Acute Diarrhea DSA Powerpoint Flashcards Preview

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Flashcards in Acute Diarrhea DSA Powerpoint Deck (129):
1

what does schistosoma mansoni cause

bloody stools
bladder cancer
liver cysts

2

most common cause of acute infectious diarrhea (2 bacteria)

salmonella
campylobacter

3

commoin in tropical and subtropical areas of the world
acute non bloody watery diarrhea
in immunosupp pts diarrhea can be severe
caused by coccidian parasite
malabsoprtion and weight loss bc can last 4 weeks

cystoisospora belli (formerly isospora belli)

4

shigella

children
potato or egg salad, lettuce, raw veggies
blood disarrhea
fecal leukocytes positive
lactrose negative
reactive arthritis and HUS

5

mutation for FAP

APC or MUTYH

6

child diarrhea defined as

>20/g/kg/day stool

7

cryptosporidium 2 main clinical symptoms

-type of diarrhea
outbreaks involving what

self limited diarrhea in immunocompetent pts
-no treatment

life threatetning intractable in immunosupp pts
-AIDS cd4 count below 200, antivirals to increase CD4 count

-watery diarrhea large volume (over 20L a day)

-outbreaks involving swimming pools

8

motile S shaped gram neg rod

campylobacter

9

HUS

shigella most common
EHEC next most common
happens in children more that are treated with antibiotics

10

yersiniosis may lead to

autoimmune type thyroiditis, pericarditis, GN

11

shigella treatment

bismuth, amp, fluoroquin, trimeth/sulfa

12

chronic diarrhea cuases

SSRI
cholinesterase inhib
NSAIDs
PPI
ACEI
metformin
allopurinol

13

what is recommended to person with IBS

low FODMAP diet

14

yersinia enterocolitica
-higher risk in
-type of diarrhea
-complications
-treatment

iron overload syndromes
bloody and non bloody
mimics appendicitis
hemochromatosis
supportive care

15

for celiac and pt with IgA defeiicency check what

anti-DGP

16

treatment of constipation/fecal impaction
diagnose too

diagnose with DRE
tx: enema, digital disruption

17

short bowel syndrome increased chance of

oxylate kidney stones
give clacium supplemntation
increawsed cholest gallstones

18

treatment for salmonella typhimurium

antiobiotics are usually not indicated

19

genetic defect Familial juvenile polyposis

18 and 10
MADH4 and BMPR1A

20

get from produce from endemic areas
-lettuce, fresh basil, imported raspberries
-travel to endemic area
-watery diarrhea
-indefinite in immunosupp and 21 days in immunocomp

cyclospora cayetanesiss

21

treatment for EHEC

supportive
antibiotics only in severe cases

22

traveler's diarrhea risk factor

H2 blocker/PPI

23

secretory diarrhea
-sodium
-osmotic gap

high, normal

24

SBS: colon removed need at least ___ cm of prox jejunum for oral nutriotino

200 cm

25

2nd most common cause of gastroenteritis in children
watery diarrhea and vomiting
conjunctivitis
pharyngitis

adenovirus

26

etiology of bacterial overgrowth

PPI
gastric surgery of small bowel
SI motility disorder
gastrocolic or coloenteric fistula

27

which organisms do you use immunoassays for

c diff
rotavirus
giardia
e histolytica

28

painless rectal bleed

diverticulosis bleed

29

whipple disease finding

PAS (+) macrohages with gram + bacilli

30

screening for lynch

colonscopy every 1-2 yrs starting at 25 or 5 yrs younger than age of youngest affect family member at diagnosis

-pelvic exam, transvag US, endometrial samp for women at 30-35
upper endoscopy every 2-3 yrs at 30-35
prophylatic hysterectomy with oophorectomy age 40 or once done childbearing

