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1.Which of these is NOT a common cause of diarrhea?
a. H. pylori
b. Salmonella enteritidis
c. Vibrio parahemolyticus
d. E. coli
2. Which of these is not associated with community-acquired or nosocomial UTI's ?
a. E. coli b. Proteus vulgaris
c. Klebsiella pneumoniae d. Salmonella enteritidis
3. Your pt is a 30 year old woman with a diarrhea [with frank blood present] for the past 2 days.
Which of the following is most likely to cause this illness, based on symptoms only?
a. Shigella sonnei b. Salmonella enteritidis c. C. jejuni d. enterotoxic E. coli
4. A 50 year old homeless alcoholic with pneumonia has been coughing up thick gelled bloody sputum.
The organism isolated from the sputum produces large extensively mucoid colonies on agar media.
Which organism is the most likely cause of this illness?.
a. Campylobacter jejuni b. Enterobacter cloaceae
c. K. pneumoniae
d. E. coli
5. Which of these is not an "out " infection due to E. coli?
a. acute watery diarrhea
b. urinary tract infection
c. neonatal meningitis
d. ventilator-assoc. pneumonia
6. Which of these bacteria is not associated with frank blood in the stools?
a. Salmonella
b. EIEC
c. ETEC d. Shigella
7. Which of these bacteria may permanently colonize the gall bladder and turn a patient
(often middle-aged women, for unknown reasons) into a lifelong carrier of the organism ?
a. Vibrio cholerae
b. ETEC
c. Campylobacter
d. Salmonella typhi
8. Of these diseases, which does NOT involve an exotoxin acting on the enteric tract?
a. cholera
b. traveler’s diarrhea
c. botulism
d. C. perfringens diarrhea
9. Which of these bacteria has a low very infective dose and can routinely
be contracted from flies/fecal/food transmission?
a. Salmonella
b. Shigella
c. Campylobacter jejuni
10. Which of these does not cause G- septicemia?
a. Shigella flexneri
b. H. pylori
c. Vibrio cholera
d. E. coli
d. none of these do
11. Which of these is the most common normal flora associated with urinary tract infections ?
a. Pseudomonas aeruginosa
b. E. coli
c. Enterobacter
d. Proteus vulgaris
12. Which of these is a common cause of nosocomial infections?
a. H. pylori
b. Salmonella
c. V. parahemolyticus
d. none of the them
13. Which of these commonly causes fatal watery diarrhea?
a. Shigella flexneri b. Enterobacter c. Vibrio cholerae d. Klebsiella pneumoniae
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14. Which of these commonly cause nosocomial Gram negative pneumonia?
a. Enterobacter b. Serratia c. Pseudomonas d. Klebsiella
e. all of them
f. none of them
15. A 5 year old child develops diarrhea, high fever, bloody urine and stools, kidney failure, and DIC.
[see notes on "Toxins" for DIC description]. Which of the following is the most likely cause?
a. E. coli 0157:H7
b. E. coli normal flora
c. ETEC
d. EIEC
16. A 17 year old female, who had an appendectomy 72 hours previously, now has fever and abdominal
pain. Which of the these is least likely to be present in the post-surgical infection?
a. Shigella
b. normal flora E. coli
c. Enterobacter
d. Proteus vulgaris
17. A 22 year old female develops frequent burning urination, cloudy urine, and a mild fever.
A urinary gram stain shows Gram negative rods. The most likely cause is:
a. EHEC
b. ETEC
c. EIEC d. E. coli normal flora
18. Your patient is a sexually active 19 year old female college student diagnosed with a urinary
tract infection. Analysis of the urine reveals a pH of 9, with a strong smell of ammonia.
Which of these is a likely cause of the infection?
a. Proteus
b. E. coli
c. Klebsiella
d. Enterobacter
19. Two hours after dining out at Salads-R-Us, a student experiences mild diarrhea. The illness progress
to high fever, headache, muscle pain, and an abdominal rash. Salmonella typhi is isolated from her
blood at the hospital the next day. As an expert witness for the restaurant, your best argument to show
that the restaurant is not involved with her illness is:
a. Salmonella typhi does not generally involve diarrhea
b. a very small portion of the population are typhoid carriers
c. The onset of the disease was too rapid to have been due to the salad.
d. Salmonella typhi is an enteric organism
20. 4 days after Thanksgiving, all members of a family develop diarrhea, fever, and abdominal pain.
Differential agar reveals only the usual lac+ E. coli normal flora. When incubated under microaerobic
conditions, many non-fermentative colonies are found. The bacteria are Gram-, strongly motile,
slightly curved rods. The cause of the infection is most likely to be:
a. Campylobacter colitis due to an undercooked, over-stuffed turkey
b. Salmonella colitis due to secondary contamination of the clam dip
c. E. coli colitis due the turkey juice on the cutting board used for the shrimp salad
d. Shigella due to the carving knife contaminated by a housefly .
