acute Diarrhea Flashcards by Adar stern Bronsthein

what is the most common pathogen for viral gastroeneritis?

Norovirus-
מונו מונו אני “לבד” וטוב לי- הפוכה, בתי ספר, קרוזים , בתי אבות.
חשיפה – אחרי יומיים הקאות ושלשולים – עובר אחרי 72 שעות

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מה הפתוגנזה של רוטה וירוס

Duedonum + proximal jeujonum&raquo_space; villi blunting, prolifration of crypts cells and loss of brush border enzymes

no fecal luekocytes

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what Administration of moderate to severe dehydration in childrens?

which fluid and how

Bolus IV istotonic fluids

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whats the pathogen?

Raw /prepared food (potato salad)&raquo_space; 3 hrs later&raquo_space; VOMITING + wattery stool

vomiting > diarrhea

S.aureus

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what is the DDx for vomiting dominant gastroenteritis?

S. aureus
Bacillus Cereus

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whats the pathogen?

Vomiting dominant Gastroenteritis after reheating rice

Bacillus cereus
סיראוס- סיר אוז
Enterotoxin

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Whats the pathogens?
return from india w/acute onset od diarrhea and abdominal pain

Traveler’s diarrhea = ETEC E.coli (Exterotoxigenic)

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what are the 2 types of ETEC toxin

Heat-labile = activation of adenylate cyclase = increase cAMP

Heat stable = activation oc Gunelate cyclase = increase cGMP

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Whats the most common causeses (3) of acute onset bloody diarrhea?

E.coli O157:H7
Compylobacter
Shigella

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whats the diagnosis?

31 yr old&raquo_space; 7 days of lower abdominal pain + bloody diarrhea (wakes at night). Hb 8. MCV 67, PLT 55K, WBC 11K, Cr 2.4, coombs negetive, schistocyts on blood smear

what cause it

Hemolytic Uremic Syndrome = HUS
Thrombocytopenia - around 40-60K

Diagnosis- E.coli O157:17 (STEC- shiga toxin) or Shigella dysenteriae

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who have the greater risk for HUS

children < 10

E.coli (STEC O157:H7) or Shigella dysentheria

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What the patogenesis of O157:H7 EHEC + Shigella dysenteriae

inhibition of 60S&raquo_space; block protein synthesis&raquo_space; cell death&raquo_space; watery diarrhea that may become bloody

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True / False

pt with EHEC will always present with fever

False
will not have fever

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how to EHEC transmitted

Contaminated / undercook foood

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How to destinguisah Inflammatory diarrhea with non inflammatory?

preseance of fecal blood and leukocytes

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which medicaiton can cause diarrhea

Metformin
allopurinol- prevent gout, lower uric acid levels
orlistat- for loosing weight
SSRI
cholinesterase inhibitor
PPI
NSAIDS

MOCA PAN

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How can we resolve osmotic diarrhea comapre to secretory diarrhea

osmotic diarrhea- can be resolved by fasting

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what do Shigella cuease to the intestital epithelium

Invade and enter enterocytes&raquo_space; cell death of epithelium&raquo_space; ulcerationd and bloody / mucoid diarrhea

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whare are the 2 classic symptoms of shigella infection?

High fever
Left side abdominal pain (rectosigmoid)

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Which complecation can shigella cause in pediatrics?

Siezures

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why shigella species rq low infection dose to cause disease?

survive in acidic enviroment of the GI tract

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What are the characterstic of shigella on labratory:
1. lactose fermantation
2. which agar

Non lactose fermentation
Non hydrogen sulfide on triple sugar iron agar

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What cause Campylobacter gastroeneritis?

Poultry (fram chickens) and domasticated animals (dogs..)

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whats the diagnosis?

