Bacterial Diarrhea Food Poisoning
CTL Week 7 - Foodborne illnesses: infectious bacterial diarrheas
CTL Week 7 - Foodborne illnesses: food poisonings
- 1.
Two male college roommates traveled to Costa Rica for spring break. At their hotel they ate fruit salad and drank bottled water with ice. The next evening they both noted abdominal cramps, slight fever, and watery diarrhea that recurred several times during the night. The hotel doctor gave them antibiotic and oral rehydration salts. What pertains best to their illness?
- A.
This could be caused by a virus such as rotavirus that produced an enterotoxin.
- B.
A bacterium attached to the mucosa and secreted a toxin that increased intracellular cAMP
- C.
A bacterium in the food invaded intestinal epithelial cells and secreted a toxin that inhibited protein synthesis.
- D.
This could be caused by a protozoan such as Giardia or Entamoeba that damaged microvilli of intestinal mucosa.
Correct Answer
B. A bacterium attached to the mucosa and secreted a toxin that increased intracellular cAMPExplanation
The symptoms of abdominal cramps, slight fever, and watery diarrhea are characteristic of a bacterial infection. The fact that both roommates experienced the same symptoms after consuming food and water suggests that they were exposed to a common source of contamination. The presence of a toxin that increases intracellular cAMP indicates that a bacterium attached to the mucosa and secreted this toxin, causing the symptoms. This explanation aligns with the given answer choice.Rate this question:
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- 2.
At a daycare in Philadelphia 5 children were noted by the teacher to be using the bathroom often because of diarrhea. It was bloody and the children with fever and fatigue were sent to the hospital. The next day 7 more children got the same symptoms. A public health nurse brought liquid soap dispensers to the school and instructed everyone about hand washing, thus stopping the outbreak. What caused this problem?
- A.
The causative bacteria require a large infective dose, enabled by growth in contaminated food served at the school.
- B.
The causative bacteria originated from pet chicks and turtles that had been handled by the children 2 days earlier.
- C.
The causative bacteria are lactose fermenters on MacConkey agar and are motile.
- D.
The causative bacteria invaded colonic epithelial cells and elaborated a cytotoxin.
Correct Answer
D. The causative bacteria invaded colonic epithelial cells and elaborated a cytotoxin.Explanation
The correct answer is that the causative bacteria invaded colonic epithelial cells and elaborated a cytotoxin. This is the most likely explanation for the symptoms described, including bloody diarrhea, fever, and fatigue. The fact that the outbreak was stopped by hand washing suggests that the bacteria were transmitted through fecal-oral route, which is consistent with the bacteria invading the colonic epithelial cells. The elaboration of a cytotoxin by the bacteria could explain the severity of the symptoms experienced by the children.Rate this question:
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- 3.
Members of 5 families developed nausea, vomiting, and crampy abdominal pain 2-3 hours after attending a family reunion picnic held during the 4th of July. The menu consisted of baked ham, coleslaw, baked beans, deviled eggs, and coconut cream pie. An investigation conducted by the local public health authorities revealed that the deviled eggs had been prepared 48 hours before the picnic by a cook with an infected finger who was not wearing gloves. Because there were too many eggs to store in the refrigerator, the cook left them on the kitchen counter. Which of the following would be the most likely finding?
- A.
Gram stain of stool would show many Gram-negative, comma-shaped bacteria
- B.
KOH preparation of the left over eggs would show many budding yeasts
- C.
Gram stain of the left over eggs would show many Gram-positive cocci in clusters
- D.
Acid-fast stain of stool would show many red-stained oocysts
- E.
Methylene blue-stained stool smear would reveal numerous leukocytes
Correct Answer
C. Gram stain of the left over eggs would show many Gram-positive cocci in clustersExplanation
The most likely finding would be that the Gram stain of the leftover eggs would show many Gram-positive cocci in clusters. This is because the cook who prepared the deviled eggs had an infected finger, which could have introduced bacteria onto the eggs. Gram-positive cocci in clusters are commonly associated with Staphylococcus aureus, which is a common cause of food poisoning.Rate this question:
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- 4.
Noting that their baked restaurant chicken was pink and undercooked, two sisters 3 days later began having cramps, fever, and frequent blood-tinged stools. What had they eaten?
- A.
Heat-stable enterotoxin produced by enterotoxigenic E. coli
- B.
Meat contaminated by E. coli 0157:H7
- C.
Chicken that had been handled by a restaurant worker sick with Shigella dysentery
- D.
Meat contaminated by Campylobacter jejuni
Correct Answer
D. Meat contaminated by Campylobacter jejuniExplanation
The two sisters most likely ate meat contaminated by Campylobacter jejuni. This bacterium is commonly found in undercooked poultry and can cause symptoms such as cramps, fever, and bloody stools. The fact that their chicken was pink and undercooked suggests that it may have been contaminated with Campylobacter jejuni.Rate this question:
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- 5.
