Deaths due to diarrheal disease

1
Deaths due to diarrheal disease

• The number of children dying from diarrheal
  disease each
• Year has been estimated at
• 1-2 million
• 30-40,000
• 4.6-6 million

2

• Persons with the following are more susceptible
  to
• Infections with Vibrio cholerae
• HLA B27
• Blood group antigen O
• Type A personality traits
• achlorhydria

3

• Mutations in CFTR may have arisen due to
  selective pressure
• From which of the following infections?
• Cholera
• ETEC
• Salmonella typhi

4
Match the infectious dose to the pathogen
Shigella dysenteriae type I Vibrio
cholerae Giardia lamblia Cryptosporidium
parvum Salmonella typhi

• 10-102
• 108
• 105

5

• Antimotility agents have been associated with
  more severe outcomes in which of the following
  infections?
• Salmonella
• Shigella
• Campylobacter
• C. difficile
• EHEC

6
Match the E. coli pathogen with the virulence
trait

• Enterotoxigenic (ETEC)
• Enterohemorrhagic (EHEC)
• Enteropathogenic (EPEC)
• Enteroinvasive (EIEC)

• heat stable (ST) and heat-labile (LT)
  enterotoxins
• Shiga toxin(s)
• attaching and effacing
• mucosal invasion

7
Match toxin and biologic effect

• Shiga toxins
• LT, cholera toxin
• ricin
• ST
• C. difficile toxins

• cAMP activation
• CFTR
• Cleaves 28S rRNA
• cGMP
• alteration of GTP-binding proteins

8
Match the organism and the culture media

• xylose-lysine deoxycholate
• thiosulfate citrate bile salt sucrose agar
• cold enrichment on sheep blood agar
• Sorbitol MacConkey agar

• EHEC
• V. cholerae
• Y. enterocolitica
• Salmonella, Shigella

9

• There are two commercially available vaccines for
  typhoid
• Fever the Typhim Vi, and Vivotif. Your patient
  is travelling
• To Bangledesh for several months where he plans
  to eat
• The local food with reckless abandon.
• Match the vaccine to the descriptions below
• injectable
• oral
• contains live Salmonella typhi Ty21a 109 cfu
• contains dead Salmonella typhi Ty21a 109 cfu
• immunization on days 1, 3, 5, 7.
• efficacy persists for 5 years
• should not be taken concurrently with mefloquine
• polysaccharide based from extraction of S. typhi
  Ty2
• single dose

10

• A 35 year old HIV man presents
• With odynophagia and fever.
• He has a labial herpetic ulcer.
• What is the best way to make a diagnosis of HSV
  esophagitis?
• Culture of brushings/bx
• Examination of the biopsy for
• Viral inclusions (Cowdry A)
• In all AIDS patients with esophagitis, a viral
  etiology is established in
• ?