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Y3R5: Medicine I 🩺 > L5: Infectious Diarrhea > Flashcards

L5: Infectious Diarrhea Flashcards

1
Q

Def of Diarrhea

A
  • Having three or more loose or liquid stools per day, or as having more stools than is normal for that person
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2
Q

Mechanisms of Diarrhea

A
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3
Q

Defect in Secretory Diarrhea

A
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4
Q

Characters of Stool in Secretory Diarrhea

A
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5
Q

Examples of Secretory Diarrhea

A
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6
Q

Defect in Osmotic Diarrhea

A
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7
Q

Characters of stool in Osmotic Diarrhea

A
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8
Q

Examples of Osmotic Diarrhea

A
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9
Q

Defect in Increased motility Diarrhea

A
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10
Q

Characters of Stool in Increased motility Diarrhea

A
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11
Q

Examples of Increased motility Diarrhea

A
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12
Q

defect in Decreased motility Diarrhea

A
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13
Q

Characters of Stool in Decreased motility Diarrhea

A
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14
Q

Examples of Decreased motility Diarrhea

A
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15
Q

Defect in Decreased surface area Diarrhea

A
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16
Q

Characters of stool in Decreased surface area Diarrhea

A
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17
Q

Examples of Decreased surface area Diarrhea

A
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18
Q

Defect in Inflammatory mucosal invasion Diarrhea

A
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19
Q

Stool Characters in Inflammatory mucosal invasion Diarrhea

A
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20
Q

Examples of Inflammatory mucosal invasion Diarrhea

A
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21
Q

Diagram of causes of diarrhea

A
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22
Q

Compare between Non-Inflammatory Diarrhea & Inflammatory Diarrhea

  • Symptoms
  • Stool
  • Site
  • Mechanism
  • Common Pathogens
A
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22
Q

Def of Dysentery

A
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23
Q

Causes of Diarrhea

A

Common Viral Causes

  • Rotavirus

Common Bacterial Causes

  • E-Coli
  • Cholera
  • Shigella
  • Salmonella
  • Colstridium
  • Staph

Common Protozoal Causes
- Amebiasis
- Giardia
- Cryptosporidium

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24
Q

Agde of Rota Virus

A

It causes severe diarrhea among infants and young children

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25
Q

MOI by Rota Virus

A

faecal-oral transmission.

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26
Q

IP of Rota Virus

A

2 days

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27
Q

CP of Rota Virus

A

Disease presented by vomiting, watery diarrhea, low grade feve

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28
Q

Hallmark of TTT in Rota Virus

A

maintenance of hydration

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29
Q

Prevention of Rota Virus

A

 Two vaccines are safe and effective in children.

 Both are taken orally and contain attenuated live virus

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30
Q

Most E. coli strains are harmless, but some serotypes are pathogenic and can cause serious food poisoning in humans

A

..

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31
Q

MOI by E-Coli

A

faecal-oral transmission

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32
Q

Enterotoxigenic E. coli (ETEC)

A

Traveler’s diarrhea

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33
Q

Enteropathogenic E.coli (EPEC)

A

Rarely causes disease in adults.

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34
Q

Enteroinvasive E. coli (EIEC)

A

Dysentery

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35
Q

Enterohemorrhagic E. coli (EHEC)

A

 Bloody diarrhea

 Severe hemorrhagic colitis

 Hemolytic uremic syndrome in 6-8% of cases

 Cattle are predominant reservoir of infection.

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36
Q

What is the most common illness in travelers?

A

Traveler’s diarrhea

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37
Q

Def of Traveler’s diarrhea

A

Three or more unformed stools in 24 hours passed by a traveler, commonly accompanied by abdominal cramps, nausea, and bloating

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38
Q

Causative agent of Traveler’s diarrhea

A

 Enterotoxigenic E.coli is the most commonly isolated pathogen.

