Block 14 Viral Gastroentiritis
Questions and Answers
- 1.
The mother of a 6-month-old child presents with her child at the emergency department in March. Earlier in the evening, the child suddenly started vomiting and has done so several times since and now presents with watery diarrhea. What is the most likely etiologic agent responsible for this child’s illness?
- A.
Astrovirus
- B.
Calicivirus
- C.
Adenovirus
- D.
Torovirus
- E.
Rotavirus
Correct Answer
E. RotavirusExplanation
Rotavirus is the most likely etiologic agent responsible for this child's illness because it is a common cause of gastroenteritis in infants and young children. The symptoms of vomiting and watery diarrhea are consistent with rotavirus infection. Additionally, rotavirus is known to be highly contagious and spreads easily in settings such as daycare centers or hospitals. It is also important to note that rotavirus infections are more common during the winter months, which aligns with the timing of the child's illness in March.Rate this question:
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- 2.
The mother of a 6-month-old child presents with her child at the emergency department in March. Earlier in the evening, the child suddenly started vomiting and has done so several times since and now presents with watery diarrhea. What is the most likely source of the child’s infection?
- A.
Aerosols from an infected, asymptomatic sibling
- B.
Breast milk
- C.
Water
- D.
Direct contact with an infected, asymptomatic sibling
- E.
Blenderised shellfish
Correct Answer
D. Direct contact with an infected, asymptomatic siblingExplanation
The most likely source of the child's infection is direct contact with an infected, asymptomatic sibling. This is because the child started vomiting and has watery diarrhea, which are common symptoms of a gastrointestinal infection. Direct contact with an infected sibling increases the risk of transmission of the infection, especially if the sibling is asymptomatic.Rate this question:
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- 3.
A 39-year-old male presents to an outpatient clinic complaining of abdominal cramps and sudden onset of vomiting and diarrhea. What is the most likely etiologic agent responsible for this man’s illness?
- A.
Giardia lamblia
- B.
Norovirus
- C.
E. coli O157:H7
- D.
Dinophysis sp.
- E.
Rotavirus
Correct Answer
B. NorovirusExplanation
In the absence of any detail, choose the most common etiology. This reasoning applies to questions 1.1 and 2.Rate this question:
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- 4.
Which statement is false?
- A.
Rotavirus infections usually occur as outbreaks
- B.
Rotaviruses are responsible for the majority of deaths due to diarrhea.
- C.
Rotavirus infections are observed primarily in children under the age of two
- D.
There are vaccines against rotaviruses.
- E.
IgA antibodies afford the best protection against rotaviruses
Correct Answer
A. Rotavirus infections usually occur as outbreaksExplanation
Rotavirus infections usually occur as sporadic cases, not necessarily as outbreaks. Outbreaks can occur in settings such as daycare centers or hospitals, but individual cases can also occur outside of these settings.Rate this question:
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- 5.
What are the characteristics of the Caliciviridae?
- A.
Naked, (-) ssRNA
- B.
Naked, (+) ssRNA
- C.
Naked, dsRNA
- D.
Naked, dsDNA
- E.
Naked, ssDNA
Correct Answer
B. Naked, (+) ssRNAExplanation
The correct answer is "Naked, (+) ssRNA". Caliciviridae is a family of viruses that have a naked capsid, meaning they do not have an envelope surrounding their genetic material. They have a single-stranded RNA genome, with a positive sense polarity, which means that the RNA can be directly translated into proteins by the host cell's machinery.Rate this question:
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- 6.
What are the characteristics of the Reoviridae?
- A.
Naked, (-) ssRNA
- B.
Naked, (+) ssRNA
- C.
Naked, dsRNA
- D.
Naked, dsDNA
- E.
Naked, ssDNA
Correct Answer
C. Naked, dsRNAExplanation
Reoviridae is a family of viruses that have a unique characteristic of being naked, meaning they do not have an outer envelope. Additionally, they have a genome made up of double-stranded RNA (dsRNA). This is in contrast to other options such as single-stranded RNA (ssRNA) or DNA (dsDNA or ssDNA).Rate this question:
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- 7.
A 75-year-old male nursing home resident complains of abdominal cramps, sudden onset of vomiting and watery diarrhea. A stool sample sent for analysis appears watery with no mucous and is negative for blood, leukocytes or parasites. Stool culture is negative for bacteria. He is the third case within the nursing home residents and one healthcare worker also presented with the same symptoms. This episode seems to be restricted to this population. What virus(es) is(are) most likely to be responsible for this outbreak? CHECK ALL THAT APPLY
- A.
