Flashcards in ClinMed Deck (288):
what will a patient with ZE's fasting gastrin level likely be?
will be high (>1000) (usually <150)
two common forms of IBD?
gold standard for dx of celiac dz
endoscopy with duodenal biopsies
procedures for hemorrhoids
minimally invasive: rubber band ligation, infrared coagulation, sclerotherapy, cryosurgery
what group of people are at increased risk for Whipple's?
farmers (animal waste/soil has more bacteria)
presence of the hep C antibody indicates what?
present or cleared infection
approximately 55% of UGIB are caused by ___?5 risk factors for this ?
NSAIDs, h.pylori, steroids, anti-coag, ethanol
treatment for SIBO
abx: rifaximin, cipro, metronidazole
free air under the diaphragm on CXR is indicative of what? seen in what dz?
MC cause of chronic pancreatitis?
ETOH abuse (70%)
imaging modality of choice for acute pancreatitis
CT A/P w contrast (has to be w contrast)
what are the most common culprits of DILI?
acetaminophen, MTX, amiodarone
what is rome IV criteria for IBS?
recurrent abdominal pain at least 1 day/week in last 3 months associated w two or more of the following:
1. related to defecation
2. assoc w a change in stool frequency
3. associated w a change in stool for (appearance)
criteria fulfilled for last 3 months w sxs onset at least 6 mo b4 dx
if a patient has multiple uclers, what should you consider as a dx?
Diverticular disease is responsible for ~33% of what?is it painful?
lower GI bleeds
nope, (also usually on right side)
coffee ground emesis
blood from stomach or esophagus being digested/xidized in stomach/acid
tropheryma whipplei causes what rare, systemic disease
confirmation of eradication of h.pylori is recommended using what and after how many weeks?
urease breath test >4 weeks after tx is the test of choice
*serology will remain positive*
Ranson criteria is used for what?
acute pancreatitis, >3 =
first step in evaluating hematochezia is
pass a NG tube.
if negative for blood/bile, then colonoscopy
if anything else is found, EGD
what is cholelithiasis
in addition to PUD, what is a common clinical finding in ZE?
increased acidity inactivates pancreatic enzymes that normally need a basic environment to become active. leads to malabsorption which leads to steatorrhea
dietary treatment for diverticulosis?
high fiber diet (want to prevent constipation)
choledocholithiasis definitive tx
HBV DNA in the blood indicates what?
scleral icterus is a finding of what ?
bleeding during bowel movements (BRBPR) could indicate what dz?
celiac dz is commonly associated with what malignancies?
primarly adeno and lymphoma of the small bowel
what populations is non-alcoholic fatty liver disease (NASH) commonly seen in?
pts with metabolic syndrome: obesity, DM, hyperlipidemia, OSA, large waist
what is a mallory-weiss tear
bleeding from laceration in the mucosa (80-90% resolve on their own)
when is colon cancer risk increased in IBD?
if CD or UC affects >1/3 of colon (left - sided dz or greater)
gold standard for dx of PUD?
what are the 3 principal stimuli of HCl secretion via the parietal cell?
1. g cell releases gastrin, stimulates ecl cells
2. ecl cells release histamine, stimulate parietal cells
3. enteric neurons release Ach, stimulate parietal cell
parietal cell releases HCl
are statins contraindicated in management of NASH?
NO! (these patients absolutely need a statin)
3 phases of digestion and absorption
1. intraluminal hydrolysis 2. digestion by brush border enzymes 3. lymphatic transport of nutrients
three pharm tx for IBS-D?
1. antidiarrheals (loperamide)
2. bile acid sequestrants (cholestyramine, colestipol)
3. 5HT3 receptor antagonists (alosetron) (more last line)
primary etiology/pathophys of GERD
transient relaxation/ incompetency of LES (lower esophageal sphincter
what symptoms might warrant a further work up for GERD?
what is sphincter of oddi dysfunction
abnormal LFTs, biliary type pain, abnormal ductal dilation in POST-CHOLECYSTECTOMY (all three at same time) (likely spasms of sphincter of oddi or stenosis)
what is the function of bile acids
bind and absorb fat
gold standard for esophageal cancer dx?
