Nurs 5461 Gastroenteritis Exam Questions and Correct
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Noncholera Vibrio spp. poresentation - ANSWER-Symptoms begin 2-48 hours after ingestion
[parahaemolyticus] or 1-7 days after ingestion [vulnificus] Patient will have belly cramps with watery
diarrhea; the majority will have fever, chills and headache and 25 percent will have vomiting Bacteremia
can occur in the immune suppressed Pathogen can be diagnosed with a stool culture or emesis
sample—but you have to tell the lab to check
Antimicrobial therapy is suggested for severe disease - ANSWER-- Doxycycline 100 mg BID for 5-7 days -
Cipro 500 mg BID or Levaquin 500-750 mg daily or Avelox 400 mg daily for 3 days - In the hospitalized
patient, treat for 10-14 days with— Fortaz [Ceftazidime] 2 grams IV q 8° or Rocephin 2 grams IV q 12° +
Doxy 100 mg IV q 12° or Minocycline 100 mg IV q 12°
Yersinia spp. - ANSWER-gram negative rods Only Yersinia enterocolitica and Yersinia pseudotuberculosis
are associated with gastroenteritis Infective dose is 10 to 4th cells Pigs are the primary reservoir;
humans can be carriers for several months after infection Raw or undercooked pork, oysters, fish,
unpasteurized milk, cheese and ice cream Organism can live at 4° C—refrigerated meats can be a source
Y. Presentation - ANSWER-⚫ Symptoms present within 24-48° after ingestion ⚫ Presents as an
appendicitis like illness—diarrhea, vomiting, fever and belly pain - Y. enterocolitica can cause reactive
arthritis in 2-3% - Bacteremia can occur in the immune suppressed ⚫ Can be detected in stool or emesis
or in blood— but you have to specifically have to request it ⚫
Antimicrobials recommended for severe disease - ANSWER-Antimicrobial therapies include
aminoglycosides, cephalosporins, Doxycycline and/or Cipro Tetracycline 250-500 mg every 6 hours or
Cipro 500 mg BID for 7-10 days Gent or Tobramycin 3-5 mg/kg/day IV every 8 hours for 7-10 days
Clostridium perfringens - ANSWER-⚫ Anerobic Gram positive spore forming rods that are ubiquitous in
the environment—soil, sediments, any area subject to human or animal fecal materials ⚫ Infective dose
is 108 cells ⚫ Disease is from toxins excreted by the bacteria—rather than infection ⚫ 2 nd cause of FBD
in the US
presentation - ANSWER-Patient presents with watery diarrhea, cramping, and nausea [fever is rare] 8-22
hours after ingestion
, ⚫ Disease is usually mild, and usually resolves in 24-48° ⚫ Diagnosed mainly by clinical presentation,
but toxin can be detected in stool samples— quantitative analysis should be asked for ⚫ Food can be
cultured ⚫ Antimicrobial therapy is usually not indicated—for severe cases, ampicillin,amoxicillin,
metronidazole or erythromycin can be used
Clostridium botulinum - ANSWER-Found in soil, and in anaerobic conditions, this rod shaped bacteria
will form spores that let them live dormant until they are exposed to a condition that allows them to
grow Produces neurotoxins—in the human, neurotoxins A, B and E cause disease Infective disease is
several nanograms Unsafe home canning of vegetables is the usual source
C.B - ANSWER-⚫ Can occur anywhere—but in the US, 27% of all cases occur in Alaska ⚫ Rate of
mortality is near 5% ⚫ In addition to home canned foods that have been prepared in an unsafe manner;
can also be seen in infants under the age of 1—from eating honey ⚫ Symptoms occur within 12-72
hours after ingestion, but may occur as late as 10 days after ingestion
C.B presentation - ANSWER-⚫ Patient presents with weakness, diplopia, dysarthria, dysphagia,
symmetric descending flaccid paralysis in the absence of sensory changes ⚫ If the symptoms of paralysis
are not treated—they can be permanent ⚫ Serum, stool, gastric fluids, emesis or food can be used to
detect botulism neurotoxins—testing should be done to rule out botulism ⚫ Category A bioterrorism
agent—and is nationally reportable
C.B RX - ANSWER-⚫ If treated early, equine antitoxin will prevent worsening of the disease - Antitoxin
can be obtained from the CDC
⚫ Induced vomiting, gastric lavage, rapid
purgation or high enema can remove
contaminated food from the gut
Bacillus cereus - ANSWER-Gram positive aerobic spore forming rods Infective dose is 10 to 6 organisms
Potential vectors are meats, milk, vegetables, fish, rice products and other starchy foods It can occur in
grains and beans—this is the food category pair most responsible for Bacillus cereus It is heat resistant
and can survive cooking
⚫ Presentation - ANSWER-is similar to that of Clostridium perfringens—watery diarrhea, abdominal
pain, nausea ⚫ Onset is 6-16° after ingestion; symptoms usually resolve within 24-48° ⚫ Presentation is