Astrovirus
- B.
Calicivirus
- C.
Adenovirus
- D.
Torovirus
- E.
Rotavirus
Correct Answer(s)
A. Astrovirus
E. RotavirusExplanation
The most likely viruses responsible for this outbreak are Astrovirus and Rotavirus. This is indicated by the sudden onset of vomiting and watery diarrhea, which are common symptoms of both viruses. Additionally, the negative stool culture for bacteria suggests a viral cause. The fact that there are multiple cases within the nursing home residents and a healthcare worker also presented with the same symptoms further supports a viral outbreak.Rate this question:
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- 8.
What is the best indicator for a norovirus outbreak?
- A.
Children and adults affected
- B.
Only adults affected
- C.
Only children affected
- D.
Confined to restricted geographical location (camp, compound, school, hospital, ship)
Correct Answer
A. Children and adults affectedExplanation
The best indicator for a norovirus outbreak is when both children and adults are affected. This suggests that the virus is spreading among different age groups and is not limited to a specific population. If only adults or only children were affected, it could indicate a different type of illness or a more localized outbreak. However, when both children and adults are affected, it is a strong indication of a norovirus outbreak. Additionally, the answer mentions that the outbreak is not confined to a restricted geographical location, further supporting the idea of a widespread norovirus outbreak.Rate this question:
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- 9.
A 20-month-old girl is brought by her mother to the emergency department following the sudden onset of vomiting and watery diarrhea (no mucus, no blood). The child has a fever and her vital signs are: HR 130/min, RR 36/min and BP 100/60 mmHg. A stool sample sent for analysis is negative for leukocytes, bacteria, cysts or ova. Which of the following is the enterotoxin involved in this child’s illness?
- A.
Neuraminidase
- B.
Shiga toxin
- C.
NSP4
- D.
CPE
- E.
NS1
Correct Answer
C. NSP4Explanation
NSP4 is the enterotoxin involved in this child's illness. NSP4 is a viral enterotoxin produced by rotavirus, which is a common cause of gastroenteritis in children. The symptoms described, such as vomiting, watery diarrhea, and fever, are consistent with rotavirus infection. The negative stool sample for leukocytes, bacteria, cysts, or ova also supports a viral etiology.Rate this question:
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- 10.
A 20-month-old girl is brought by her mother to the emergency department following the sudden onset of vomiting and watery diarrhea (no mucus, no blood). The child has a fever and her vital signs are: HR 130/min, RR 36/min and BP 100/60 mmHg. A stool sample sent for analysis is negative for leukocytes, bacteria, cysts or ova. What best describes the most likely virus responsible for this child’s illness?
- A.
Naked, (+) ssRNA
- B.
Naked, (-) ssRNA
- C.
Naked, ssDNA
- D.
Naked, dsRNA
- E.
Naked, dsDNA
Correct Answer
D. Naked, dsRNAExplanation
The most likely virus responsible for this child's illness is a naked, dsRNA virus. This is because the child is presenting with symptoms of gastroenteritis, such as vomiting and watery diarrhea, which are commonly caused by viral infections. The absence of leukocytes, bacteria, cysts, or ova in the stool sample suggests a viral etiology. Additionally, the fact that the virus is described as naked and dsRNA indicates that it is likely a member of the Reoviridae family, which includes rotaviruses, a common cause of gastroenteritis in young children.Rate this question:
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- 11.
A 10-year-old boy presents with his mother to an outpatient clinic in March following an abrupt onset of vomiting and diarrhea. The child has a low-grade fever and his vital signs are: HR 120/min, RR 28/min and BP 110/70 mmHg. A stool sample sent for analysis and culture yields the following results: Watery with no mucus Negative for blood Negative for leukocytes Negative for parasites Negative for pathogenic bacteria Negative for rotavirus antigen Negative for norovirus antigen Positive for a naked, (+) ssRNA virus What is the most likely etiologic agent responsible for this child’s gastroenteritis?
- A.
Astrovirus
- B.
Coronavirus
- C.
Adenovirus
- D.
Norovirus
- E.
Rotavirus
Correct Answer
A. AstrovirusExplanation
The most likely etiologic agent responsible for this child's gastroenteritis is Astrovirus. This is suggested by the positive result for a naked, (+) ssRNA virus in the stool sample analysis. Astrovirus is a common cause of viral gastroenteritis in children, characterized by symptoms such as vomiting, diarrhea, and low-grade fever. The negative results for other pathogens, such as rotavirus and norovirus, further support the likelihood of Astrovirus as the cause.Rate this question:
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- 12.