21. Which of these is least useful in accurately diagnosing the cause of acute diarrhea?
a. elapsed time of since eating
b. presence of fever
c. patients gender
d. recently consumed foods
22. College clinics treats 10 times as many females as males for E. coli UTI’s, while the number of
nosocomial UTI’s at the local hospital is roughly the same for males and females. Why?
a. community acquired UTI’s are much more common in females than in males
b. nosocomial UTI's are generally due to catheterization; catheterization is unrelated to gender
c. uncomplicated UTI’s are infrequent in males unless they are catheterized
d. all of the above contribute to the disparity in rates
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23. What is the usual target for an exotoxin?
a. macrophages
b. platelets
c. a specific host cell type
d. complement system
24. A healthy college age female has cloudy urine, burning urination, mild fever, and mild abdominal
pain. A urine Gram stain reveals Gram negative rods. Based on the symptoms, which of these is the
cause and what is the proper course of treatment?
a. common E. coli UTI; treatment is hydration +/- oral ABX (sulfa or cipro commonly)
b. UTI due to Klebsiella, treat with cipro
c. Proteus infection, treat with sulfa, and acidify urine
d. all are possible [and common], not enough information to identify the organism.
FILL THESE IN ON THE ANSWER SHEET. They are final exam questions. NO, I didn't supply
the list of diseases and bacteria that would be on the final….since this is "open book".
25 A bile resistant, G-, bacteria is isolated from the colon of patients with food-associated diarrhea.
The organism is not associated with disease at other locations. What kind of enteric organism
(in/out/both) is this?______________
26 A bile resistant, G- organism is isolated from a case of nosocomial sepsis that began at an IV line.
The organism does not cause enteric tract infection, but can be isolated from the colon.
What kind of G- rod is it? (in/out/both)___________?
27. This enteric bacteria is the #1 cause of UTI’s, traveler's diarrhea, and neonatal meningitis . _E.
coli________
28. A patient has diarrhea with painful abdominal cramps, rectal spasms, and high fever.
There is pus, mucus, and frank blood in the stools. What's the name of the disease?Shigellosis
29 What bacteria is the common cause (80% of cases) of #28?Shigella
30 The enteric bacteria in #28-29 unique; it is only transmitted human to human.
What is the other G- enteric rod that is only transmitted H2H Salmonella typhii________________?
31. What species of #28-29 only occurs rarely in the USA [imported from other countries]
and produces a powerful exotoxin – "Shiga toxin" ? _ Shigella dysenteriae _____________
32 A patient has chronic upper abdominal pain that is not relieved by antacids.
A urease breath test is positive. What's the disease?___Gastritis_____________
33 What bacteria causes the disease in #32 __H. pylori_________________?
34. A patient recently returned from Mexico develops watery diarrhea.
What bacteria is the common cause? ETEC____________ [give the correct abbreviation]
35 What is the common name for the diarrhea in #34 ?_ Traveler's diarrhea _____________________
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36. A newborn develops a stiff neck, high fever, cries incessantly, has unresponsive pupils, and her
retina's reveal intracranial pressure due to inflammation. She develops coma and dies.
What's was the likely disease?_Neonatal meningitis__________
37. What enteric organism is the most likely cause in #36 ?__E. coli____________
38. Who was the source of the infection in #36? _Mom____________
39 A patient who returned yesterday from India develops rice-water diarrhea, and severe dehydration.
Treatment with ORT is continued for 2 days as she loses 1 liter of fluid per hour.
What bacteria causes this often fatal epidemic diarrhea? Vibrio cholerae ___________
40. What is the common name for the disease in #39?_Cholera________?
41 A 10 year old develops mildly bloody diarrhea, high blood urea, bloody urine, and kidney failure.
She now requires lifelong kidney dialysis, and has been placed on the transplant list.
What's the disease___ Hemolytic uremic syndrome______________?
42 What's the usual organism in #41 ? ___
E. coli O157:H7
43. A student develops acute vomiting without fever 2 hours after eating samples of non-pasteurized
cheese at the county fair. The acute onset and lack of fever suggest that this disease is _ mild type
dysentery __________.
44. What bacteria is associated with the food-associated illness in #43. _EIEC_____________
45. A patient with a high fever, frequent painful urination is producing urine that reeks of ammonia.
Microscopic examination of the urine reveals extensive precipitation of phosphate salts.
A gram stain shows G- rods. This bacteria is likely to be __Proteus_________.
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PRINT 25-45 NEATLY OR I WON'T GRADE IT.
Enteric Homework
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