MGRADES EXAMS
Nurs 5461 Gastroenteritis UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Gastroenteritis - CORRECT ANSWER - caused by bacterial food toxins in food- "food
poisoning" In healthy adults—the s/sx usually self-limited CDC says that 1 in 6 Americans
affected q yr.
Can be acute or chronic (food allergy)
The most common players - CORRECT ANSWER - —**Norovirus (1/3), Hep A, Rotavirus
most common V
nontyphoid Salmonella, Clostridium perfringens, Campylobacter, Staphylococcus aureus,
Toxoplasma gondii, Listeria monocytogenes, Yersinia, and ***Shiga toxin-producing E. coli
[aka know as STEC E. coli 0157 ]
Non-Shiga toxin producing—enteropathogenic E. coli; enteroinvasive E. coli; enteroaggregative
E coli and diffusely adherent E. c
Epidemiology and Causes - CORRECT ANSWER - Acute gastroenteritis is most often from
an infectious agent— food and waterborne outbreaks are important causes, fecal-oral route
-Person-to-person transfer is more common in hospitals and day care centers **Those at high
risk—anyone traveling to a developing country, immunosuppressed, those engaging in anal
intercourse, residents of LTAC, those consuming raw shellfish and seafood
Pathophysiology - CORRECT ANSWER - Most forms of gastroenteritis manifest with
diarrhea—which is not considered an emergency unless it affects an older adult who cannot
regulate their fluid intake
With *viral FBD it is usually transmitted through infected food handlers, in a given setting [café,
banquet, etc.]
Most states require reporting of - CORRECT ANSWER - Hepatitis A - Botulinum -
Salmonella - STEC 0157 - Listeria - Shigella - Vibrio
, MGRADES EXAMS
Parasites - CORRECT ANSWER - Parasitic protozoa do multiply in food—but can live on
moist food for months in a cool, damp environment, most common transmission is contaminated
water Cryptosporidium, Cyclospora, Giardia and Toxoplasma gondii are the big players
Overview of the Common FB Pathogens—the Big Picture - CORRECT ANSWER - 60 and
older—Salmonella and Campylobacter are the most common bacteria in FBD
- Noroviruses are the leading cause of food related illness in the US
- In the US, parasitic FBD is not common— Cryptosporidium is the most common parasite seen,
but according to CDC—Toxoplasma gondii is the 2nd leading cause of FB illness-related death
and hospitalizations in the US - Listeria is the pathogen most likely to cause death
Overview of the Common FB Pathogens—the Big Picture 2 - CORRECT ANSWER - - Raw
foods and beverages—because they have not been processed, cooked or refrigerated/frozen -
Fruits and vegetables can be contaminated in the field or from contaminated water—with
Salmonella, STEC 0157, Cyclospora, Hepatitis A - If not pasteurized, milk or fruit juices can be
a source of Listeria and Salmonella - Campylobacter, E. coli, Yersinia and Toxoplasma gondii
live in the intestines of animals—causing contaminated raw meats and poultry
General Ancillary Testing - CORRECT ANSWER - Stools culture—positive in <40
percent of cases PCR testing may be available for the pathogen you are suspicious of (have
to specify pathogen) ?CRP, CBC, blood cultures, UA, abdominal x-rays, anoscope,
endoscopy—based on severity Toxic megacolon can be identified on abdominal x-rays
Severe inflammation changes can be seen on CT BC in those with fever and diarrhea—as
1% of these patients have nontyphoidal Salmonella bacteremia
General Ancillary Testing 2 - CORRECT ANSWER - Stool microscopy for C. difficile
Stools with RBCs, WBCs suggest colonic source Stool microscopy is done to identify
ova, cysts, parasites [antigen test for Giardia is more sensitive] Microscopic evaluation of the
stool for fecal leukocytes or lactoferrin suggest inflammatory etiology Flexible
sigmoidoscopy is reserved for those with colitis that is unresponsive to antimicrobial therapy and
for those with persistent diarrhea
Symptomatic Treatment - CORRECT ANSWER - Oral rehydration therapy [Pedialyte or
Gatorade] to prevent and treat dehydration Intake should exceed output by at least 500 cc
Nurs 5461 Gastroenteritis UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Gastroenteritis - CORRECT ANSWER - caused by bacterial food toxins in food- "food
poisoning" In healthy adults—the s/sx usually self-limited CDC says that 1 in 6 Americans
affected q yr.
