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Gastrointes 3 > 012015 diarrhea w infec > Flashcards

012015 diarrhea w infec Flashcards

1
Q

clinical course of acute diarrhea

A

USUALLY SELF LIMITED

usually infectious, but even non-infectious causes will typically resolve

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2
Q

etiology of small bowel infectious diarrhea

A

small bowel inflammed–leading to villous blunting, then malabsoprtion, then gut microbiome utilization of substrate, then abd cramping/bloating/gas/weight loss

cellular or intracellular leaking–mechanism similar to above

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3
Q

fever is rare in small bowel infectious diarrhea-true or false

A

true

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4
Q

infectious causes of infectious diarrhea

A

most gastroenteritis is viral

there’s also severe community acquired diarrhea (majority of which is bacterial)

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5
Q

can get Salmonella typhi from

A

poultry, eggs, milk

pet turtles

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6
Q

shigella

A

highly contagious

daycare settings

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7
Q

why are antidiarrheal meds not used for infectious diarrhea?

A

b/c diarrhea is the body’s natural way of cleansing out pathogens

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8
Q

most common bacterial infectious cause of diarrhea

A

campylobacter jejuni

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9
Q

campylobacter jejuni

A

influenza like prodrome usually (fever, malaise, myalgias)

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10
Q

campylobacter jejuni infectious diarrhea can present also with what other symptoms?

A

reactive arthritis, erythema nodosum (palpable, painful)

Guillain Barre syndrome

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11
Q

like an appendicitis/RLQ pain

A

Campylobacter jejuni

Yersinia

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12
Q

giardia lamblia

A

acute or chronic diarrhea
upper abdominal bloating
sm bowel disease

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13
Q

E coli

A

colonize healthy GI tract-most are nonpathogenic but a subset cause human disease

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14
Q

traveler’s diarrhea E coli

A

enterotoxigenic E coli (ETEC)

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15
Q

pathogenesis of ETEC

A

expresses either heat labile toxin (similar to cholera toxin) or heat stable toxin (which increases cGMP with similar effects)

for heat labile toxin, cAMP causes secretion of Cl through its channel. prevents reabsorption of NaCl at villus tips. so you get net water secretion

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16
Q

types of E coli diarrhea

A

ETEC
EIEC
EAEC
EHEC

17
Q

ATTACHES to enterocytes by adherence fimbriae

A

EAEC

18
Q

associated with hemolytic uremic syndrome (anemia, thrombocytopenia, uremia)

A

enterohemorrhagic E coli (EHEC)

19
Q

seafood associated disease (shellfish, plankton)

A

vibrio cholerae

20
Q

pathogenesis of vibrio cholerae

A

cholera toxin causes increased cAMP which opens CFTR to release Cl into lumen and draw water out

21
Q

norovirus is common in

A

adults

22
Q

rotavirus is common in

A

children

23
Q

which organism can cause pneumonitis?

A

ascaris lumbricoides (nematode)

24
Q

strongyloides

A

larvae live in fecally contaminated ground soil-can penetrate unbroken skin such as feet

migrate to lungs from which they are swallowed
mature into adult worms in intestines. eggs can hatch and release larvae that penetrate mucosa–AUTOINFECTION

25
Q

leading cause of iron deficiency anemia in the developing world

A

necator maericanus and ancylostoma duodenale (hookworms)

they do autoinfection like strongyloides

26
Q

in immunocompromised hosts, what are they likely to get

A

cryptosporidium parvum
MAC
CMV

27
Q

nosocomial causes of diarrhea

A

C diff is really important

28
Q

proctitis

A

suggests rectal cause b/c the rectum is inflammed and in pain with stool there so you want to get it out

29
Q

waking up in the night

A

rectal cause

30
Q

gas/bloating

A

small bowel process of C diff

31
Q

hx of fever w diarrhea, think

A 
invasive bacteria
enteric viruses
cytotxic organism (C diff or entamoeba histolytica)
ischemia
IBD
32
Q

why is scoping not helpful really for infectious colitis?

A

most bacterial infections all induce similar histopathology

33
Q

when should you do stool studies for infectious colitis?

A

do NOT do for acute and pt who looks good b/c disease is self limited

severely ill
outbreaks
requires hospitalization
immunocompromised pts
pts with comorbdities (IBD)
employees may need the test to return to work
34
Q

ELISAs or DFA microscopy is used more or less commonly than stool test for ova and parasites?

A

more commonly

35
Q

indications for empiric antibiotics

A

fever, bloody diarrhea, and presence of occult blood or fecal leukocytes in stool (except for suspected EHEC or C diff)

greater than 8 stools per day, volume depleted, hospitalized, immunocompromised

36
Q

C diff’s virulence factors

A

toxins A, B

etc

37
Q

toxic megacolon

A 
C diff (severe forms)
it's a surgical emergency
38
Q

pseudomembranous colitis

A

C diff

39
Q

tx for C diff

A

vancomycin (inpt) and metronidazole (outpt)

Gastrointes 3 (17 decks)

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