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Anatomy Review Mouth Stomach Hepatobiliary Tree Small Intestine Large Intestine 1 Oral Cavity Bacterial Diseases Dental Plaque – Accumulations of ________ (biofilm) – May calcify Dental Caries – _______________________ – Lactic acid erodes dental enamel Periodontal disease – Tooth support structures – _______________ – gum inflammation – _________________ – root of tooth also affected 2 Oral Cavity Viral Diseases Mumps – Paramyxovirus – URT and salivary glands are affected – Resurgence recently due to complacency and failure to vaccinate – Complications – male sterility, meningitis, eye, ear infections, attack on other exocrine/ endocrine glands glands 3 Gastrointestinal Bacterial Intoxications Staphylococcal Enterotoxicosis – High starch or cream content, high protein foods – Foods subjected to temperature abuse • Cooked foods need to be covered/refrigerated to avoid bacterial growth and toxin production – Toxin can survive 30 minutes of boiling – Low mortality – Diarrhea symptoms 1-8 hr after food consumption 4 Clostridium perfringens Enterotoxicosis Casseroles Anaerobic bacterium Toxin produced during ____________ formation Diarrhea 8-24 hr after food consumption Self-limiting *Also causes gas gangrene, see Nervous System diseases 5 Gastrointestinal Bacterial Intoxications Botulism (______________________) – Consumed toxin can cause flaccid paralysis – Life support needed to prevent suffocation Bacillus cereus – Food poisoning associated with rice/ meat contamination – Found in water and soil Pseudomonas cocovenenans – Polynesian coconut contamination – Food poisoning may be fatal 6 Bacterial Infections Enteritis – Inflammation of the intestine – Physical damage • Invasion of cells by bacteria Dysentery • Submucosal damage leads to blood and mucus in the stool – Gram negative bacteria may cause fever to accompany symptoms 7 Bacterial Infectious Disease Salmonellosis – Poultry and poultry products – ___________________________ • 2000 strains • Notifiable disease • Strains help to trace public health problems to their source – Diarrhea 8-24 hr after food consumption – Self limiting, low mortality in infants and elderly 8 Typhoid Fever __________________________ Human reservoir only Fever headache diarrhea Many organs invaded Less than 500 cases/yr in U.S.A. Drugs Good public health measures prevent transmission 9 Bacterial Infections Shigellosis _______________________ and others _____________ are a reservoir Contaminated water assists spread 10 bacteria may be enough to cause diarrheal disease 450,000 cases/yr in U.S.A. Symptoms for 2-7 days, self limiting Asiatic Cholera – – – – ____________________ Developing nations Rice water stool Death due to __________________ – Rehydration therapy may be more effective than antibiotics 10 Bacterial Intestinal Infection Vibriosis – – – – _________________________ Seafood associated Marine bacteria, may also infect wounds Self limiting 2-5 days Traveller’s Diarrhea – – – – ____________________ is a common pathogen Water sources Dehydration is biggest danger Complications – IBS , lactose intolerance 11 Bacterial Infections Enterohemorrhagic E. coli – ______________________ – Shiga toxins cause intestinal hemorrhage, kidney failure, blindness – Children most sensitive – Ground beef, uncooked produce – 3000 cases/yr estimated, 30 deaths in U.S.A. 12 Bacterial Infectious Disease _________________________ – Food/H2O borne, copious diarrhea – Opportunistic – Second only to Salmonella in incidence – Animal intestines are source – Fluid replacement most important 13 Bacterial Upper G.I. Disease Peptic Ulcer/Chronic Gastritis – – – – __________________________ Neutralizes stomach acid by degrading urea 4 million sufferers in U.S.A. Treatment 14 Viral Gastrointestinal Disease Viral Enteritis – Rotavirus – Entrovirus – Norwalk virus 15 Viral Hepatitis Hepatitis A (HAV) – RNA virus – Oral-fecal transmission – Family transmission or contaminated water/shellfish – 15 – 40 day incubation – Jaundice, fever, malaise, nausea, diarrhea, abdominal pain, anorexia – 50% of cases asymptomatic – Self-limiting, immunity is gained – Vaccine since 1995 16 Hepatitis B Ds DNA virus Blood to blood transmission Symptoms as for HAV but liver cell damage is occurring Vaccine recommended for all health care workers since 1986 Also recommended for infants (90% will become chronic carriers) Carrier status linked to cirrhosis and liver cancer in later life 17 Protozoan GI Disease Giardia lamblia Balantidium coli Entameba histolytica 18