Diarrhea mucoid / bloody + fever + pseudoappendecitis (oliocetis) in a pt that have a dog

Study These Flashcards

Compylocabter

which pathogs are the 2 most common cuase of **psuadoappendicitis** in USMLE

* Yersinisa enterolitica * Campulobacter jejuni

# whats the diagnosis trip to india >> eat local food >> 2 weeks later >> fever 1 week >> severe abdominal pain + distenaion + salomon colur (rose spots) circular lesions | also, who is the pathogen and how transmitted

* Thypoid fever * Slamonella Thypi * Feco-oral transmittion

Which pathogen associated with contaminated food and water can cause **Hemorrhagic enteritis (Bowl perforation)**

Salmonella Thypi

How Slamonella thypi invade the immune sys?

Via capsular antigen >> inhibit nuetophils >>replication in macrophages

Which Hematological disease can present with Non-typhoidal salmonella osteomoylietis

Sickle cell

What the presentation of Non typpoidal salmonella?

bloody diarrhea after eating a lot of eggs / contact with turtules/pets

which pathogen cause a foul smelling amniotic fluid + gram positive bacilli

Listeria monocytogenes

Which pathogen is presented with " Thumnling motility in room Tm"

Listeria monocytogenes | facultative anaerobe

Listeria monocytogenes: in adult in pregnent women what the presentation?

Story of expose to deli meet / cheeses adults- Self limiting Gastroenteritis Pregnant- Intrauntrine fetal demise = death (Hepatic abcess)

When we will give Abx for acute diarrhea?

1. Severe with systemic symptoms > 7 days 2. immunocompromised

How to diagnosed C.difficle

**stool PCR analysis or enzyme Immunoassay ** for C.diff toxins or Glutamtate dheydrogenase antigen

Whats the diagnosis? inpatint stay / use of antiontics in pat 12 wks , on day 3 on hospital present with fever, Watery diarrhea with trace of mucus and blood

C.difficile

All the following are major risk factor for ___________ Abx use, PPI, cytotoxic Chemotherapy, age >65, recent hospitalization

C. difficile

Whats C.difficle typical finding on colonoscopy

psuedomembranes | Fibrin & inflammatory cells

how so psuadomembranous form?

Ingestion of pores >> Toxin A &Toxin B >> inflammatory reaction >> actin cytoskeletal structre disrapture | C. difficile (gram positivie)

Tx for C.difficile?

Vanco or Fidaxomicin (macrolide)

What is the mechanism of aciton of macrolide?

inhibit RNA polymerase >> Bactericial

Tx for toxic mega colon after C.difficle

Bowl rest + NG tube + PO and rectal fidaxomicin / vanco and consider Metronidazole + Stop antinotility agents | if severe = consider colectomy

Which of the following wont prevent/ kill bacterial spoers of C.difficile? 1. handwashing 2. Alcohol 3. Nonsterile gloves + Gown

Alcohol woldn't kill bacterial spores

Watery diarrhea after return from trip

ETEC

Watery diarrhea with "rice water stool"

Vibrio cholera

Watery diarrhea on cruise ship

Norovirous/ Norwalk virus

Watery diarrhea in HIV

Cryptospardium parvum

Bloddy diarrhea + consuming meat

Shigella (or maybe EHEC, Compylobacter)

Bloddy diarrhea + lactose ferment

EHEC

Most common cause of bloddy diarrhea in usa

c. jujuni

Diarrhea that feels like Appendicitis

Yersiniea enterolitica

Protozoal cause bloody diarrhea

Entamoeba hystolitica

Blodody diarrhea + HUS

EHEC or Shigella

Diarrhea after consuming oysters / seafood

Vibrio parahemolyticus

Diarrhea after consuming oyster / seafood + elevated liver enzymes

Vibrio vulnificus

Diarrhea after sweimming in fresh water- (also aquarium association)

Aeromonas

Diarrhea after reheat rice

Bacillus cereus

Diarrhea 6-15 hrs after meat/ poultry left out long

Clostirdium Perfingens

Rash + slapped cheeks apprerance

parvo B12

acute Diarrhea Flashcards

(59 cards)