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UCONN / nursing / NURS 3110 / List 4 diseases caused by spore forming bacteria. what are the symptom

List 4 diseases caused by spore forming bacteria. what are the symptom

List 4 diseases caused by spore forming bacteria. what are the symptom

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Clinical Science II Exam II


List 4 diseases caused by spore forming bacteria. what are the symptoms of each?



1. List 4 diseases caused by spore forming bacteria. What are the symptoms of  each?

∙ Bacillus anthracis

o Necrotic ulcer if skin is exposed

o X-ray: mediastinal widening

o Thrombosis

o CV shock

∙ Bacillus cereus

o Food poisoning

o Eye infection associated with trauma or surgery

o Short 24 hour stomach bug

o Nausea

o Cramps

o Vomiting

o Diarrhea

∙ Clostridium perfringens

o Food poisoning

o Gas gangrene

o Pus

o Necrotic tissue


What causes sudden lockjaw?



∙ C. difficile

o Food poisoning

o Diarrhea

o Colitis

o Spasms in muscles

∙ C. tetani

o Incubation 4-5 days to many weeks

 Then begin replication of vegetative cells and symptoms manifest  Lockjaw could have been caused by an event from weeks ago

o Convulsive contractions of voluntary muscles  

 Jaw muscles (lock jaw)

∙ Arched back

∙ Arm flexion

∙ Extension of legs

 Tetonic seizure

 Facial expression (looks like the Joker) risus sardonicus

 Paralysis respiratory muscles

∙ Surrounding lungs to inhale and exhale


What is voluntary muscle contraction?



∙ High rate of mortality

o Advanced progression

∙ C. botulinum

o Begin 12-72 hours

 Food borne infection, not toxication

 Spore germinates and vegetates to produce toxinDon't forget about the age old question of What environmental factors suggest that the concept would not work?

 Longer than food poisoning

o Manifest in head firstextremities

o Double vision

o Can’t swallow, dry mouth, can’t talk

 Need to contract muscles to swallow

o Respiratory paralysis, death (10%)

 Won’t be able to inhale or exhale

o No sensory or mental lapse

2. Compare and contrast the time of onset and symptoms of food poisoning/food  infection caused by: Clostridium perfringens, Staphylococcus aureus, Clostridium  botulinum.

∙ Clostridium perfringens  

o Incubation 6-18 hours

o Enterotoxin causes diarrhea

 Self limiting

∙ Staphylococcus aureus  

o Food preparer touches face, then food

o With time, temp., S. aureus grows, releases toxin

 Time, temp affect likelihood of intoxication

o Onset is quicker than food borne infection

o Ex. egg salad, cream fillings, lime pie

∙ Clostridium botulinum  

o Home processed foods: canned

 Higher pH (basic) have higher risk of aggregation

o Ingest food containing toxin (canned foods with high pH) toxin creates  flaccid paralysis We also discuss several other topics like What is the difference between empiricism and rationalism?

 Most cases from home cooked green beans, corn, meat, fish  

(spores highly heat resistant)

∙ Spore is ingested and germinates the human host

 Common cause of death in livestock, aquatic birds (esp. mallards) 3. What is the target organ that is damaged by each of the following clostridial  species: C. botulinum, C. difficile, C. tetani, C. perfringens.

∙ C. botulinum (food poisoning) - paralysis in presynaptic membrane, lungs ∙ C. difficile - can produce toxins that attack the lining of the intestine ∙ C. tetani (lockjaw) – jaw, arms, legs, lungs

∙ C. perfringens – GI food poisoning, necrotizing ulcers

4. Compare and contrast the clinical presentation (symptoms) of each of the following in a young child: Corynebacterium diptheriae, Bordetella pertussis. ∙ Corynebacterium diptheriae

o Toxin causes destruction of epithelium mixed with fibrin; RBC’s, WBC’s =  pseudomembrane (like c. dif) that covers pharynx (can cause  

asphyxiation)

 You breathe in the other person’s droplets and get the infection  where you breathe it in

