Which one of the following best describes the reason for the marked decline in the incidence of epiglottitis in the pediatric population?
Correct Answer C: The dramatic decrease in the incidence of epiglottitis is the result of routine vaccination with Haemophilus influenzae type b vaccine. This decreased incidence has also dramatically reduced morbidity and mortality.
About 30 people came back home from a party where there was a lot of food such as pastries, cheese sandwiches with mayonnaise and sweets. Within 4-6 hours later, most of them develop vomiting and have loose diarrhea.
What is the most likely organism to cause this?
Correct Answer A: The is a classic case of food poisoning. Many different bugs can cause food poisoning including all of the above choices.
When vomiting is the major presenting symptom, suspect Staphylococcus aureus. Improperly stored foods with high salt or sugar content favor growth of staphylococci. Intense vomiting and watery diarrhea start 1-4 hours after ingestion and last as long as 24-48 hours.
→ Salmonella (choice B) is found in beef, poultry, eggs, and dairy products. Abrupt onset of moderate to large amount of diarrhea with low-grade fever is seen and in some cases, bloody diarrhea.
→ Campylobacter jejuni (choice C) is found in domestic animals, cattle, chickens. It is spread through fecal-oral transmission in humans and will cause foul smelling watery diarrhea followed by bloody diarrhea.
→ Enterohemorrhagic coli (eg, E coli O157:H7) (choice D) is found in improperly cooked hamburger meat and recently spinach and is the most commonly isolate pathogen in bloody diarrhea. Diarrhea starts 3-4 days after ingestion and usually progresses from watery to bloody diarrhea. It lasts for 3-8 days.
→ Giardia lamblia (choice E) is found in contaminated ground water. Campers are a common group who get this infection. It is spread through fecal-oral transmission and will cause mild bloody diarrhea with nausea and abdominal cramps, which start 2-3 days after ingestion, lasting for 1 week.
Which one of the following is least helpful in the investigation of an outbreak of suspected food poisoning?
Correct Answer A: In the investigation of a food poisoning outbreak it is important to have rapid identification of cases. All samples of food eaten should be collected and identified. To know with certainty that a bacterium is causing food poisoning, the bacterium must be cultured, usually from stool and is rarely ever done from vomitus.
Outbreaks of diarrheogenic Escherichia coli 0157:H7 have been associated with which one of the following?
Correct Answer C: Recent outbreak of E.coli 0157:H7-related illnesses have been associated with contaminated ground beef brought either uncooked in supermarkets or as cooked hamburgers at fast-food restaurants.
What is the most common cause of death in women (all age) worldwide?
Correct Answer D: 1/3 of all female deaths are due to cardiovascular disease and stroke (WHO).
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