84. Gastroenteritis Flashcards
(37 cards)
1
Q
RFs
A
Travel camping recent abx daycare raw seafood anal sex HIV + outbreaks
2
Q
Indications to order labs
A
o fever
o bloody
o severe abdo pain
o persistent diarrhea
3
Q
indications for stool Cx
A
o fever > 38.5 o dysentery o > 14 days o Recent Abx o Immunocompromised
4
Q
Indication for O+P
A
persistent diarrhea
5
Q
4 most common bacteria
A
campylobacter, salmonella, STEC, shigella
6
Q
signs of invasive infection
A
o Fever
o Blood
o Tenesmus
o Severe abdo pain
7
Q
source of campylobacter
A
- More common in summer
- Gr- bacteria
- Undercooked poultry
- Wilderness water
8
Q
MGMT campylobacter
A
- No empiric Abx if otherwise healthy
- Exception is traveler
- If not improving
o Erythro or azithro
o Cipro has high resistance now
9
Q
source of salmonella
A
- Contaminated food
o Poultry and beef - Must ingest large amount of bacteria
10
Q
MGMT salmonella
A
- No empiric Abx if otherwise healthy
o Possible for <3mon and > 50yo - Cipro or azithro
- If require hospitalization, then ceftriaxone
- No food handling until carrier state eradicated
11
Q
source of shigella
A
- Most common in poor sanitation countries
- Penal and nursing homes
- <5yo are 30% of cases
- MSM
- Requires very few bacteria
12
Q
MGMT shigella
A
- Fluids and lyte correction
- No need to Abx unless public health risk
- Abx shorten clinical course within 48 hours
o Cipro is drug of choice
13
Q
source of yersina
A
- Gr- bacterium
- More common in children
- Invades mucosa and localizes to lymphoid tissue
- Invasive in 2/3
- From contaminated food or milk
14
Q
MGMT yersina
A
- Usually self limited
- No anti-peristaltic unless abx
- No Abx if uncomplication
- Usually susceptible to TMP-SMX
15
Q
source of vibrio
A
raw fish in tropical waters
16
Q
MGMT vibrio
A
Most need none
no antimotility agents
17
Q
source of STEC
A
undercooked hamburger
18
Q
complication of STEC
A
o TTP Neuro findings predominate Renal failure uncommon o HUS Renal failure
19
Q
MGMT STEC
A
- Symptomatic
- Abx not helpful and can worsen risk of HUS
- Only Abx if fever > 38.5
20
Q
source of staph
A
- Most protein rich food have some
- Large outbreaks common worldwide
- Bacteria killed above 60C, but toxin is heat stable
21
Q
MGMT staph
A
- Rapid recovery is the rule
- Antiemetics
- IVF
- No Abx
22
Q
source of clostridium
A
- Common in large groups
- Meat or poultry
- Usually cooked food that was rewarmed poorly
- Illness caused by toxins
23
Q
mgmt clostridium
A
supportive
24
Q
source of baccilus cereus
A
- 2 forms Emetic Heat stable toxin Fried rice Diarrheal Meat and veggies
25
MGMT cereus
supportive
26
source of ETEC
fecal contamination of food
27
MGMT ETEC
nothing for most
| single dose cipro+loperamide
28
complications for cdiff
pseuodmembrane
toxic megacolon
perfs
29
MGMT c diff
- DC Abx
- Flagyl for 10-14 days for mild to moderate
- Vanco for severe
30
labs signs for toxic megacolon
older, immunosuppressed and have WBC >20
31
source of norovirus
fecal oral
| highly infectious
32
MGMT of rotavirus
supportive
| vaccine
33
MGMT norovirus
supportive
34
source of giardia
- Both active and inactive forms
- Infection through active form, spread through inactive form
- Contaminated food and water
- Common in hikers
35
MGMT giardia
flagyl
36
source of amebiasis
- Developing countries and poor sanitation
- Cysts can survive in environment for months
- Fecal oral food or anal-oral sex
37
MGMT amebiasis
flagyl