 Mixes with fibrin: rough and leathery

 Can interfere with aeration and can cause asphyxiation

o Enlarged lymph nodes, sore throat, neck swelling, fever

o Toxin can damage heart / valves

∙ Bordetella pertussis We also discuss several other topics like What is the meaning of amplitude?
We also discuss several other topics like How does culture affect communication?

o Sx in > age 12: flu/cold like with persistent cough but no whoops  o Risk of transmitting to unvaccinated infants!

o Purple in mouth

5. How do the symptoms of Bordetalla pertussis differ in an infant or young child compared to an adult?

∙ Child

o Pauses in breathing

 Gasping for air

∙ Adult

o Prolonged cough

 Can cause cracked ribs, vomiting, and even fainting

o Flu/cold symptoms

6. List 3 gram negative organisms that can cause nosocomial infections. What is the mode of transmission of each?

∙ Pseudomonas aeruginosa

o Found on disinfected instruments and in respiratory equipment ∙ Legionella

o Transmitted by aerosol droplets

∙ Klebsiella pneumonia

o Transmitted by bird droppings

∙ Serratia marcescens

o Transmitted quickly in hospitals

o Found in soil, water, and intestines

7. What organism causes most cases of traveler’s diarrhea?

∙ Enteropathogenic E. coli

8. What are the food sources for Listeria monocytogenes? What are results of infections of Listeria monocytogenes in infants compared to adults? ∙ Food sources Don't forget about the age old question of What is a kill shelter?

o Contaminated foods

o Mexican cheese

o Coleslaw

o Milk

o Ice cream

o Hummus

o Cold cuts

∙ Infants

o Meningitis between birth & 3 weeks or brain infection

o Respiratory distress

 Flared nostrils, rapid breathing, blue color (cyanosis)

o Not eating well, fever, rash, maybe fevers

o Rash with flu or cold symptoms means something more serious is going  on (not a normal baby)

 If it gets into CSF and causes meningitis, it can cause  

hydrocephalus (fluid buildup in the brain, increased pressure), can  induce mental retardation

∙ Might need a shunt to release fluid and pressure

∙ Adults

o Flu like symptoms

 Nausea, vomiting, diarrhea, fever, back pain, headache

o Exposed woman can carry on vaginal tract unknowingly (asymptomatic), than accidentally expose to baby

9. What patient characteristics place them at risk for infections from Listeria monocytogenes? Pseudomonas aeruginosa? Tuberculosis? MAC? How is each acquired? What are the virulence factors of each?

∙ Listeria Monocytogenes

o Pregnant patients

o Patients with respiratory symptoms

o HIV/AIDS (200-300x more likely)

o Cancer patients with chemo or radiation We also discuss several other topics like What refers to private and personal decision-making by an autonomous individual?

o Bone marrow transplant unit

 At risk for environmental and food borne exposures

∙ Pseudomonas aeruginosa

o Often in patients with burns, neoplastic Dx, cystic fibrosis (biofilm from P. cepacia)

o Avoid improperly chlorinated hot tubs, pools, water parks

o Avoid use of body sponges (e.g.. loofahs), soggy washcloths,  contaminated contact lens solutions, cake soap sitting in water

∙ Tuberculosis

o Normal immune system

 Untreated, 5% of infected persons with normal immunity develop  TB in first 1–2 years post infection, another 5% later in life

 Thus, about 10% of infected persons with normal immunity will  develop TB at some point in life if not treated

o Weak immune system

 Persons with weak immunity at increased risk of progressing to TB  disease

∙ Untreated HIV infection highest risk factor: risk of developing

TB disease is 7%–10% each year;  

