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Questions and Answers
Which of the following are considered as part of the upper respiratory tract (URT)? (Select all that apply)
Which of the following are considered as part of the upper respiratory tract (URT)? (Select all that apply)
The lower respiratory tract is normally sterile.
The lower respiratory tract is normally sterile.
True
Which of the following is a common cause of community-acquired pneumonia in adults?
Which of the following is a common cause of community-acquired pneumonia in adults?
What is the most common route of transmission for most gastrointestinal pathogens?
What is the most common route of transmission for most gastrointestinal pathogens?
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Which of the following media is commonly used for the isolation of Salmonella and Shigella?
Which of the following media is commonly used for the isolation of Salmonella and Shigella?
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What is the name of the bacteria that causes the life-threatening infection epiglottitis, which is primarily seen in children 2-6 years of age?
What is the name of the bacteria that causes the life-threatening infection epiglottitis, which is primarily seen in children 2-6 years of age?
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What specimen type is typically collected from patients suspected of sinusitis but not responding to therapy?
What specimen type is typically collected from patients suspected of sinusitis but not responding to therapy?
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Gram stain is a useful tool for diagnosing respiratory tract infections, particularly in the case of URT infections where the sample is likely to contain normal flora.
Gram stain is a useful tool for diagnosing respiratory tract infections, particularly in the case of URT infections where the sample is likely to contain normal flora.
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Which of the following media is NOT routinely used for the isolation of bacteria from sputum samples?
Which of the following media is NOT routinely used for the isolation of bacteria from sputum samples?
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Sputum samples should be collected in a ______ container.
Sputum samples should be collected in a ______ container.
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Bronchoscopy with bronchial brush technique is only used for unusual infections that cannot be diagnosed with a standard sputum sample.
Bronchoscopy with bronchial brush technique is only used for unusual infections that cannot be diagnosed with a standard sputum sample.
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What is the name of the procedure used to collect fluid from the middle ear, often performed in children with suspected otitis media?
What is the name of the procedure used to collect fluid from the middle ear, often performed in children with suspected otitis media?
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Study Notes
Gastrointestinal Tract
- The gastrointestinal tract involves the esophagus, stomach, small intestines (duodenum, jejunum, ileum), large intestines (cecum, colon, rectum), and anus.
- Inflammation of the stomach is called gastritis.
- Inflammation of the stomach and intestines is gastroenteritis.
- Inflammation of the small and large intestines is enterocolitis.
- Diarrhea is an abnormal increase in bowel movements, ranging from loose to liquid stool.
- Dysentery is diarrhea accompanied by cramping abdominal pain.
- Proctitis is inflammation of the rectal mucosa, caused by bacteria like N. gonorrhoeae, C. trachomatis, and T. pallidum.
- Normal flora accounts for 80% of the dry weight of feces, comprising bacteria like anaerobic bacilli (Bacteroides spp.), GN enteric bacilli, Enterococci, Streptococci, S. aureus, and Yeast (Candida).
- Non-inflammatory diarrhea results from bacterial toxins or enterotoxins, causing an outpouring of electrolytes and fluid, producing a large-volume watery stool. No PMN, blood, or mucous are present.
- Examples of causes include V. cholerae, enterotoxigenic E. coli, certain Bacteroides spp., viruses (like Giardia lamblia, Cyclospora, Cryptosporidium), etc.
- Inflammatory diarrhea involves organisms invading the intestinal mucosa, destroying intestinal cells (raw). Fever, loose, and small-volume stool are common. Fecal specimen contains PMN, blood, and mucus.
- Common causative agents include Salmonella spp., Shigella spp., Y. enterocolitica, Campylobacter spp., Enteroinvasive E. coli, and Clostridium difficile.
- Enterotoxins originating from food cause enterotoxin-mediated diarrhea, with symptoms developing rapidly (within 12 hours). Food poisoning culprits can include V. cholera, S. aureus, C. perfringens, and B. cereus.
- Diarrheal diseases include Salmonella (gastroenteritis), Shigella (bacillary dysentery), Y. enterocolitica (enterocolitis), Campylobacter jejuni & C. coli, Edwardsiella tarda, Vibrio cholerae, V. parahaemolyticus, Plesiomonas shigelloides, and Listeria monocytogenes.