Diseases caused by EHEC and ETEC, for example, differ from EIEC in a number of ways. Which of the following ways does EIEC differ?
- A.
EHEC and ETEC are both pyogenic, EIEC is not
- B.
EHEC and ETEC are both pyrogenic, EIEC is not
- C.
EIEC is pyrogenic but not pyogenic, whilst EHEC and EHEC are neither pyrogenic nor pyogenic
- D.
EIEC is both pyrogenic and pyogenic, whilst EHEC and ETEC are neither pyrogenic nor pyogenic
Correct Answer
D. EIEC is both pyrogenic and pyogenic, whilst EHEC and ETEC are neither pyrogenic nor pyogenicExplanation
EIEC differs from EHEC and ETEC in that it is both pyrogenic and pyogenic, while EHEC and ETEC are neither pyrogenic nor pyogenic. This means that EIEC is capable of causing fever (pyrogenic) and producing pus (pyogenic), whereas EHEC and ETEC do not possess these characteristics.Rate this question:
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- 6.
A 6-year-old boy presents with abdominal pain and a bloody diarrhea, but without pyrexia. His mother suspects that he was infected at a family barbecue where many of the hamburgers were undercooked. As the diarrhea has been present for only one day, you send a fecal sample to a specialized laboratory for analysis. What would you recommend that the lab should do to confirm the presence of the suspected infectious agent?
- A.
Culture the organism on Sorbitol-MacConkey agar and check for the presence of colorless colonies
- B.
Culture the sample on nutrient agar and look for colonies of E. coli
- C.
Culture the colonies and then transfer a bacterial sample to culture medium to test for solubility in bile salts
- D.
Tell the lab to test the sample for the presence of all bacteria and to notify you if any are unusual
Correct Answer
A. Culture the organism on Sorbitol-MacConkey agar and check for the presence of colorless coloniesExplanation
The recommended approach is to culture the organism on Sorbitol-MacConkey agar and check for the presence of colorless colonies. This is because Sorbitol-MacConkey agar is a selective and differential medium that can help identify the presence of certain bacteria, such as E. coli O157:H7. This specific strain of E. coli does not ferment sorbitol, resulting in the growth of colorless colonies on the agar. Therefore, by observing the presence of colorless colonies, it can confirm the presence of the suspected infectious agent, E. coli O157:H7, which is commonly associated with undercooked hamburgers and can cause bloody diarrhea.Rate this question:
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- 7.
A 30 year old male presents with complaints of vomiting, abdominal pain, and fever associated with Bloody diarrhea.A CT scan of the abdomen shows liver abscesses.Most like agent causing these symptoms would be:
- A.
Entamoeba histolytica
- B.
Shigella
- C.
Camplobacter
- D.
Entero-hemorrhagic E. Coli
Correct Answer
A. Entamoeba histolyticaExplanation
The most likely agent causing the symptoms of vomiting, abdominal pain, fever, and bloody diarrhea along with liver abscesses seen on the CT scan is Entamoeba histolytica. This parasitic infection is commonly associated with amoebic dysentery, which presents with similar symptoms. The presence of liver abscesses further supports the diagnosis of Entamoeba histolytica, as this organism has a predilection for invading the liver. Shigella, Campylobacter, and enterohemorrhagic E. coli can also cause similar symptoms, but they are less likely in this case given the presence of liver abscesses.Rate this question:
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- 8.
A 28 year old female presents with complaints of abdominal pain fever and constipation after traveling to India. On physical exam she is noted to have lympadenopathy, splenomegly, and “rose spots” on her chest and abdomen. Most likely agent causing her symtoms and physical findings would be
- A.
Entamoeba hystolitica
- B.
Vibrio cholera
- C.
Shigella
- D.
Salmonella typhi
Correct Answer
D. Salmonella typHiExplanation
The most likely agent causing the patient's symptoms and physical findings is Salmonella typhi. This is because the patient has traveled to India, which is an endemic area for typhoid fever caused by Salmonella typhi. The symptoms of abdominal pain, fever, and constipation, along with the physical findings of lymphadenopathy, splenomegaly, and "rose spots" on the chest and abdomen, are characteristic of typhoid fever. Entamoeba hystolitica is the causative agent of amoebic dysentery, Vibrio cholera causes cholera, and Shigella causes shigellosis, but these conditions do not typically present with the specific symptoms and physical findings described in the question.Rate this question:
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- 9.
A day after eating raw oysters, a 27-year-old oil field worker in Louisiana developed cramps followed by voluminous watery diarrhea. Feeling faint while standing, he went to the ER where he was rehydrated with intravenous saline. What caused this illness?
- A.
Bacteria that belong to either El Tor or classical biotypes and cause an increase in intracellular cAMP
- B.
Bacteria that are Gram-negative and produce an enterotoxin that increases intracellular cGMP
- C.