∙ Children <5 years of age also at increased risk

o Elderly

 Haven’t been vaccinated in a while, especially if they have been  exposed a long time ago then their immune system degraded

o Non-white males>30

o Non-white females >60

o Immigrants from Africa or Asia: more likely to be exposed in childhood o HIV patients

o Living in close quarters with someone who has ACTIVE TB

o Latent: not contagious

o Active: very contagious

∙ MAC

o HIV patients

10. Which organism causes each of the following: Legionnaires’s Disease, whooping cough, typhoid fever?

∙ Legionnaires’s Disease

o Legionella pneumophila

∙ Whooping Cough

o Bortella pertussis

∙ Typhoid Fever

o Salmonella typhi

11. How is active TB confirmed?

∙ Mantoux tuberculin skin test (TST) IGRAs:

o QuantiFERON-TB Gold In-Tube (QFT-GIT)®, and T-Spot.TB® 

∙ These tests do not exclude LTBI or TB disease

∙ Decisions about medical/public health management should include other  info/data, and not rely only on TST/IGRA results

∙ Tb test

o Old test = concentrated filtrate of broth in which Tb have grown for 6  weeks

o PPD (Purified Protein Derivative) = chemical fractionation of Tb o Reactions to PPD

 TB + persons are at risk of developing reactivated dx

 False - due to anergy from:

∙ Overwhelming TB Immunosuppression Malnutrition

 Only elimination of viable TB results in reversion of TB test to  negative

12. What are the symptoms of active TB?

∙ Can spread

∙ Cough, fever, weight loss

∙ Radiograph abnormal

∙ Positive sputum and cultures

∙ Need treatment

∙ Isolation

13. Why are hopes high for the new TB-GOLD screening test? ∙ These tests include latent AND active TB so you can treat early 14. How long is a person with tuberculosis contagious?

∙ As long as they are active, they can remain contagious until weeks of treatment

∙ Latent are not contagious

15. What is the most common cause of multiple drug-resistant TB (MDRTB) infection?

∙ Being exposed to someone with MDRTB

∙ Waxy texture makes the organism highly resistant

16. How is Legionnaires’ disease transmitted? What are the common reservoirs of the organism?

∙ Transmitted by aerosol droplets

o Air conditioners, supermarket vegetable sprayers, volcanoes, ice cubes,  spas, cooling towers

17. Compare and contrast the onset and symptoms of food poisoning/food infection caused by Salmonellosis, Shigella, Campylobacter. What foods are associated with each?

∙ Salmonellosis

o Water, fairy, eggs, poultry, turtles, reptiles

o Incubates for 8-48 hours before showing symptoms

o Resolves in 2-3 days

o Nausea, vomit, diarrhea, headache

∙ Shigella

o Non-bloody, voluminous diarrhea

o At risk for hemolytic uremic syndrome

o Incubates for 1-2 days

o Fever, watery diarrhea, abdominal pain

∙ Campylobacter

o Undercooked meat, contaminated water/milk

o Incubates 1-7 days

o Headache, fever, abdominal pain, watery diarrhea may have blood (not perfuse)

18. What is the most important treatment for patients with dysentery? ∙ Oral rehydration therapy

19. What organism causes gastric and duodenal ulcers?

∙ Helicobacter pylori

20. What are the symptoms of Rocky Mountain Spotted Fever versus Lyme Disease?

∙ Rocky Mountain Spotted Fever

o Dog tick bite

o Rash: extremities, trunk (include palms / soles), centripedal spread  o Late Sx: thrombosis, hemorrhage, gangrene, delirium, coma (20% fatal)  ∙ Lyme Disease

o Billseye rash

o Flu symptoms

o Sore joints

o Arthralgia, arthritis, neurologic effects, cardiac disease

21. Name one factor about Rickettsia and Legionella that makes them fairly unique among bacteria.

∙ Rickettsia

o Obligate intracellular parasites

o Multiply in endothelial cells of small blood vessels causing vasculitis and thrombosis

o Rash starts on trunk and spreads outwards

∙ Legionella

o Not communicable from person to person

o Transmitted by aerosol droplets

22. What is the most prevalent sexually transmitted disease? ∙ Chlamydia

23. What organ(s) are attacked by Chlamydia trachomatis? ∙ Eyes

∙ Urethra

∙ Cervix

24. What organisms cause each of the following: granuloma, gumma, ghon complex, chancre.

∙ Granuloma

o Tubercuoles

o Listeria monocytogenes

∙ Gumma

o Syphilis

∙ Ghon complex

o Tuberculosis

∙ Chancre

o Syphilis

o Spirochete

25. What organism can be contracted from bat droppings?

∙ Histoplasmosis

o Fever

o Chills

o Headache

o Muscle aches

o Coughing

o Chest pain

26. Probionibacterium acnes causes acne vulgaris and also what other infections?

∙ Chronic blephaeitis, endophthalmitis, and sarcoidosis

∙ Can infect eyes and artificial joints

27. Your burn patient has blue-green pus on one of his wounds and the room is filled with the odor of _____? What organism is he likely infected with? ∙ Pseudomonas aeruginosa