31

salmonella typhimurium

gram negative, non lactose fermenting, motile, rod shaped
blood diarrhea
fecal leukocytes +
eggs and poultry
reptile exposure
complications are septic arthitis, osteomyelitis
increased risk sicle cell pts
non typhoidal--> gastroenteritis

32

short bowel syndrome from what disease

crohns ,mesenteric infarction, radiation enertiis, volvuus, tumor resetion and trauma

33

diarrhea defined clinically

3 or more loose or watery stools/day
or
decreaes in consistency and increase in frequency of BM of individual

34

undercooked foods, lunch meat, soft cheeses

listeria

35

alcohol gels are ineffective aginast

norovirus and c dif

36

lynch syndrome inherit

auto dom

37

TD in nepal

cyclospora

38

gene mutaiton lynch

MLH1, MSH2

39

microscopic colitis presentation

idiotpathic or from meds
women in 50s,60s
chronic or intermittent watery diarrhea
normal mucosa on endoscopy
-histo: chronic inflammation, thickened band subep collagen

40

need to asks for specific labs for

c diff pcr/toxin
ova parasites
giardia and cryptosporidium stool antigen

41

fever, abdominal pain, bloody diarrhea in immunosuppresed pts under 200 CD4

CMV

42

seafood especially if raw

vibrio species mainly

43

watery diarrhea that occurs in immunocompromised host that can be found on a modified acid fast staining of the stool

cystoisorpora belli

44

MEN2A

PTH hyperplasia
Medullary throid carcinoma
pheochromocytoma

45

antimotility agents should not be used with

C diff or EHEC infection

46

pathogen typically affects large bowel presents with

frequent
small volume stools
pain in lower abd or rectum

47

adult diarrhea defined as

greater than 200g/day of stool weight

48

how do you detect norwalk

PCR

49

short bowel syndrome

removal of significant segment of SI
TI resection
bile salt and vit b12 malabsorption
B12 injectables, bile salt binding resins low fat diet, fat soluble vitamin replacement

50

autoimmune gastritis

desrution of fundic glands
achlorhydria
pronounced hypergastrinemia
hyperplasia gastric enterochromaffin like cells
development of small multicentric carcinoid tumors

51

cowden diseae

lipoma, harmartomas, and benign hair follicle tumors
hair follicle tumor on the skin and face

52

strongyloides stercoralis

how get, where, what type parasite, what pts more susceptible, how diagnose, treat

bare feet on contaminated soil
roundworm
rural areas
HTLV-1 pts are more susceptible
rhabditiform larvae in stool, eosinophils in stool

treat: ivermectin

53

EIEC

fever, abd pain, watery bloody diarrhea with leukocytes
dysnetery

54

diverticulitis tx

antibiotics and npo/clear liquid diet

55

protozoa that can penetrate bowel and into portal circulation and cause liver lung or brain abscess

e histolytica

56

osteoma of mandilble, skull, and long bones
-95% develop colorectal polyps (adenomatous)

supernumerary teeth
thydoid adrenal tumors
desmoid tumors
auto dom

gardner's syndrome

57

fish tapeworm, can get long (30 ft), raw/undercooked fish

diphyllobothrium latum

58

vibrio cholera
get from what
treatment

waterborne illness
raw oysters
rehydration/electrooyte replacement

59

echinococcus granulosus

what is parasite
get from what
complications
image on CT

tapeworm
unsanitary livestock slaughter especially sheep
dogs main carrier
form cysts in liver or lungs
looks like free flowing hydatid sand on CT

