howto
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a man got diarrhea from a family's BBQ just 4 hrs before....what is the source of his diarrhea
a. chicken intestines
b. anterior nares
c. unclean grilled
d. soil
e. dirty welled-water..
this was asked before so any suggestion is appreciated...thanks
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| mjl1717
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Chicken intestine can have anything in it because a chicken eats its own feces
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| bactitech
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But what did he EAT? Diarrhea within 4 hours after eating is usually Staphylococcal in origin. If this is the case, the anterior nares of a huge amount of people carries Staph. aureus. Guess how it is spread? We check for MRSA carriers with anterior nares specimens.
Bottom line - don't pick and wash your hands!
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| Renegade
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a -Salmonella is notorious here
b -Heh... I'd say they were aiming for Strepto with this one..?
c -I believe this is the one. Staph can easily stay alive on a dirty medium like this long enough...
d/e -Not soil / well water; these are here for Clostridium, maybe amoebas...
I'd answer C; most of the options... I rule out because I believe they are there to suggest other agents.
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| bactitech
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http://www.cdc.gov/ncidod/eid/vol5no5/mead.htm
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodbo...
These sites give lots of information.
Key to diagnosis still is time to onset. Four hours has to be Staphylococcal. None of the others listed give that fast of an onset. You still need a culture to confirm any food poisoning, as times overlap.
http://www.prn2.usm.my/mainsite/bulletin/sun/1996...
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| alexbuc
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i would say c
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hello...i strated to prepare my usmle step1....need to know more about...looking for someone to work with
alex
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| mikhail
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it is d
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| mikhail
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i want to take it 2006y sept 1 and step2 2007 feb
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| mikhail
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sorry mistaked
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| alexbuc
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i think that is not a correct question...it is very ambigous....i looked some kaplan items....they are so clear.....very intelligent questions.....usually it is a cardinal sign that suggest clear the agen t.....here is not like this..
cheers..me i want to take the step in the summer
lord help me:L))
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hello...i strated to prepare my usmle step1....need to know more about...looking for someone to work with
alex
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| bactitech
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The anterior nares houses Staph. aureus in a huge percentage of the population. This is how it is passed to hospital patients and subsequently causes wound infections (i.e. nose picking - sorry to be gross but it's a fact). Doctors are notoriously lax in handwashing!!!!!!! I've seen doctors skip this step numerous times over the years. I used to work in a teaching hospital. We had a patient that was in isolation for TB and the residents didn't even mask up - apparently they were sure THEY wouldn't catch it. This kind of thinking can get you in serious trouble nowadays, as everything is that much more resistant.
Staph. aureus diarrhea can be very fast - 4 hours from intake. I don't see why everyone is having a problem with this question.
Chicken intestines -----> Campylobacter which takes much longer to cause diarrhea. Nothing else on that list will give you food poisoning in such a short period of time.
Now go wash your hands :-) :-) :-).
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| phuluong2k
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Yeah, i agree with bactitech
There is 2 cause of food intoxication for less than 4 hours
1. Staphylococcus aureus, i think it is in this case
2. B. cereus ( in rice) in the context of food poisoning in a chinese restaurant
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| bactitech
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http://www.ccc.govt.nz/Health/cereus.asp
The Symptoms (of B. cereus food poisoning)
"Symptoms with the diarrhoeal toxin are nausea, cramplike abdominal pains and watery diarrhoea, beginning 8 to 16 hours after eating and are related to the lower intestine. With the emetic toxin the symptoms are more severe and acute and are nausea and vomiting beginning 1 to 6 hours after eating and are related mainly to the upper intestine."
According to this, the diarrheal form takes 8-16 hours, and the emetic form 1-6 hours. So, I still stand by my Staph. aureus response.:-)
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| Moctopod
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Just a quick question. What does it mean by upper and lower intestine? I haven't heard that before.
Thanks
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| bactitech
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I'm assuming the B. cereus produces two toxins. One affects the upper intestine, which causes symptoms that come on quickly, and the other affects the large intestine, which causes the diarrhea symptoms. Obviously transit time to the lower till take longer.
At least that's what I got out of the article. I just found it on google - I'm not the author :-).
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| phuluong2k
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In hemorrhage we seperate upper GI hemorrhage and lower GI hemorrhage by the treitz ligament.
(the suspensory ligament of the duodenum: a band from the crus of the right diaphragm and a band around the coeliac artery :arrow: the third and fourth parts of the duodenum)
So i think upper & lower intestine is classified by this way
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| Moctopod
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Thanks a lot Phuluong and Bacitech! That makes it a lot clearer
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| bactitech
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http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4901a3...
Check out this great link for different enteric pathogens causing food poisoning.
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