May of 2010, the CDC began to notice a sudden increase in the number of salmonellosis cases reported that month. That trend continued until July 2010, when the number of cases began to slowly decline. Explain what type of epidemic these data represent, and why the number of cases finally went down after 3 months.
b. The above cases turned out to be linked to Salmonella contamination found at egg-producing facilities inIowa. Nearly 2,000 people became ill in multiple states. Explain how proper cooking of the eggs involved in thisoutbreak did not ensure elimination of the food-bornepathogen.

Question 7

This hepatitis virus is an enveloped DNA virus.

A) hepatitis A virus
B) hepatitis B virus
C) hepatitis C virus
D) hepatitis E virus

Question 8

From chapter 13, figure 13.6 b. Imagine for a minute that the organism in this illustration is E. coli O157:H7. What would be one reason to not treat a patient having this infection with powerful antibiotics
Figure 13.6 b: The origins and effects of circulating exotoxins and endotoxin. (b) Endotoxin, given off when the cell wall of gram-negative bacteria disintegrates, has more generalized physiological effects.

Question 9

Which of these microorganisms is considered the most common cause of diarrhea (not just food-borne) in the United States

A) E. coli
B) Salmonella
C) Campylobacter
D) Shigella

Question 10

Identify three causative agents for chronic diarrhea.

Question 11

You have recently finished your nursing degree and are working at a health care clinic. A patient presents with symptoms of hepatitis. He also reports that he is a health care worker.
As a clinician, what is your first assumption about the source of the infection

Question 12

List the possible causative agents for the following infectious gastrointestinal conditions: dental caries, periodontal diseases, mumps, and gastric ulcers.

Question 13

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
One hundred individuals present to a health care clinic complaining of gastrointestinal distress. As the head triage physician, please detail all steps you will take to definitively determine what disease the patients are suffering from and to identify the source of the apparent outbreak.

Question 14

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
List the microorganisms involved in tooth decay and discuss the sequence of events leading to the development of periodontitis.

Question 15

The patient further reports that he has been fully vaccinated against hepatitis as a requirement for his employment and has had no needlestick injuries.
What is the potential source of infection

Question 16

In which helminth life cycle is a grazing animal involved

A) A
B) B
C) C
D) D

Question 17

The microorganism(s) most associated with acute necrotizing ulcerative periodontitis (ANUP) is (are)

A) Treponema vincentii.
B) Prevotella intermedia.
C) Fusobacterium.
D) all of the above.

Question 18

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
a. An outbreak of cholera occurred in Haiti following a devastating earthquake in 2010. Based upon your knowledge of the bacterium involved, discuss the factors that may have allowed for the outbreak to develop within this country.
b. Explain why many recreational water parks have chosen to use ultraviolet light filtration systems to effectively treat their water supply.

Question 19

Differentiate among the main types of hepatitis and discuss causative agents, modes of transmission, diagnostic techniques, prevention, and treatment of each.

Question 20

List the natural defenses present in the gastrointestinal tract.

Question 21

Which of these microorganisms is associated with Guillain-Barré syndrome

A) E. coli
B) Salmonella
C) Campylobacter
D) Shigella

Question 22

Describe some distinguishing characteristics and commonalities seen in helminthic infections.

Question 23

From chapter 12, figure 12.15. Assume that the growth on the first plate represents normal intestinal microbiota. How could you use these illustrations to explain the development of C. difficile -associated colitis

Figure 12.15: The role of antimicrobials in disrupting microbial biota and causing superinfections. (a) A primary infection in the throat is treated with an oral antibiotic. (b) The drug is carried to the intestine and is absorbed into the circulation. (c) The primary infection is cured, but drug-resistant pathogens have survived and create an intestinal superinfection.

Question 24

Name eight bacterial and three nonbacterial causes of acute diarrhea, and identify the most common cause of food-borne illness in the United States.

Question 25

If the statement is true, leave as is. If it is false, correct it by rewriting the sentence.
Mumps is a disease that affects humans and several other species.

Question 26

You have recently finished your nursing degree and are working at a health care clinic. A patient presents with symptoms of hepatitis. He also reports that he is a health care worker.
What virus(es) is (are) potentially involved through this source

Question 27

The patient further reports that he has been fully vaccinated against hepatitis as a requirement for his employment and has had no needlestick injuries.
What treatments, if any, are available

Question 28

List four helminths that cause primarily intestinal symptoms, and identify which life cycle each follows and one unique fact about each helminth.

Question 29

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
Provide evidence in support of or refuting the following statement: Blood type can help predict your risk of developing ulcers.

Question 30

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
Create a chart comparing the modes of transmission and means of prevention for all types of hepatitis viruses.

Question 31

If the statement is true, leave as is. If it is false, correct it by rewriting the sentence.
Giardia lamblia is a water-borne, flagellated protozoan often associated with chronic diarrhea.

Question 32

Gastric ulcers are caused by

A) Treponema vincentii.
B) Prevotella intermedia.
C) Helicobacter pylori.
D) all of the above.

Question 33

This microorganism is commonly associated with fried rice and produces an emetic (vomiting) toxin.
a. Bacillus cereus
b. Clostridium perfringens
c. Shigella
d. Staphylococcus aureus

Question 34

List three helminths that cause intestinal symptoms that may be accompanied by migratory symptoms, identifying which life cycle each follows and one unique fact about each helminth.

Question 35

List the types of normal biota presently known to occupy the various regions of the gastrointestinal tract.

Question 36

Name one distinct feature for each of the acute diarrhea pathogens.

