Nurs 5461 Gastroenteritis EXAM QUESTIONS AND
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Hepatitis A - ANSWER-Infective dose is 10-100 particles Virus replicates in the liver and sheds in high
concentrations in the stool Hepatitis A is self-limited and does not cause chronic infection There is a
vaccine that was developed in 1995—it has led to a 95% decrease in the incidence Outbreaks have been
linked to strawberries; green onions contaminated during packing from farms outside the US
Incubation Period - ANSWER-Hours-Toxin, One day-Virus, Several days Bacteria
Inflammatory diarrhea - ANSWER-mucosal invasion [usually of LB] causes stools to be bloody and be +
for fecal leukocytes; this patient usually has fever, belly pain or tenderness, headache, n/v, malaise and
myalgias
Listeria monocytogenes - ANSWER-Aerobic, gram positive usually pathogenic bacillus ⚫ Resistant to
freezing, drying and heat and it multiples in refrigerated foods ⚫ enters the bloodstream (via gi
epithelium to replicate)—it can enter the brain and placenta by infecting circulating phagocytes ⚫
Infective dose is 1,000 cells
⚫ Pregnant women are very high risk—the s/sx are nonspecific and diagnosis is difficult - Maternal
infection can cause premature birth and/or spontaneous abortion ⚫ Mortality rate from this bug—20 to
30 percent ⚫ Found in herd animals, birds, marine life; contaminated of fruits and vegetables or farm
animals ⚫ Raw unpasteurized milk and cheese are primary sources ⚫ 10 percent of humans are carriers
of Listeria
Listeria monocytogenes - ANSWER-Amoxicillin 500 mg TID for 3-5 days; Bactrim DS [1] BID for 3-5 days
IV Ampicillin, Penicillin, TMP-SMX +/- Gentamicin can be used for severe disease Meningitis must be
treated for 2-3 weeks
Listeria Presentation - ANSWER-Fever, myalgias, nausea and diarrhea Signs and symptoms begin within
9-48° after ingestion In pregnant, it presents as the flu Bacteremia and meningitis is possible Meningitis
is associated with a 70% mortality Invasive disease typically manifests in 2-6 weeks after ingestion
Blood, CSF, gastric washings, meconium, placenta and other tissues can be cultured for the pathogen
, Most states require reporting of - ANSWER-Hepatitis A - Botulinum - Salmonella - STEC 0157 - Listeria -
Shigella - Vibrio
Mushroom Toxins - ANSWER-Mushrooms can contain neurotoxic chemicals; gastrointestinal irritation
and/or disulfiram-like toxicity * mushrooms that are harmful to humans CANNOT be made safe by
cooking
Diagnosis is based on clinical presentation and history of eating mushrooms Commercial RAI tests to
detect mushroom toxins in the urine and plasma are available Supportive care is the primary treatment
for mushroom poisonings
Noncholera Vibrio spp. - ANSWER-⚫ Vibrio parahaemolyticus and Vibrio vulnificus ⚫ Both are found in
seawater; parahaemolyticus is in coastal waters in the US and Canada; vulnificus lives in warmer
seawater ⚫ Infective dose is cells of 107 ⚫ Incidence is highest in those >60 years ⚫ Raw/undercooked
seafood [oysters, shrimp and crab] is the primary vector
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
Noninflammatory diarrhea - ANSWER-mild dehydration, watery stool [sometimes severe], fever and
systemic symptoms are absent—this type of diarrhea is from mucosal hypersecretion or decreased
absorption without mucosal destruction—and usually SB is involved
Norovirus - ANSWER-leading cause of gastroenteritis and FBD in the US,
⚫ Transmitted fecal-oral route —contaminated water can also be a source - Aerosolized in emesis -
Most common sources are prepared foods— sandwiches, salads, raw produce ⚫ Patient presents with
n/v/watery diarrhea, belly cramps, fever, myalgias, headaches ⚫ Onset of disease is 24-48° after
ingestion, but may be as little as 12°
Symptoms resolve within 24-72°—viral shedding lasts 2 weeks—longer in the immune suppressed ⚫
Diagnosis is usually made on clinical presentation and lack of + results on stool cultures - No WBCs in the
stools suggests Norovirus - Labs can identify it by RT-PCR, immunoassays and electron microscopy for
