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Flashcards in Green PANCE book Deck (76)
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1

How is norovirus spread?

Food
water
person to person

2

Onset 1-3 days
Watery diarrhea
Low grade fever
Duration= 1-2 days

Therapy= hydration! and prevention (hand washing)

Norovirus

3

How is cholera (vibrio spp.) spread?

Water

4

Onset 2-3 days
Profuse, watery diarrhea
Some N/V
Rarely a fever
Duration= days!

Therapy= hydration!

Cholera (vibrio spp.)

5

What is the source of enterotoxic E. coli

Food

6

Onset 5-15 days
Cramping, watery diarrhea
Some N/V
Low grade fever
Duration= 1-5 days

Therapy= hydration, bismuth/loperamide

Enterotoxic E. Coli

7

What is the source of Salmonella?

Poultry

8

Onset 6-72 hours
Purulent diarrhea
Nausea, some vomiting
FEVER! Septicemia
Duration= 4-7 days

Therapy= hydration!

Salmonella

9

What is the source of Enterohemorrhagic E. coli?

Undercooked ground beef

10

Onset 12-60 hours
Purulent, bloody diarrhea. cramping
No N/V
Fever
Duration= 5-10 days

Therapy= supportive, unless severe

Enterohemorrhagic E. Coli

11

What is the source of Shigella?

Fecal-oral

12

Onset 1-6 days
Purulent, bloody diarrhea. cramping
No N/V
Fever
Duration= 1-7 days

Therapy= supportive

Shigella

13

systemic immune response occurring 15-20 days after exposure to streptococcal pharyngitis

*early tx of streptococcal infection is imperative to prevent!

Acute rheumatic fever

14

A strictly anaerobic, spore forming bacillus found in the soil
*may accidentally end up in food (home canned, smoked or commercial)

Clostridium botulinum

15

Inhibits the release of Ach at the neuromuscular junction

*IV drug users at high risk!
*babies who eat honey are at high risk!

Botulism

16

Initial clinical sx= visual changes, including diplopia and loss of accommodation
*manifestation usually 12-36 H after ingestion

Additional sxs...ptosis, impaired EOM, fixed dilated pupils, cranial nerve palsies, dysphonia, dry mouth, dysphagia, N/V

Botulism

17

Tx of botulism?

Anti toxin

(and respiratory support if needed)

18

Produces a toxin than activates adenylyl cyclase in intestinal epithelia cells of the small intestine..results in hyper secretion of water and Cl ion and massive diarrhea

*death results from HYPOvolemia

Cholera

19

"rice water" diarrhea (gray, turbid and without odor, blood or pus"

Cholera

(stool cultures positive for Vibrio cholerae)

20

Tx of cholera

Fluid and electrolyte replacement

Oral if tolerated, IV if severe
*Abx will shorten duration and reduce severity of symptoms (tetracycline, ampicillin, etc)

21

Is a cholera vaccine available?

Yes! but protection is temporary, with boosters needed every 6 months

22

Clostridium tetani spores are found in...

soil

23

Spores germinate in wounds (esp puncture wounds!!) where the bacteria produce a neurotoxin, which interferes with neurotransmission at spinal synapses of inhibitory neurons

*result=uncontrolled spasm and exaggerated reflexes

Tetanus

(incubation pd= 5 days to 15 weeks)

24

Pain and tingling at site of inoculation, followed by spasticity of muscles nearby
**jaw and neck stiffness, dysphagia, irritability
*hyerperreflexia and muscle spasms, especially in jaw (truisms) and face

Tetanus

25

Painful tonic convulsions, spasms of the glottis and respiratory muscles and asphyxia if pts is untreated

Tetanus

26

Treatment for tetanus?

Tetanus immune globulin given intramuscularly (IM)

Full course of tetanus toxoid once pt recovers

27

Salmonella enteric are transmitted by ingestion of contaminated....

food and water

28

Enteric fever (typhoid fever)
Gastroenteritis
Bacteremia

3 patterns of Salmonellosis

29

incubation pd 5-14 days
*organisms enter mucosal epithelium of the intestine and invade and replicate within macrophages in Peyer patches, mesenteric lymph nodes and the spleen

Enteric (typhoid) fever

30

Onset insidious with a prodrome of malaise, HA, cough and sore throat
*abdominal pain, distention and constipation and/or diarrhea ("pea soup") develops as fever increases

*fever reaches peak on 7-10 days and the pt appears toxic, then generally improves over the next 7-10 days

Typhoid fever