Can be acute or chronic (food allergy)
The most common players - CORRECT ANSWER - —**Norovirus (1/3), Hep A, Rotavirus
most common V
nontyphoid Salmonella, Clostridium perfringens, Campylobacter, Staphylococcus aureus,
Toxoplasma gondii, Listeria monocytogenes, Yersinia, and ***Shiga toxin-producing E. coli
[aka know as STEC E. coli 0157 ]
Non-Shiga toxin producing—enteropathogenic E. coli; enteroinvasive E. coli; enteroaggregative
E coli and diffusely adherent E. c
Epidemiology and Causes - CORRECT ANSWER - Acute gastroenteritis is most often from
an infectious agent— food and waterborne outbreaks are important causes, fecal-oral route
-Person-to-person transfer is more common in hospitals and day care centers **Those at high
risk—anyone traveling to a developing country, immunosuppressed, those engaging in anal
intercourse, residents of LTAC, those consuming raw shellfish and seafood
Pathophysiology - CORRECT ANSWER - Most forms of gastroenteritis manifest with
diarrhea—which is not considered an emergency unless it affects an older adult who cannot
regulate their fluid intake
With *viral FBD it is usually transmitted through infected food handlers, in a given setting [café,
banquet, etc.]
Most states require reporting of - CORRECT ANSWER - Hepatitis A - Botulinum -
Salmonella - STEC 0157 - Listeria - Shigella - Vibrio
, MGRADES EXAMS
Parasites - CORRECT ANSWER - Parasitic protozoa do multiply in food—but can live on
moist food for months in a cool, damp environment, most common transmission is contaminated
water Cryptosporidium, Cyclospora, Giardia and Toxoplasma gondii are the big players
Overview of the Common FB Pathogens—the Big Picture - CORRECT ANSWER - 60 and
older—Salmonella and Campylobacter are the most common bacteria in FBD
- Noroviruses are the leading cause of food related illness in the US
- In the US, parasitic FBD is not common— Cryptosporidium is the most common parasite seen,
but according to CDC—Toxoplasma gondii is the 2nd leading cause of FB illness-related death
and hospitalizations in the US - Listeria is the pathogen most likely to cause death
Overview of the Common FB Pathogens—the Big Picture 2 - CORRECT ANSWER - - Raw
foods and beverages—because they have not been processed, cooked or refrigerated/frozen -
Fruits and vegetables can be contaminated in the field or from contaminated water—with
Salmonella, STEC 0157, Cyclospora, Hepatitis A - If not pasteurized, milk or fruit juices can be
a source of Listeria and Salmonella - Campylobacter, E. coli, Yersinia and Toxoplasma gondii
live in the intestines of animals—causing contaminated raw meats and poultry
General Ancillary Testing - CORRECT ANSWER - Stools culture—positive in <40
percent of cases PCR testing may be available for the pathogen you are suspicious of (have
to specify pathogen) ?CRP, CBC, blood cultures, UA, abdominal x-rays, anoscope,
endoscopy—based on severity Toxic megacolon can be identified on abdominal x-rays
Severe inflammation changes can be seen on CT BC in those with fever and diarrhea—as
1% of these patients have nontyphoidal Salmonella bacteremia
General Ancillary Testing 2 - CORRECT ANSWER - Stool microscopy for C. difficile
Stools with RBCs, WBCs suggest colonic source Stool microscopy is done to identify
ova, cysts, parasites [antigen test for Giardia is more sensitive] Microscopic evaluation of the
stool for fecal leukocytes or lactoferrin suggest inflammatory etiology Flexible
sigmoidoscopy is reserved for those with colitis that is unresponsive to antimicrobial therapy and
for those with persistent diarrhea
Symptomatic Treatment - CORRECT ANSWER - Oral rehydration therapy [Pedialyte or
Gatorade] to prevent and treat dehydration Intake should exceed output by at least 500 cc