28. Recurrent infections in a neonatal ICU were attributed to what organism that is harbored under long/artificial fingernails?

∙ Pseudomonas aeruginosa

29. What is “herd protection?” Name two diseases where herd protection is important.

∙ Herd immunity

o Indirect protection

o Everyone else is vaccinated so you don't need to be because you can’t catch the disease from them

∙ Tuberculosis

∙ Diptheria

30. How do Foley indwelling catheters (which are related to 80% of nosocomial UTIs) increase the risk of nosocomial UTI?

∙ They can cause klebsiella pneumonia

∙ Feces attach to catheter and can travel to urinary tract and infect 31. Compare and contrast enteropathogenic E. Coli, enterotoxigenic E. Coli and enterohemorrhagic E. Coli 0157:H7 with respect to symptoms and prevention of disease.

∙ Enteropathogenic E. Coli

o Travelers diarrhea

o Not common in US

 Usually in 3rd world countries

o Babies at risk if formula is mixed with water

o Toxigenic

o One is heat labile, one heat stable

o Low grade fever, nausea, vomiting

 High level of fluid loss, quickly dehydrated

o Virulence: fimbriae

∙ Enterotoxigenic E. Coli

o Traveler's Diarrhea

o Profuse watery diarrhea with no blood nor leukocytes and abdominal  cramping

o Fever, nausea with or without vomiting, chills, loss of appetite,  headache, muscle aches and bloating

o Prevented by avoiding foods and beverages that could be contaminated with bacteria

 High-risk foods

∙ Raw fruits and vegetables (e.g., salads)

∙ Raw seafood or undercooked meat or poultry

∙ Unpasteurized dairy products

∙ Food from street vendors

∙ Untreated water (including ice) in areas lacking adequate  chlorination

∙ Enterohemorrhagic E. Coli

o E. Coli 0157:H7

o Associated w/ undercooked ground beef, spinach (07)

 Primarily in GI of cattle, not our normal flora

o Can lead to hemolytic uremic syndrome

o Causes meningitis in infants

o Tends to come with salmonella

o Cloudy urineUTI

o O antigen: cell wall and lipopolysaccharide

 All gram negative, all different

o H antigen: flagella

o Symptoms

 Abdominal pain

 Gastroenteritis

 Bloody diarrhea

o 10% then develop hemolytic uremic syndrome

 Hemolytic Uremic Syndrome

∙ Hemolysis

∙ Kidney damage/failure

∙ Antibiotics ineffective

∙ Young, elderly, immunocompromised most at risk

∙ Shiga toxin

o Targets blood itself

 Fragmented RBCs

 Target plateletsthrombocytopenia

∙ Vomiting, diarrhea, more severe bruising, urine output  

significantly reduced, yellow skin

∙ To clear of toxins, the liver has to compensate for additional  RBCs

∙ Treatment

o Dialysis

o Steroids to reduce level of inflammation

o Careful with raw and cooked cross contamination

o Rainbow agar

 Black colony

32. What is the significance of the coliform count in water samples? ∙ Indicates presence of sewage or geese droppings in water

∙ If E. coli are present, fecal pathogens are likely present

o Salmonella, viruses, or protozoan

o 50-100 is a serious problem

33. Klebsiella pneumoniae causes pneumonia, UTIs, bacteremia, and wound infections. Where does it inhabit? How is infection acquired?

