American Board of Internal Medicine (ABIM) Certification Practice Exam

What makes gastrointestinal infections from Vibrio species particularly severe?

1. Obesity

2. Age under 5

3. Liver dysfunction

4. Diabetes mellitus

The correct answer is: Liver dysfunction

Gastrointestinal infections caused by Vibrio species can lead to severe outcomes, particularly in individuals with liver dysfunction. The underlying reason for this heightened severity lies in the role that a properly functioning liver plays in immune response and detoxification. The liver is crucial in filtering out pathogens and toxins from the bloodstream. In cases of liver dysfunction, which may arise from conditions like cirrhosis or chronic liver disease, the host's ability to manage infections diminishes significantly. This immune impairment increases the risk of severe illness when exposed to Vibrio species, which often thrive in aquatic environments and can contaminate food or water. Infected individuals may suffer from severe diarrhea, dehydration, and systemic issues like sepsis. Vibrio cholerae, for example, can cause cholera, which is characterized by acute watery diarrhea and can quickly lead to severe dehydration and death if not treated promptly. In contrast, while conditions such as obesity, being under 5 years of age, or having diabetes mellitus may contribute to overall health vulnerabilities, they do not specifically heighten susceptibility to the severe manifestations of Vibrio infections in the same direct manner as liver dysfunction does. The liver’s critical functions in immune regulation and nutrient metabolism are central to understanding why individuals with liver dysfunction