60

what can develop in peutz heghers syndrome

GI malignancy or breast cancer
also gonadol or pancreati cancer

61

what kind of toxins does staph have and what type of diarrhea

preformed enterotoxins
watery diarrhea
rapid onset wtithin 6 hours

62

causes of osmotic diarrhea

mg antacids, sorbitol, lactose intolerance, laxatives

63

MEN1

pituitary adenoma
PTH hyperplasia
pancreatic tumors

64

95% of cases of colon adenocarcinoma believed to come from
higher risk

adenomas and serrated polyps
higher risk if over 1 cm or 1 cm

65

most common cause of chronic diarrhea

stool osmotic gap

meds
IBS
lactose intolerance

SOG = normal

66

special cultures for

EHEC
virbrio
yersinia
others

67

cyclospora cayetanensis

treament of water or food with chlorine or iodine is ____ to kill cyclospora oocysts

how detect cysts
treatment

unlikely

stool sample

trimethoprim/sulfamethoxazole

68

anaerobic toxin forming gram + bacillus

C diff

69

widal test positive with O and H antigens

salmonella typhi

70

multiple myeloma is associated with what

impaction and hypercalcemia

71

what does FIT detect

human globin

72

TD in asia

campylobacter jejuni

73

pathogen typically affects small bowel presents with

large volume
watery stool
abdominal cramps
weight loss
pain is mid abdomen or diffuse

74

whipple disesae present

fever, arthralgias, LAD
weight loss
malabsroption, chronic diarrhea
encephalitis

75

causes of constpiation
diet
thryoid
drug
supplement

inadequate fiber and fluid intake
hypothryroidism
CCB use
calcium supplementation

76

routine stool culture includes

salmonella
shigella
e coli (ask for shiga toxin)
most detect campylobacter

77

diagnosis lynch:
besthesda criteria

CRC under 50

CRC or lynch syndrome associated tumor at any age

CRC with with one or more 1st degree relations with CRC or lynch syndrome related cancer with one of the cancers before

CRC with two or more second degree relative with CRC or lynch syndrome related cancer at any age

tumors with infiltrating lymphocytes, mucious.signet ring diff or medullary growth pattern in pts younger than 60

78

C diff description

anaerobic, gram positive, spore forming bacillus

79

vibrio vulnificus

how you get it
associated with
life threat in

warm shallow coastal salt water
raw shellfish (oysters)
open wound in water
bullous skin lesions
life threatening in cirrhosis pts

80

other risk factors for C diff

chemo
PPI
IBD
enteral tube feeding

81

protozoa that can cause toxic megacolon or pneumatosis coli
how to diagnose this infection
and treatment

e histolytica
stool antigen to diagnose
metronidazole treatment

82

watery diarrhea
pear shaped 4 flagella 2 nuclei protozoan

giardia

83

treatment for salmonella typhi

fluorquin
ceftriaxone
azithromycin

84

profuse watery diarrhea that doesn't improve with fasing, episodes of getting hot and her face turns red
what tumor and whats elevated

carcinoid tumor secreting serotonitn
5-HIAA

85

most common form of TD

ETEC

86

cytoisospora belli negative stool exam then what

-treatment

duodenal specimen by biopsy
also modified acid-fast stain

treat: trimeth/sulfameth

87

sign that goes with colon ancer which is lesions all over the skin

sign of lesar-trelat

88

clostridium perfringens

toxin
diarrhea
onset
cause

preformed enterotoxin
watery diarrhea
rapid onset 8-16 hrs
beef, ham, poultry, legumes, gravy

89

lynch syndrome associated with

HNPCC
associated with endometrial, bladder, ovarian, rneal, and SI cancer

90

MEN 2B

mucosal neuromas

marfanoid body habitus

medullary thryoid carcinoma

pheochromocytoma

91

hook worm, fecal oral transmission, can get long, can cause bowel obstruction

ascaris lumbricoides

92

cerebellar lesions
trichilemmomomas
hamartromatous polyps and lipomas
PTEN syndrome

cowden disease

93

suspect HNPCC in

personal early onset CRC
FH CRC, or assocaited cancers

94

osmotic diarrhea
-stool sodium
-osmotic gap

low, increased

95

worldwide problem (africa), 2nd most common cause of esophageal varices behind alcohol in africa
get from contaminated freshwater snails

schistosoma mansoni

96

pt has rash on knees and elbows which is ___ associated with malabsorption disease which can lead to ___ so check with ___

dermatitis herpatitis with celiac
can lead to vitamin D deficiency
check with DEXA scan