Norovirus
VERIFIED ACCURATE SOLUTION |GET IT 100%
ACCURATE
Hepatitis A - ANSWER-Infective dose is 10-100 particles Virus replicates in the liver and sheds in high
concentrations in the stool Hepatitis A is self-limited and does not cause chronic infection There is a
vaccine that was developed in 1995—it has led to a 95% decrease in the incidence Outbreaks have been
linked to strawberries; green onions contaminated during packing from farms outside the US
Incubation Period - ANSWER-Hours-Toxin, One day-Virus, Several days Bacteria
Inflammatory diarrhea - ANSWER-mucosal invasion [usually of LB] causes stools to be bloody and be +
for fecal leukocytes; this patient usually has fever, belly pain or tenderness, headache, n/v, malaise and
myalgias
Listeria monocytogenes - ANSWER-Aerobic, gram positive usually pathogenic bacillus ⚫ Resistant to
freezing, drying and heat and it multiples in refrigerated foods ⚫ enters the bloodstream (via gi
epithelium to replicate)—it can enter the brain and placenta by infecting circulating phagocytes ⚫
Infective dose is 1,000 cells
⚫ Pregnant women are very high risk—the s/sx are nonspecific and diagnosis is difficult - Maternal
infection can cause premature birth and/or spontaneous abortion ⚫ Mortality rate from this bug—20 to
30 percent ⚫ Found in herd animals, birds, marine life; contaminated of fruits and vegetables or farm
animals ⚫ Raw unpasteurized milk and cheese are primary sources ⚫ 10 percent of humans are carriers
of Listeria
Listeria monocytogenes - ANSWER-Amoxicillin 500 mg TID for 3-5 days; Bactrim DS [1] BID for 3-5 days
IV Ampicillin, Penicillin, TMP-SMX +/- Gentamicin can be used for severe disease Meningitis must be
treated for 2-3 weeks
Listeria Presentation - ANSWER-Fever, myalgias, nausea and diarrhea Signs and symptoms begin within
9-48° after ingestion In pregnant, it presents as the flu Bacteremia and meningitis is possible Meningitis
is associated with a 70% mortality Invasive disease typically manifests in 2-6 weeks after ingestion
Blood, CSF, gastric washings, meconium, placenta and other tissues can be cultured for the pathogen
, Most states require reporting of - ANSWER-Hepatitis A - Botulinum - Salmonella - STEC 0157 - Listeria -
Shigella - Vibrio
Mushroom Toxins - ANSWER-Mushrooms can contain neurotoxic chemicals; gastrointestinal irritation
and/or disulfiram-like toxicity * mushrooms that are harmful to humans CANNOT be made safe by
cooking
Diagnosis is based on clinical presentation and history of eating mushrooms Commercial RAI tests to
detect mushroom toxins in the urine and plasma are available Supportive care is the primary treatment
for mushroom poisonings
Noncholera Vibrio spp. - ANSWER-⚫ Vibrio parahaemolyticus and Vibrio vulnificus ⚫ Both are found in
seawater; parahaemolyticus is in coastal waters in the US and Canada; vulnificus lives in warmer
seawater ⚫ Infective dose is cells of 107 ⚫ Incidence is highest in those >60 years ⚫ Raw/undercooked
seafood [oysters, shrimp and crab] is the primary vector
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
Noninflammatory diarrhea - ANSWER-mild dehydration, watery stool [sometimes severe], fever and
systemic symptoms are absent—this type of diarrhea is from mucosal hypersecretion or decreased
absorption without mucosal destruction—and usually SB is involved
Norovirus - ANSWER-leading cause of gastroenteritis and FBD in the US,
⚫ Transmitted fecal-oral route —contaminated water can also be a source - Aerosolized in emesis -
Most common sources are prepared foods— sandwiches, salads, raw produce ⚫ Patient presents with
n/v/watery diarrhea, belly cramps, fever, myalgias, headaches ⚫ Onset of disease is 24-48° after
ingestion, but may be as little as 12°
Symptoms resolve within 24-72°—viral shedding lasts 2 weeks—longer in the immune suppressed ⚫
Diagnosis is usually made on clinical presentation and lack of + results on stool cultures - No WBCs in the
stools suggests Norovirus - Labs can identify it by RT-PCR, immunoassays and electron microscopy for
Norovirus