- Intestinal parasites are also implicated, including Giardia, Entamoeba, Cryptosporidium, Cyclospora, and Microsporidia.
- Common conditions like H. pylori (chronic gastritis, peptic and duodenal ulcers), C. difficile (antibiotic-associated diarrhea, pseudomembranous colitis), C. perfringens (enterotoxin), and Mycobacterium avium (GI diseases in AIDS patients) also contribute.
- E. coli (enterohemorrhagic, O157:H7,others), causative of hemorrhagic colitis and hemolytic uremic syndrome (HUS); alongside enteroinvasive E. coli, can cause a Shigella-like disease. Enterotoxigenic, enteropathogenic (enteroadherent), and enteroaggregative E. coli can also result in traveler's diarrhea.
- Transmission routes for these infections include the fecal-oral route, direct person-to-person contact, or animal contact.
- Symptom presentation commonly includes nausea, vomiting, abdominal discomfort, and diarrhea.
Respiratory Tract
- URT infections affect structures above the larynx: oral cavity, nose, mouth, throat, and epiglottis.
- LRT infections affect the trachea, bronchi, bronchioles, and alveoli.
- Normal flora of the URT includes Staphylococcus spp., Streptococcus spp., Neisseria spp., Haemophilus, anaerobes, and Candida spp.
- URT infections include thrush, laryngitis, epiglottitis, pharyngitis, tonsillitis, sinusitis, otitis media, diptheria and whooping cough.
- Common respiratory virus pathogens include influenza, parainfluenza, RSV, adenovirus, rhinovirus, coronavirus, coxsackie A, EBV, and CMV, affecting the URT.
- Bacteria like S. pyogenes, b-hemolytic strep group C, F, and G, and Arcanobacterium haemolyticum are other URT pathogens.
- H. influenzae, N. gonorrhoeae, Corynebacterium diphtheriae, B. pertussis and B. parapertussis, are also noted URT pathogens.
- Sputum collection, swabbing the pharynx and tonsils is a common URT specimen collection method. Transport media, and biopsies may be used.
- URT pathogens are often analyzed with gram stains, cultures, and special media.
- Lower respiratory tract (LRT) infections include bronchitis, influenza, pneumonia, empyema, pleural space fluid, and tuberculosis.
- Potential bacterial pathogens for LRT include S.pneumoniae, H. influenzae, M. catarrhalis, M. pneumoniae, and various Chlamydia species. Also GNR and S. aureus and anaerobes, Legionella, Mycobacteria, and fungi.
- Community-acquired pneumonia agents commonly include S. pneumoniae, Mycoplasma pneumoniae, H. influenzae, and M. catarrhalis.
- Hospital-acquired pneumonia agents can include contaminants, Enterobacteriaceae, K. pneumoniae, S. marcescens, S. aureus, various NFGNR, P. aeruginosa, Burkholderia cepacia, CF and nosocomial S. pneumoniae, and anaerobic bacteria.
- Other agents like Mycobacteria (MTB), Legionella (especially in immunocompromised), Chlamydia (in neonates and young adults), can also occur.
- Emerging viral infections from avian influenza(H5N1), H1N1, SARS, and Coronavirus.
- Bioterrorism agents are notably B. anthracis (anthrax), Y. pestis (plague), Coxiella burnetii (Q fever), and F. tularensis (tularemia).
- Infectious matter is often aerosolized, disseminated through the bloodstream or via aspiration.
- Sputum and other specimens can be collected via various invasive and noninvasive methods. Invasive procedures include bronchoscopy (lavage, brushings), while less invasive approaches involve sputum expectoration, induced sputum, or tracheostomy/endotracheal aspirates
- Anaerobic transport media is important for certain specimen types, particularly when bacterial infections are suspected.
- Gram stain evaluation is crucial for sputum specimens to evaluate the quality of the specimen for culture.
- Cultures of specimens, especially sputum samples, can be done through aerobic and anaerobic processing on appropriate bacterial growth media.
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Description
Explore the various components of the gastrointestinal tract, including the esophagus, stomach, and intestines. Learn about conditions like gastritis and gastroenteritis, along with the role of normal flora in digestion. This quiz covers both inflammation and types of diarrhea associated with the gastrointestinal system.
