Infectious Diarrhea

Question 1

definition of diarrhea

Answer 1

3 or more loose or water stools w/in a 24 hr period

Question 2

timeframe for acute, persistent, and chronic diarrhea

Answer 2

acute-<14
persistent >14-30
Chronic >30 days

Question 3

two classifications of ID

Answer 3

inflammatory
non inflammatory

Question 4

functionally based infectious diarrhea metrics

Answer 4

mild > 3 a day
moderate 3-10
severe >10 a day

Question 5

type of virus that causes VID

Answer 5

norovirus
(rotavirus in children)

Question 6

incubation period for VID

Answer 6

12-48 hours

Question 7

presentation of VID (norovirus/norwalk virus)

Answer 7

cramps, N/V/D, HA, fever.
self limited. 1-3 day recovery

Question 8

Types of bacterial ID/Escherichia coli (E. coli)

Answer 8

Enterotoxigenic (ETEC)
Enterohemorrhagic (EHEC) also called STEC (Shiga toxin)

Question 9

treatment for E coli infectious diarrhea

Answer 9

oral rehydration, antimotility agents, antiemetics. depending on severity level, maybe Abx

STEC should NOT be treated with ABx

Question 10

what type of bacteria is salmonella enterica?

Answer 10

gram negative, rod shaped bacillus

Question 11

typical sx of salmonella

Answer 11

acute diarrhea, abdominal pain, fever, and vomiting for 4-7 days. (can cause focal infections such as osteomyelitis and abscesses)

Question 12

what is a cause of bacterial ID that is normally carried in intestinal tracts of domestic and wild animals

Answer 12

Campylobacter

Question 13

severe sx of campylobacter can mimic what diseases?

Answer 13

acute appendicitis or ulcerative colitis and causes complications such as IBS, temprary paralysis, and arthiritis

Question 14

what is the most common intestinal parasitic disease affecting humans in the united states and is MER REQ

Answer 14

Giardia

Question 15

acute giardiasis has what sx

Answer 15

diarrhea characterized as foul smelling and greasy, cramps, bloating, fatigue, anorexia, and nausea.

Question 16

lab diagnosis for giardiasis

Answer 16

antigen detection assay
stool microscopy

Question 17

treatment for giardiasis

Answer 17

Tinidazole 2gm PO single dose
Metronidazole (Flagyl) 250 mg PO TID

patient can shed cyst in the water and infect other so cannot go into water until asymptomatic for 48 hrs.

Question 18

Timeline of sx and food history for ID

Answer 18

w/in 6 hrs- S. aureus or B. cereus
8-16 hrs- C perfringens
>16 hrs- viral or other bacterial

Question 19

Infectious diarrhea TX guidelines

Answer 19

rule out more serious/life threatening pathologies
good History
rehydration
BRAT diet

loperamide
Bismuth subsalicylate
LR if needed.

Question 20

when to consider medevac/medadvice with infectious diarrhea

Answer 20

fever 101.3
positive hemoccult
severe dehydration
multiple patients at once
inability to control N/V w antiemetics