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39
Q

TTT of Traveler’s diarrhea

A
  • Antibiotics are typically given for three to five days, but single doses of azithromycin or levofloxacin have been used.
40
Q

TTT of Traveler’s diarrhea if it persists despite antibiotics

A

If diarrhea persists despite therapy, travelers should be evaluated for possible viral or parasitic infections, bacterial or amoebic dysentery, Giardia, helminths, or cholera

41
Q

IP of Cholera

A

1 - 5 days

42
Q

MOI by Cholera

A
  • fecal-oral route, especially contaminated water
43
Q

CP of Cholera

A
  • Sudden profuse, painless diarrhea and vomiting of clear fluid.
  • “rice water” in nature and may have a fishy odor
44
Q

Investigations in Cholera

A

1) A rapid dip-stick test is available

2) Stool and swab samples collected and cultivated using Enrichment media

45
Q

TTT of Cholera

A
46
Q

Prevention of Cholera

A
47
Q

vaccination of Cholera

A
48
Q

Another Names of Shigellosis

A

Bacillary dysentery or Marlow Syndrome

49
Q

IP of Shigellosis

A

12 - 96 h

50
Q

MOI by Shigellosis

A
  • Feco-oral route especially contaminated water
  • Less than 100 bacterial cells can be enough to cause an infection
51
Q

Investigations for Shigellosis

A

1) Stool smear revealed red and white blood cells.

2) Culture

52
Q

CP of Shigellosis

A

Range from mild abdominal discomfort to severe dysentery

53
Q

TTT of Shigellosis

A
54
Q

What not to use as TTT in Shigellosis?

A

Antidiarrheal drugs (loperamide) may prolong the infection and should not be used in shigellosis

55
Q

Another Names of Enteritis Salmonellosis

A

food poisoning Salmonell “Non typhoidal”

56
Q

IP of Enteritis Salmonellosis

A

12 - 72 h

57
Q

MOI by Enteritis Salmonellosis

A

1) Poultry, pork, and beef, if the meat is prepared incorrectly or is infected with the bacteria after preparation.

2) Infected eggs, egg products, and milk.

58
Q

CP of Enteritis Salmonellosis

A
  • Nausea, vomiting, abdominal cramps, and bloody diarrhea with mucus.
  • Headache, fatigue, and rose spots may present.
  • Can be severe, especially in young children and the elderly.
59
Q

Investigations for Enteritis Salmonellosis

A
  • Stool smear revealed red and white blood cells.
  • Culture (from stool or vomitus) is positive in 10-15%.
60
Q

TTT of Enteritis Salmonellosis

A
  • Immunocompromised and patients with evidence of Bacteremia

⇒ Antibiotics, such as norfloxacin, ciprofloxacin or third generation cephalosporin may be given

61
Q

Def of C. difficile

A
  • C. difficile is a commensal bacterium of the human
    intestine in 2-5% of the population
62
Q

Method of Infection by C. difficile

A

Antibiotics (clindamycin) (antibiotic associated colitis)

63
Q

CP of C. difficile

A
  • the most common cause of pseudomembranous colitis, and in rare cases this can progress to toxic megacolon, which can be life-threatening
64
Q

Investigations for C. difficile

A

 Isolation of toxin in stool
 Culture of organism

65
Q

TTT of C. difficile

A

 Stop offending agent
 metronidazole + vancomycin

66
Q

MOT of Staph-Induced Diarrhea

A

ingestion of contaminated food Containing preformed staph (cake, salad, ham) with heat stable

67
Q

CP of Staph-Induced Diarrhea

A
  • Nausea, vomiting, abdominal pain followed by diarrhea
  • Fever is rare
68
Q

INVx for Staph-Induced Diarrhea

A
  • Definite diagnosis is by culturing the organism from
    contaminated food, stool or vomitus
69
Q

TTT of Staph-Induced Diarrhea

A
  • Supportive.
  • No role for antibiotics bacterial toxins.
70
Q

Common Protozoal Causes of Diarrhea

A
  • Amebiasis
  • Giardiasis
  • Cryptosporidium
71
Q

MOT by Amebiasis

A

Ingestion of cyst (Feco-oral)

72
Q

CP of Amebiasis

A

1) Asymptomatic

2) Amoebic dysentery.