∙ Inhabits intestines, also respiratory tracts of many normal individuals ∙ Often nosocomial

∙ Bird droppings

34. Where do carriers of salmonella infections harbor the organism? ∙ Organism enters via oral route

o Fecal oral contamination

∙ Affects small intestine, lymphatics, blood

35. Describe the updated Lyme disease guide from the Infectious Diseases Society of America (IDSA).  

∙ Give single 200 mg dose doxycycline (reduces risk from 3/100 to 4/1,000) if: o Tick has been attached for 36 hr or more

o It is within 72 hrs from time tick is removed

o Local rate of ticks with B. burgdorferi is 20% or more (now all of CT) o DON’T WAIT FOR SYMPTOMS

∙ Can eradicate before it causes disease with a single dose

36. Why is infection from Mycoplasma peumoniae called “atypical pneumonia?” How is it diagnosed?

∙ Asymptomatic to serious pneumonitis

∙ Diagnostic Lab Tests

o Specimens: sputum, swab pharynx (will appear to be devoid of bacterial  cells upon staining)

o Blister on tympanic membrane

o Culture: difficult to grow (2-3 weeks)

o Serology: best test, helpful in diagnosis (immunofluorescence, etc.) o Cold agglutinins: non-specific substances in serum that agglutinate type  O RBC’s at 40C

37. Compare and contrast infections from Chlamydia trachomatis with Chlamydia pneumoniae.

∙ Chlamydia trachomatis

o Genital infections / inclusion conjunctivitis

 Men: nongonnococcal urethritis, epididymitis, 10% asymptomatic  Women: urethritis, cervicitis (white discharge), pelvic inflammatory disease (PID), sterility or ectopic pregnancy, many (70%)  

asymptomatic

 Newborns: acquired during birth

∙ Inclusion conjunctivitis

∙ Neonatal pneumonia (tachypnea, cough, no fever)

o Trachoma strain

 Important cause of blindness worldwide

 Lacrimation, discharge, keratoconjunctivitis, scarring, blindness   Risks: Hot climate, sand, flies, fingers, fomites,

 Caretakers with a baby or flies land in a carrier

o Trachoma

 Culture conjunctival scrapings

 Serology helpful in confirming diagnosis

 Treatment: tetracycline or erythromycin  

 $$ from Carter and Gates foundations

∙ Chlamydia pneumonia

o Infections increase risk of MI?

o Causes mild pneumonia or bronchitis in adolescents and young adults o Older adults may experience more severe disease and repeated  infections

38. Fingers, fomites, flies in a hot dry climate can increase risk of infection from what organism known to cause blindness?

∙ Chlamidia trachomatis

The Vaccine War Movie

∙ Why do we provide vaccines? What is the impact they can have? o Can prevent against diseases that can kill people

o Prevent deadly diseases

o Can expand life span

∙ Immunization schedule

o 6 immunizations

o Some parents are concerned that vaccines cause autism

 No actual proof of linkage

o Concern that all the immunizations are at one time so you are injecting in  the baby and it can overtax their immune system

∙ In total, we have eradicated 16 different diseases that were major health concerns o Gone for so long that we are no longer sensitive to a sick family member ∙ Pros

o Vaccinations are extensively tested

 Ingredients have been tested so don't worry so much

o No link to autism and no positive relationship between vaccines and autism ∙ Cons

o They think immunizations are linked to autism

o Side effects aren’t worth getting the vaccine

 Think that their kids won’t ever get the disease anyways

o Some ingredients are questionable

 Aluminum

 Formaldehyde

Grandma’s Got a Brand New Bag

Never Too Old to Learn a Bad Habit

∙ What is most likely cause of Olivia’s problem?

o UTI

 Probably from E. coli

∙ How can this be treated?

o Antibiotics

o Different strains of E. coli so you need to figure out which antibiotic it is  susceptible to

o Not all antibiotics that can kill e. coli in a petri dish can eradicate UTI o Many can’t concentrate at high enough levels in the urinary tract to kill E.  coli

∙ Olivia’s new problem resolves with treatment. But 3 weeks later her symptoms  return. What is most likely cause of the return of her symptoms o She has the same bad habits

o Giving herself more UTIs

o She wipes back to front

o Cleans herself with toilet water after she flushes

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