97

aeromonas hydrophila
description
environment
eating what
other transmission
2 types
treatment

gram negative, non spore forming rod, facultatively anaerobic bacteria, motile with flagellum

fish or shellfish

wounded in fresh water or open wounds, foot and ankle most common

necrotizing faciitis aka flesh eating bacteria

-choleral like
-bloody mucoid stools
-ampicillin

98

risk factor diverticular disease of colon

older
CT disease

99

c diff toxin
type of diarrhea
other risk factor
treatment
complication

toxin A and B (PCR to detect)
pseudomembranes
recent hospitalization, PPI use, antibiotic use
-clindamycin, cephalosporins, fluorquin risk factors
treatment: metronidazole or oral vancomycin
complication: toxic megaclon, need surgery

100

EAEC

persistent diarrhea in children

101

what do you get malabsoprtion of in whipples

ADEK

102

vibrio parahemolyticus

cytotoxin production
bloody diarrhea
from seafood consumption
positive fecal leukocyte
non-O1 and non O139 variants

103

organism that is assciated with sinus bradycardia, neutropenia, and enlarged spleen
-invades peyers patches

salmonella typhi
-carrier state in GB

104

lactose intolerance test

hydrogen breath

105

test for bacterial overgrowth

breath test: glucose, lactulose, or C-xylose

106

most common cause of dysentery in the world

e histolytica

107

what do you lose in diarrhea

bicarb
potassium

108

treatment for campylobacter

supportive bc self limited

109

ROME III criteria for IBS dx

ab discomfort or pain 3/days month for past 3 months with symptom onset over 6 months before diagnosis and at leas 2/3:

-relieved with defecation
-onset associated with change in frequency of stool
-onset associated with a change in form (appearance) of stool

110

blood in urine, haptoglobin decreased, hemolysing (elevated indirect bilirubin), schistocytes

HUS

111

confirmation of listeria

blood culture

112

treatment for microscopic colitis

stop offending meds, loperamide, budesonide, bile-salt binding agents or 5-ASA

113

treatment C diff

metronidazole
vancomycin

114

motile comma shaped gram negative bacillus

cholera

115

watery diarrhea in infants under 2
wagon wheel appearance on electron microscopy

rotavirus

116

B cererus toxin is ___
main symptom
onset
presenttation

preformed enterotoxin
vomiting
rapid within 6 hrs
fried race consumption
watery diarrhea

117

TD with Russia visit, especially st. petersburg

giardia
also campers

118

SBS: colon and 100 cm prox jejunum preserved

oral nutrition with low fat and high complex carb diet

119

reactive arthritis following infection by

salmonella
campylobacter
shigella
yersinia

120

adenomatous colon polpys
brain tumor
CRC 100% over 40
auto dom

turcot's syndrome

121

taenia solium

pork tape worm
most asymptomatic
rare serious cases of seizures and muscle or eye disease

122

pernicious anemia from
increase risk of

autoimmune gastritis
increased risk of gastric adenocarcinoma

123

causes of secretory diarrhea

hormones (tumors)
laxative abuse
villous adenoma
bile salt malabsorption

124

no colon and less than 100-200 cm of prox jejunum

TPN

125

what does a medullary thyroid carcinoma secrete

calcitonin

126

toxic shock syndrome bateria most common and second most

staph aureus 1
strep pyogenes (group A) 2

127

pt had all small bowel resected except 50 cm of proximal jejunum what should be diet

TPN
low fat if still had colon and 100 cm of jejunum

128

EPEC

infantile watery or bloody diarrhea

129

familial juvenil polyposis

hamartomatous polyposis syndrome
auto dom
>10 juvenile hamartomous polyps mainly in colon
increased risk adenocarinoma