3) Amoebic liver abscess

stool samples ELISA or RIA can also be used

73
Q

TTT of Amebiasis

A
  • Metronidazole for the invasive trophozoites
  • A luminal amoebicide for cysts paromomycin or
    diloxanide furoate (Furamide).
74
Q

MOT by Giardiasis

A

Ingestion of cyst

75
Q

CP of Giardiasis

A
  • Steatorrhea.
  • Multiple stool examinations
76
Q

TTT of Giardiasis

A
  • Metronidazole (7 days)
  • Tinidazole (single dose)
  • Nitazoxanide (3 days)
77
Q

Def of Cryptosporidium

A

an acute, short-term infection, but can become severe and non-resolving in

  • Children
  • Immuno compromised individuals (HIV)
78
Q

Nature of CP of Cryptosporidium in Children & Immu ocomprimised

A

can become severe and non-resolving in:

  • Children
  • Immuno compromised individuals (HIV)
79
Q

CP of Cryptosporidium

A
  • Usually suspected and isolated in HIV patients presenting by diarrhea
80
Q

TTT of Cryptosporidium

A
  • Treatment is symptomatic, with fluid rehydration, electrolyte correction
81
Q

Diarrhea is a defense mechanism

A

…

82
Q

Diarrhea may function as an evolved expulsion defense mechanism

  • As a result, if it is stopped, there might be a delay in recovery
A

…

83
Q

Managment of Acute Diarrhea

A
  • Rehydration
  • Role of Antibiotics
  • Other drugs
84
Q

Managment of Acute Diarrhea

  • Rehydration
A
85
Q

The primary treatment of gastroenteritis in both children and adults is …..

A

Rehydration

86
Q

This is preferably achieved by ……, although intravenous delivery may be required if a there is a decreased level of consciousness or if dehydration is severe.

A

oral rehydration therapy

87
Q

Managment of Acute Diarrhea

  • Role of Antibiotics
A

Antibiotics are not usually used for gastroenteritis, although they are sometimes recommended if:

1) Symptoms are particularly severe

2) If a susceptible bacterial or protozoal cause is isolated or suspected.

3) A macrolide (such as azithromycin) is preferred over a fluoroquinolone in traveler diarrhea due to higher rates of resistance.

88
Q

Bacteria and protozoans that are amenable to treatment include ……

A

(Shigella, Salmonella typhi and, Giardia. Species)

89
Q

Antibiotics are specific to …..

A
  • Giardia species / Entamoeba histolytica.
    ⇒ Tinidazole treatment is recommended and superior to metronidazole
90
Q

Antibiotics are useless in …….

A

Viral gastroenteritis

91
Q

Antibiotics are harmful in cases of …..

A
  • The Pseudomembranous colitis usually caused by antibiotic
  • TTT: stop offending agent + metronidazole + vancomycin
92
Q

Other Drugs used in Diarrhea

A
  • Antimotility drugs
  • Physical adsorbents
  • Role of micronutrients
  • Role of probiotics
93
Q

Other Drugs used in Diarrhea

  • Antimotility Drugs
A

Should be avoided.

94
Q

Other Drugs used in Diarrhea

  • Physical Adsorbents
A

Compounds as Bismuth, kaolin, charcoal are postulated to act by adsorbing toxins.

95
Q

Other Drugs used in Diarrhea

  • Role of Micronutrients
A
  • Trials of zinc supplementation in India demonstrated clinically important decrease in severity and duration of diarrhea.
96
Q

Other Drugs used in Diarrhea

  • Role of Probiotics
A
  • Recommended in diarrhea after use of antibiotics
97
Q

The following types of diarrhea may indicate further investigation

A

Y3R5: Medicine I 🩺 (48 decks)

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