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GI #1 > infectious DIARRHEA > Flashcards

infectious DIARRHEA Flashcards

1
Q

define diarrhea

A

> 3 liquid or semi solid stools daily for at least 2-3 days

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2
Q

inflammatory vs non-inflammatory diarrhea

A
  • inflammatory diarrhea: bloody or purulent diarrhea associated w/ fever, tenesmus & cramps (dysentery)
  • non-inflammatory diarrhea: non-bloody–suggests enterotoxic bacterial, viral or protozoan process
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3
Q

what is travelers diarrhea

A

watery, crampydiarrhea (sometimes fever too) that occurs w/in 10 days of travel to developing nation

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4
Q

4 differential diagnosis for acute (under 14 days) diarrhea

A
  1. bacteria or virus
  2. medication
  3. food
  4. mesenteric ischemia
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5
Q

8 differential diagnosis for chronic diarrhea

A
  1. parasites
  2. IBD or IBS
  3. celiac
  4. malabsorption
  5. pancreatic insufficiency
  6. hyperthyroidism
  7. endocrine tumor
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6
Q

fifth leading cause of death in kids under 5

A

diarrheal disease

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7
Q

when do most diarrhea cases happen in the US

A

winter d/t viruses

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8
Q

2 HEENT signs of dehydration that i dont often think of

A

sunken eyes
sunken fontanelle in neonates

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9
Q

1 CBC and 2 BMP findings that are suggestive of dehydration

A

CBC: increased HCT or leukocytosis
BMP: elevated BUN & CR
BMP: possible non-anion gap metabolic acidosis (high Na or low K)

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10
Q

blood cultures are particular helpful for…

A

salmonellosis

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11
Q

what is the most common testing for diarrhea? what variation of that testing is helpful for chronic diarrhea?

A

stool antigen & PCR
stool ova & parasite exam– chronic diarrhea

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12
Q
  • typohoidal (sewage contaminated water) or non-typhoidal (chicken,eggs, dairy, birds, reptiles) aerobic gram-neg bacillus
  • antiacid use
  • purulent, bloody (non-typhoid) diarrhea w/ fever or septicemia

what is this? tx?

A

salmonella gastroenteritis
PO ciprofloxacin 500mg BID x 7-14 days

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13
Q
  • gram-neg enterotoxin producng bacillus
  • anal-oral transmission & sewage water
  • risk factors– daycare
  • purulent, bloody, cramping w/ fever

what is this? what is the tx?

A

shigella
tx: PO cipro 500mg BID x 3 days or Bactrim

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14
Q
  • comma-shaped gram neg rod in pairs; seagull shape
  • undercooked poultry or raw milk
  • purulent, bloody, cramping w/ fever
  • increased risk w/ antiacid use

what is this? what is the tx?

A

campylobacter
**PO azithromycin ** or Cipro

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15
Q
  • gram neg bacillus
  • cattle; undercook & contaminated ground beef, cider, milk, lettuce
  • kids are at risk for HUS
  • purulent, bloody cramping w/ fever

what is it and how is it treated?

A

EHEC ECOLI
NO abx– supportive care

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16
Q

main cause of travelers diarrhea

A
  1. ETEC ecoli
  2. EAEC ecoli
17
Q

how is travelers diarrhea tx (first line & alt)? how is it prevented ?

A

tx: PO ciprofloxacin or PO levofloxacin
prophylaxis: PO Rifaximin

18
Q
  • shellfish & sushi
  • watery, very dehydrating
  • NO fever

condition & tx

A

vibrio (cholerae)
tx: single dose oral cipro or doxy.

19
Q
  • refrigerated meats, pasteurized milk
  • can mimic appendicitis
  • bloody watery diarrhea w/ fever

condition & tx

A

Yersinia
PO cipro or IV doxy (if severe) or IV gentamicin (if severe

20
Q
  • spore forming
  • prior abx use
  • profuse watery diarrhea

conditon & tx

A

PO VANCO or PO Fidaxomicin, FMT or colectomy if toxic megacolon

21
Q

very contagious
most common viral GI pathogen in winter
cruise ships & shellfish
watery diarrhea

A

norovirus; self limiting + hydration

22
Q
  • resistant to hand washing and most disinfectants
  • almost only kids under 3yo
  • watery diarrhea w/ low grade fever
A

Rotavirus
PO vaccine prophylaxis & supportive care

23
Q

parasitic infection

  • fecal-oral; water & food; liver abscess
  • watery or bloody & cramping
  • parasite

what is it? tx??

A

amoebiasis
PO tinidazole or PO metronidazole

24
Q
  • contaminated STREAM water while camping
  • beaver fever
  • watery diarrhea w/ bloating
A

Giardiasis
PO tinidazole

25
Q
  • fecal-oral route
  • AIDS & other immunocompromised
  • watery diarrhea
A

cryptosporidiosis
PO nitazoxanide

26
Q

BRAT diet

A

easily digestible foods

27
Q

tx for minimal dehydratoin (under 3% loss)

A

1tbsp salt + 2tbsp sugar in 1L water
oral rehydration solution (120-240 ml)

28
Q

tx for moderate dehydration (3-9% loss)

A

50-100 ml per kg over 2-4 hrs

29
Q

tx for severe dehydration (10+% loss)

A

requires hospitalization for IV hydration of normal saline 20ml/kg until improved

30
Q

two meds that must be avoided in dysentry or confirmed bacterial or parasitic diarrhea

A

PO loperamide (imodium)
PO diphenoxylate (lomotil)

ANTIMOTILITY DRUGS

31
Q

opiod receptor agonist of ENS

A

PO loperamide (imodium)

32
Q

acts on pre-synaptic opioid receptors (mainly mu receptors) of the ENS

A

PO diphenoxylate

33
Q
  • Inhibits DNA synthesis in obligate anaerobes
  • avoid alcohol d/t disulfiram rxn
  • metallic taste; peripheral neuropathy w/ prolonged use
A

metronidazole

34
Q

targets DNA gyrase to impair DNA replication
QT prolongation, interactions w/ di & trivalent cations and spontaneous tendon rupture

A

PO cipro

35
Q

impairs precursors to PCN binding proteins for wall stabilization
suspension > pills

A

PO vancomycin

36
Q

when is fecal microbiota transplant (FMT) used?

A

treatment-refractory C. diff

GI #1 (10 decks)

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