Bacteria that are Gram-positive, catalase positive, and oxidase positive
- D.
Bacteria that are Gram-negative, catalase positive, and oxidase negative
Correct Answer
A. Bacteria that belong to either El Tor or classical biotypes and cause an increase in intracellular cAMPExplanation
The correct answer is "Bacteria that belong to either El Tor or classical biotypes and cause an increase in intracellular cAMP." This is the most likely cause of the oil field worker's illness based on the symptoms described. The cramps and watery diarrhea are consistent with a bacterial infection, and the increase in intracellular cAMP is a characteristic effect of these specific bacteria. The other options do not match the symptoms or characteristics described in the scenario.Rate this question:
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- 10.
A 27-year-old woman, who lives on a small farm, is brought to the emergency department because of a 2-day history of difficulty swallowing, slurred speech, dry mouth, blurred vision, and progressive weakness. The patient is so weak that she cannot hold her head up. Two nights ago she ate a cold, 3-bean salad made with home-canned green beans and commercially canned red kidney beans and garbanzo beans. In addition to providing supportive care, which of the following is the most appropriate next step in patient care?
- A.
Administer equine-derived specific immune globulin
- B.
Perform a colonoscopy to obtain biopsies of the mucosa
- C.
Administer appropriate intravenous antibiotics
- D.
Administer human-derived specific immune globulin
- E.
Administer an anti-motility agent
Correct Answer
D. Administer human-derived specific immune globulinExplanation
The patient's symptoms, including difficulty swallowing, slurred speech, dry mouth, blurred vision, and progressive weakness, are consistent with botulism poisoning. Botulism is caused by the toxin produced by Clostridium botulinum, which can be found in improperly canned foods. The most appropriate next step in patient care is to administer human-derived specific immune globulin, which contains antibodies against the botulinum toxin and can help neutralize the toxin in the patient's body. Administering equine-derived specific immune globulin is not recommended as it can cause allergic reactions. Performing a colonoscopy, administering antibiotics, and administering an anti-motility agent are not indicated in the management of botulism.Rate this question:
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- 11.
Four hours after eating egg salad and fried chicken at a picnic, 3 boy scouts after getting home began having belly aches and vomiting, which lasted for 3 hours. What happened most likely to cause their illness?
- A.
The fried chicken was contaminated with Clostridium perfringens bacteria, which produced enterotoxin in the intestine
- B.
The egg salad contained spores of Bacillus cereus, which germinated in the stomach and produced enterotoxin
- C.
The egg salad was contaminated with Staphylococcus aureus from someone’s hands and contained staphylococcal enterotoxin
- D.
The fried chicken contained Salmonella bacteria which multiplied in the stomach after ingestion and invaded the mucosa
Correct Answer
C. The egg salad was contaminated with StapHylococcus aureus from someone’s hands and contained stapHylococcal enterotoxinExplanation
The most likely cause of the boy scouts' illness is that the egg salad was contaminated with Staphylococcus aureus from someone's hands and contained staphylococcal enterotoxin. This is indicated by the symptoms of belly aches and vomiting, which are consistent with food poisoning caused by Staphylococcus aureus. Staphylococcus aureus is commonly found on the skin and can be transferred to food through improper hand hygiene. The bacteria produce enterotoxins that can cause gastrointestinal symptoms when ingested.Rate this question:
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- 12.
Peter and Jack attend an office picnic on Saturday afternoon. They ate hot dogs, egg salad, and jello at about 3 pm. After they went home and were watching a movie at 7 pm, they noted abdominal cramps and nausea followed by several bouts of vomiting that lasted for 2 hours. After this they felt fine. Which is applicable to this illness?
- A.
Staphylococcus aureus in the egg salad produced an enterotoxin in their stomachs during the 4 hours after they ate it
- B.
Bacillus cereus spores in the hot dogs germinated in their stomachs and produced an enterotoxin
- C.
An enterotoxin produced by Clostridium perfringens spores in the hot dogs caused the vomiting
- D.
Staphylococcus aureus from someone’s hands produced an enterotoxin in the egg salad before they ate it
- E.
Staphylococcus aureus enterotoxins are heat-labile and could have been destroyed if the picnic food had been reheated before the picnic
Correct Answer
D. StapHylococcus aureus from someone’s hands produced an enterotoxin in the egg salad before they ate itExplanation
The symptoms experienced by Peter and Jack, including abdominal cramps, nausea, and vomiting, are consistent with food poisoning caused by Staphylococcus aureus. This bacterium can produce enterotoxins that can cause these symptoms. Given that the symptoms occurred shortly after consuming the egg salad, it is likely that the Staphylococcus aureus from someone's hands contaminated the salad and produced the enterotoxin.Rate this question:
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Mar 21, 2023Quiz Edited by
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Oct 05, 2012Quiz Created by
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