Question 37

If the statement is true, leave as is. If it is false, correct it by rewriting the sentence.
Pseudomembranous colitis (or antibiotic-associated colitis) is caused by Clostridium difficile.

Question 38

You have recently finished your nursing degree and are working at a health care clinic. A patient presents with symptoms of hepatitis. He also reports that he is a health care worker.
What are the general symptoms of hepatitis

Question 39

You have recently finished your nursing degree and are working at a health care clinic. A patient presents with symptoms of hepatitis. He also reports that he is a health care worker.
What treatments, if any, are available

Question 40

The patient further reports that he has been fully vaccinated against hepatitis as a requirement for his employment and has had no needlestick injuries.
What other vaccination might you recommend to this patient

Question 41

List the modes of transmission for each of the helminthic infections resulting in liver and intestinal symptoms. These are infections caused by Opisthorchis sinensis, Clonorchis sinensis, and Fasciola hepatica.

Question 42

Multistate Listeria Outbreak Tied to Cantaloupe
In September 2011, reports began to emerge of a food-borne outbreak of listeriosis. The initial CDC investigation found a number of cases in Colorado, Nebraska, Oklahoma, and Texas. By the time the outbreak was over in December 2011, it had stretched to 147 people in 28 states with 33 deaths and 1 miscarriage all tied to a single source: cantaloupe. Colorado was found to have the highest incidence of disease, with 40 cases and 9 deaths documented. Epidemiologists discovered why: Colorado was the home of Jensen Farms, the farm supplying the contaminated cantaloupes.
Shortly after the outbreak began, Jensen Farms voluntarily recalled shipments of cantaloupe. The FDA issued a press release warning consumers not to consume cantaloupes with the "Rocky Ford" label that Jensen Farms had sent to 17 states. After the FDA warning, several other companies issued recalls of products containing fresh-cut cantaloupes originating from Jensen Farms.
What are the signs and symptoms of listeriosis
Who is at greatest risk of infection with Listeria
Why was this an unusual outbreak of listeriosis
Listeria monocytogenes is a gram-positive rod and is primarily spread through contaminated food. Symptoms of listeriosis are generally muscle aches, fever, diarrhea, and other gastrointestinal symptoms. Depending on the individual and the invasiveness of the organism, symptoms can include headache, stiff neck, loss of balance, confusion, and convulsions. Pregnant women can experience mild flulike symptoms, but because the organism can cross the placenta, an infection during pregnancy can cause miscarriage, premature delivery, life-threatening infection of the newborn, or stillbirth. Those at greatest risk for serious illness with listeriosis are pregnant women; newborns; people with cancer, diabetes, liver disease, kidney disease, or alcoholism; older adults; and people with AIDS or others who have weakened immune systems due to organ transplants and certain diseases.

Usually, outbreaks of Listeria infection are associated with processed dairy or deli meats such as soft cheeses, hot dogs, and smoked seafood. Any unpasteurized milk or cheese is likely to be contaminated with Listeria. The bacterium can grow at refrigerator temperatures, which is why cheeses and processed meats can be the source of the pathogen. There have been numerous outbreaks associated with cheeses produced in the home such as "queso fresco" or locally produced cheeses sold in farmers' markets. This outbreak was the first outbreak in history associated with cantaloupe. Listeriosis is interesting because it is an unusual food-borne pathogen that causes its main symptoms outside of the gastrointestinal system. For that reason, the disease is covered in chapter 19, "Infectious Diseases Affecting the Nervous System." The case in this chapter will help you remember that listeriosis is a food-borne disease.
How did the CDC trace so many widespread cases to Jensen Farms
What could have been done to prevent the outbreak

Question 43

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.

A) Summarize the characteristics that differentiate food poisoning from other gastrointestinal diseases.
B) Conduct additional research and discuss at least two new methods for detecting or eliminating microbial contaminants in the global food supply today.

Question 44

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
a. Describe the methods used to definitively diagnose helminthic infections in humans.
b. Explain why antihelminthic drugs are so difficult to develop, and list at least three therapeutic targets of successful drugs used today.

Question 45

If the statement is true, leave as is. If it is false, correct it by rewriting the sentence.
Poor oral health has been associated with heart disease.

Question 46

Appendix D provides guidance for working with concept maps.
Using the words that follow, please create a concept map illustrating the relationships among these key terms from chapter 22.
exotoxins
shiga toxin
Shigella
E. coli
STEC
bacteriophage
transduction
protein synthesis
EIEC
EAEC

Question 47

Virus family Paramyxoviridae contains viruses that cause which of the following diseases

A) measles
B) mumps
C) influenza
D) both a and b
E) both b and c

Question 48

This endospore former contaminates meats as well as vegetables and is also the causative agent of gas gangrene.

A) Bacillus cereus
B) Clostridium perfringens
C) Shigella
D) Staphylococcus aureus

Question 49

Describe the type of disease caused by Trichinella species.

Question 50

Critical thinking is the ability to reason and solve problems using facts and concepts. These questions can be approached from a number of angles and, in most cases, they do not have a single correct answer.
a. Summarize the current knowledge of normal biota in the human mouth. To what domain of life do most of these microorganisms belong
b. Explain why many patients undergoing dental surgery are placed on antibiotic therapy before the procedure.

Question 51

Summarize the known functions of the gastrointestinal microbiota and the role they may play in disease development.

Question 52

Differentiate between food poisoning and food-borne infection.

Question 53

If the statement is true, leave as is. If it is false, correct it by rewriting the sentence.
Enterobius vermicularis, commonly known as the pinworm, is a common cause of anal itching in young children in the United States.