A 2-year-old boy presents with his mother to an outpatient clinic in July following an abrupt onset of several episodes of diarrhea. The mother reports that the child ‘seems colicky and that his stools are very liquid with mucus in them’. On physical examination, the child has a low-grade fever, but all other findings are unremarkable. A stool sample sent for analysis and culture yields the following results: What is the most likely etiologic agent responsible for this child’s gastroenteritis? Watery with mucus Negative for blood Negative for leukocytes Negative for parasites Negative for pathogenic bacteria Negative for rotavirus antigen Negative for norovirus antigen Positive for a naked, dsDNA virus
- A.
Rotavirus
- B.
Norovirus
- C.
Adenovirus
- D.
Coronavirus
- E.
Astrovirus
Correct Answer
C. AdenovirusExplanation
The most likely etiologic agent responsible for this child's gastroenteritis is adenovirus. This is indicated by the positive result for a naked, dsDNA virus in the stool sample analysis. Adenovirus is a common cause of gastroenteritis in children, particularly in the summer months. It can cause symptoms such as diarrhea, fever, and mucus in the stools, which align with the presentation described in the question.Rate this question:
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- 13.
A 7-year-old girl presents with her mother to an outpatient clinic in February following an abrupt onset of vomiting and diarrhea. On physical examination, the child has a low-grade fever and complains of abdominal pain; all other findings are unremarkable. A stool sample sent for analysis and culture yields the following results: Watery with no mucus Negative for blood Negative for leukocytes Negative for parasites Negative for pathogenic bacteria Negative for rotavirus antigen Negative for norovirus antigen Positive for a naked, (+) ssRNA virus What is the most likely etiologic agent responsible for this child’s gastroenteritis?
- A.
Coronavirus
- B.
Adenovirus
- C.
Astrovirus
- D.
Reovirus
- E.
Calicivirus
Correct Answer
C. AstrovirusExplanation
Astrovirus is the most likely etiologic agent responsible for this child's gastroenteritis. This is indicated by the positive result for a naked, (+) ssRNA virus in the stool sample analysis. Astrovirus is a common cause of viral gastroenteritis in children, especially during the winter months. The symptoms of vomiting and diarrhea, along with a low-grade fever and abdominal pain, are consistent with astrovirus infection. The negative results for blood, leukocytes, parasites, pathogenic bacteria, rotavirus antigen, and norovirus antigen further support this diagnosis.Rate this question:
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- 14.
During a food safety conference held on a cruise ship, 164 attendees and crew members are struck with a sudden onset of vomiting (average of 5 times/day), abdominal cramps, and watery diarrhea (average of 8 times/day) within a 48-hour period. At the next scheduled stop, water, food, and stool samples are sent for analysis by local health authorities. Results for the stool samples are as follows: Watery with no mucus Negative for blood Negative for leukocytes Negative for parasites Negative for viral enterotoxins Negative for bacterial enterotoxins What is the most likely etiologic agent responsible for this outbreak?
- A.
Coronavirus
- B.
Adenovirus
- C.
Astrovirus
- D.
Reovirus
- E.
Calicivirus
Correct Answer
E. CalicivirusExplanation
Based on the symptoms described (vomiting and watery diarrhea), as well as the negative results for bacterial and viral enterotoxins, the most likely etiologic agent responsible for this outbreak is Calicivirus. Calicivirus is a common cause of gastroenteritis and is known to cause symptoms such as vomiting and diarrhea. The negative results for other pathogens such as parasites and leukocytes further support this conclusion.Rate this question:
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- 15.
What is the most likely source of ABOVE outbreak (question No. 14)?
- A.
Whipped cream
- B.
Undercooked hamburger meat
- C.
Devilled eggs
- D.
Garden salad
- E.
Undercooked chicken
Correct Answer
D. Garden saladExplanation
Garden salad is the most likely source of the outbreak because it is often made with a variety of raw vegetables which can easily become contaminated with bacteria such as E. coli or Salmonella if not properly washed or handled. Additionally, if the salad dressing or other toppings are made with raw eggs, it can further increase the risk of foodborne illness.Rate this question:
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Current Version
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Mar 22, 2023Quiz Edited by
ProProfs Editorial Team -
Oct 17, 2012Quiz Created by
Chachelly
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