1

Anatomy Review

Mouth

Stomach

Hepatobiliary Tree

Small Intestine

Large Intestine

2

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

3

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

4

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

5

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

6

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

7

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

8

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

9

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

10

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

11

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

12

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.

13

Bacterial Infectious Disease

_________________________– Food/H2O borne, copious diarrhea

– Opportunistic– Second only to Salmonella in

incidence– Animal intestines are source– Fluid replacement most important

14

Bacterial Upper G.I. Disease

Peptic Ulcer/Chronic Gastritis– __________________________– Neutralizes stomach acid by degrading urea– 4 million sufferers in U.S.A.– Treatment

15

Viral Gastrointestinal Disease

Viral Enteritis– Rotavirus

– Entrovirus– Norwalk virus

16

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

17

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

18

Protozoan GI Disease

Giardia lamblia

Balantidium coli

Entameba histolytica