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Noncholera Vibrio spp. poresentation - ANSWER-Symptoms begin 2-48 hours after ingestion
[parahaemolyticus] or 1-7 days after ingestion [vulnificus] Patient will have belly cramps with watery
diarrhea; the majority will have fever, chills and headache and 25 percent will have vomiting Bacteremia
can occur in the immune suppressed Pathogen can be diagnosed with a stool culture or emesis
sample—but you have to tell the lab to check
Antimicrobial therapy is suggested for severe disease - ANSWER-- Doxycycline 100 mg BID for 5-7 days -
Cipro 500 mg BID or Levaquin 500-750 mg daily or Avelox 400 mg daily for 3 days - In the hospitalized
patient, treat for 10-14 days with— Fortaz [Ceftazidime] 2 grams IV q 8° or Rocephin 2 grams IV q 12° +
Doxy 100 mg IV q 12° or Minocycline 100 mg IV q 12°
Yersinia spp. - ANSWER-gram negative rods Only Yersinia enterocolitica and Yersinia pseudotuberculosis
are associated with gastroenteritis Infective dose is 10 to 4th cells Pigs are the primary reservoir;
humans can be carriers for several months after infection Raw or undercooked pork, oysters, fish,
unpasteurized milk, cheese and ice cream Organism can live at 4° C—refrigerated meats can be a source
Y. Presentation - ANSWER-⚫ Symptoms present within 24-48° after ingestion ⚫ Presents as an
appendicitis like illness—diarrhea, vomiting, fever and belly pain - Y. enterocolitica can cause reactive
arthritis in 2-3% - Bacteremia can occur in the immune suppressed ⚫ Can be detected in stool or emesis
or in blood— but you have to specifically have to request it ⚫
Antimicrobials recommended for severe disease - ANSWER-Antimicrobial therapies include
aminoglycosides, cephalosporins, Doxycycline and/or Cipro Tetracycline 250-500 mg every 6 hours or
Cipro 500 mg BID for 7-10 days Gent or Tobramycin 3-5 mg/kg/day IV every 8 hours for 7-10 days
Clostridium perfringens - ANSWER-⚫ Anerobic Gram positive spore forming rods that are ubiquitous in
the environment—soil, sediments, any area subject to human or animal fecal materials ⚫ Infective dose
is 108 cells ⚫ Disease is from toxins excreted by the bacteria—rather than infection ⚫ 2 nd cause of FBD
in the US
presentation - ANSWER-Patient presents with watery diarrhea, cramping, and nausea [fever is rare] 8-22
hours after ingestion
, ⚫ Disease is usually mild, and usually resolves in 24-48° ⚫ Diagnosed mainly by clinical presentation,
but toxin can be detected in stool samples— quantitative analysis should be asked for ⚫ Food can be
cultured ⚫ Antimicrobial therapy is usually not indicated—for severe cases, ampicillin,amoxicillin,
metronidazole or erythromycin can be used
Clostridium botulinum - ANSWER-Found in soil, and in anaerobic conditions, this rod shaped bacteria
will form spores that let them live dormant until they are exposed to a condition that allows them to
grow Produces neurotoxins—in the human, neurotoxins A, B and E cause disease Infective disease is
several nanograms Unsafe home canning of vegetables is the usual source
C.B - ANSWER-⚫ Can occur anywhere—but in the US, 27% of all cases occur in Alaska ⚫ Rate of
mortality is near 5% ⚫ In addition to home canned foods that have been prepared in an unsafe manner;
can also be seen in infants under the age of 1—from eating honey ⚫ Symptoms occur within 12-72
hours after ingestion, but may occur as late as 10 days after ingestion
C.B presentation - ANSWER-⚫ Patient presents with weakness, diplopia, dysarthria, dysphagia,
symmetric descending flaccid paralysis in the absence of sensory changes ⚫ If the symptoms of paralysis
are not treated—they can be permanent ⚫ Serum, stool, gastric fluids, emesis or food can be used to
detect botulism neurotoxins—testing should be done to rule out botulism ⚫ Category A bioterrorism
agent—and is nationally reportable
C.B RX - ANSWER-⚫ If treated early, equine antitoxin will prevent worsening of the disease - Antitoxin
can be obtained from the CDC
⚫ Induced vomiting, gastric lavage, rapid
purgation or high enema can remove
contaminated food from the gut
Bacillus cereus - ANSWER-Gram positive aerobic spore forming rods Infective dose is 10 to 6 organisms
Potential vectors are meats, milk, vegetables, fish, rice products and other starchy foods It can occur in
grains and beans—this is the food category pair most responsible for Bacillus cereus It is heat resistant
and can survive cooking
⚫ Presentation - ANSWER-is similar to that of Clostridium perfringens—watery diarrhea, abdominal
pain, nausea ⚫ Onset is 6-16° after ingestion; symptoms usually resolve within 24-48° ⚫ Presentation is
