GI- Diarrhea Flashcards
24 y/o male comes to clinic with a CC of abrupt onset of watery diarrhea, abdominal cramping, and vomiting. He has just returned 2-days ago from Tijajuna, Mexico and states he did not drink the local tap water but did have ice in his cocktails. During physical exam the patient has normal appearing skin, good skin turgor, has a blood pressure of 102/88. His lip appear dry and cracked. What organism is the most likely cause?
A. Norovirus
B. Enterotoxigenic E. Coli
C. Vibrio Cholerae
D. Shigella
B. Enterotoxigenic E. Coli
Explanation: The patient has Traveller’s diarrhea. He has recently traveled to an area with known poor sanitation standards and poor drinking water quality. Although he did not directly drink local tap water he ingested water from ice cubes in his cocktails. All forms of diarrhea can present with dehydration however V. Cholerae will present with severe dehydration.
17 y/o girl presents with sudden onset of abdominal pain, nausea, vomiting, and bloody diarrhea. She has no significant past medical history. She is currently using benzoyl peroxide for her ance. She was recently prescribed clindamycin becasue her acne was refractory to benzoyl peroxide treatment. She has a temperature of 100.6 deg. F, heart rate of 98, respiration of 20, skin signs appear normal, and her blood pressure is 102/72.
What organism is the most likely cause?
A. Shigella
B. Salmonella
C. Campylobacter
D. Clostridium Difficle
D. Clostridium Difficle
Explanation: The was recently prescribed clindamycin as concomittant therapy with benzoyl peroxide for her ance. Clindamycin is a known cause for c-diff.
Watery diarrhea, abdominal cramps, bloating, and flatulence after ingesting milk and dairy products.
Lactose intolerance
Watery diarrhea caused from eating rice. Typical board question is a person whom was eating rice at a buffet or restaurant.
B. Cereus
Watery diarrhea which later turns mucioid and bloody. It is spread through the fecal/oral route and caused from contaminated water, poor sanitation, overcrowding, daycares, and/or shelters. It can cause febrile seizures in kids, toxic megacolon and Reiter’s syndrome
Shigella
Spread via the fecal-oral route with greater incidence in summer months. Causes mucous streaked bloody diarrhea. Mainly caused by undercooked poultry products, exotic pets (reptiles, turtles).
Salmonella
24 y/o male comes to clinic with a CC of frequent bouts of watery diarrhea that is grey in color with no odor. He has just returned 2-days ago from Tijajuna, Mexico and states he did not drink the water but did have ice in his cocktails. During physical exam the patient looks pale, has poor skin turgor, and has a blood pressure of 88/68. What organism is the most likely cause?
A. Norovirus
B. Enterotoxigenic E. Coli
C. Vibrio Cholerae
D. Shigella
C. Vibrio Cholerae
Explanation: The patient has recently traveled to an area with known poor sanitation standards and is overcrowded. Although he did not directly drink water he ingested water from ice cubes in his cocktails. He is also severely dehydrated as shown with his low blood pressure and poor skin signs. “Rice water stools” is a classic presentation of vibrio cholerae and is described as grey with no odor, blood, or pus.
Bloody diarrhea after chicken and uncooked eggs
Salmonella
Caused watery stool which later turns bloody. Usually caused by ingestion of undercooked ground beef and unpasteurized milk, and contaminated water.
Enterohemmorrhagic E. Coli
Watery diarrhea caused by unsanitary drinking water Main cause of Traveller’s diarrhea.
Enterotoxigenic E. Coli
Medication contraindicated with invasive and bloody diarrhea?
Loperamide (anti-motility). may cause toxicty
Remote stream, dam, backpacker’s diarrhea, beaver fever
Giardia Lamblia
Wasting illness characterized by arthralgias, arthritis, fever, and watery steatorrhea diarrhea. Weight loss, statorrhea, and joint pain are characteristics of this disease.
Whipple’s disease:
Shigella Tx in > 18 y/o
Cipro or fluroquinolones
Symptoms mimic acute appendicitis with fever, and watery diarrhea. Sources include contaminated pork and tofu. Sometimes contaminated water and milk.
Yersinia Eterocolitica
Prolonged constipation (1-2 weeks) which changes to diarrhea associated with Salmonella and “pea soup” stools (brown and green color). Patient’s will also have an intractable fever and “rose spots,” skin lesions that blanch.
Typhoid fever
Watery diarrhea caused by water contamination in areas with poor sanitation and overcrowding. This will cause extreme dehydration due to “copius” amounts of watery diarrhea. Stools are described as grey with no odor, blood, or pus (“rice water stools”).
Vibrio Cholerae
