Anatomy Review n Mouth n Stomach n Hepatobiliary
Anatomy Review n Mouth n Stomach n Hepatobiliary Tree n Small Intestine n Large Intestine 1
Oral Cavity Bacterial Diseases n Dental Plaque – Accumulations of ____ (biofilm) – May calcify n Dental Caries – ____________ – Lactic acid erodes dental enamel n Periodontal disease – Tooth support structures – ________ – gum inflammation – _________ – root of tooth also affected 2
Oral Cavity Viral Diseases n 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 3
Gastrointestinal Bacterial Intoxications n 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 n n n Casseroles Anaerobic bacterium Toxin produced during ______ formation Diarrhea 8 -24 hr after food consumption Self-limiting *Also causes gangrene, see Nervous System diseases 5
Gastrointestinal Bacterial Intoxications n Botulism (___________) – Consumed toxin cause flaccid paralysis – Life support needed to prevent suffocation n Bacillus cereus – Food poisoning associated with rice/ meat contamination – Found in water and soil n Pseudomonas cocovenenans – Polynesian coconut contamination – Food poisoning may be fatal 6
Bacterial Infections n Enteritis – Inflammation of the intestine – Physical damage • Invasion of cells by bacteria n Dysentery • Submucosal damage leads to blood and mucus in the stool – Gram negative bacteria may cause fever to accompany symptoms 7
Bacterial Infectious Disease n 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 _____________ n Human reservoir only n Fever headache diarrhea n Many organs invaded n Less than 500 cases/yr in U. S. A. n Drugs n Good public health measures prevent transmission n 9
Bacterial Infections n n n n 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 n Asiatic Cholera – – __________ Developing nations Rice water stool Death due to _________ – Rehydration therapy may be more effective than antibiotics 10
Bacterial Intestinal Infection n Vibriosis – – n _____________ 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 n 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 n _____________ – Food/H 2 O borne, copious diarrhea – Opportunistic – Second only to Salmonella in incidence – Animal intestines are source – Fluid replacement most important 13
Bacterial Upper G. I. Disease n Peptic Ulcer/Chronic Gastritis – – _____________ Neutralizes stomach acid by degrading urea 4 million sufferers in U. S. A. Treatment 14
Viral Gastrointestinal Disease n Viral Enteritis – Rotavirus – Entrovirus – Norwalk virus 15
Viral Hepatitis n 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 n n 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 n Also recommended for infants (90% will become chronic carriers) n Carrier status linked to cirrhosis and liver cancer in later life n n 17
Protozoan GI Disease n Giardia lamblia n Balantidium coli n Entameba histolytica 18
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