EGD with biopsy
mc etiology of traveler's diarrhea
two big non-pharm components of management for IBS include:
what does carcinoma in situ mean?
cancer that has not spread beyond the layer of cells in which it began (non-invasive)
what do carcinoid tumors secrete?
recall: carcinoid tumors are neuroendocrine
how is shigella transmitted? where is it commonly found?
daycare, nurseries, long-term care
describe the epidemiology of IBD
bimodal distribution: 1st peak 15-30 y/o
caucasians > blacks > hispanics > asians
lipase vs amylase in pancreatitis. which is more specific for acute pancreatitis?
lipase (usually >3x ULN)
steady, epigastric, periumbilical pain that radiates to the back is often
unconjugated bilirubin comes from what type of cell
risk of IBS increases 6 fold after what infection
name 4 drugs that can cause constipation
CCBs, diuretics, anti-Ach's, narcotics/opioids
tx for Whipples dz
1-2 years of bactrim
what are typical lab findings for alcohol hepatitis?
AST/ALT > 2, but neither above 500
AST usually higher than ALT
name 4 causes of hepatocellular liver injury
1. autoimmune hepatitis
2. viral hepatitis
4. drug-induced liver injury (DILI)
how do you treat eosinophilic esophagitis?
1. remove foods that incite allergic response
2. inhaled topical corticosteroids
define acute liver failure (aka fulminant hepatitis)
rapid liver failure (INR >/= 1.5) AND encephalopathy
sxs of sclerosing cholangitis
usually asymptomatic with cholestasis (elevated ALP) or jaundice
what are Gray Turner's and cullen's signs? what is it associated with
gray turners = hemorrage from pancreas (on flank)
Cullen's = periumbillical bruising
both show acute pancreatitis
what do you do for baby if pregnant mom has HepB?
vaccine for baby and Hep B immunoglobulin (HBIG) right after delivery
what is guaiac? what are two diseases can it be seen in (one we talked about more than others)?
blood in stool
what abx can you consider giving a pt with IBS (more effective in IBS-D)?
what are the signs of bleeding varices? 1st step to management?
hematemesis, melena, hematochezia
what 3 pre-formed toxins cause food poisoning
1. s. aureus
2. c. perfringens
3. b. cereus
ulcers in ZE are most commonly found in the ___
gold standard for dx GERD?
when is it usually ordered?
24h ambulatory pH monitoring
ordered for: refractory sxs with normal EGD, atypical sxs, failure to respond to pharm therapy, those considered for antireflex surgery
treatment for chronic pancreatits
oral pancreatic enzymes
what lifestyle modifications can a patient make to help with GERD?
1. wt loss
2. elevation of head of bed at night
3. diet modification: more frequent/smaller meals, avoid fatty & fried foods, peppermint, chocolate, alcohol, carbonated beverages, coffee, tea
4. avoid eating 2-3 hrs of bed time
5. quit smoking
fixed risk factors for colon cancer
black > whites
fam hx of CRC
IBD (crohn's, UC)
personal hx of adenomas, genetic syndromes
the 4 classic symptoms of whipple dz are diarrhea, abdominal pain, wt loss, and WHAT?
joint pain (80%, often migratory)
clinical features of chronic pancreatitis? (3)
1. abdominal pain
2. steatorrhea (fatty diarrhea (not secreting enzymes that would break down fat))
3. diabetes mellitus
non invasive testing for h.pylori? (3)
1. urea breath test
2. serology (looking for Abs)
3. stool antigen (>90% specific)
what other dz is seen and screened when someone has celiac
osteopenia (screened with DEXA 1 year post dx)
what percentage of bile acid is recycled via portal venous return to hepatocytes?
95% of biliary secretion
how are fats broken down
via pancreatic enzyme lipase (with help from bile acids and phospholipids to form micelles)
what are the 3 most common causes of acute inflammatory diarrhea?
what is commonly seen on bx for celiac?
screening recommendations if family hx of CRC in 1st degree relative?
starting 10 years before than youngest affected family member w CRC or at age 40 (whichever is earlier)
every 5 years
3 indications for liver transplant?
hep C (#1!)
what can cause false negative testing of h.pylori (3)?
PPIs, abx, bismuth
what diarrheal etiology is associated with water transmission (esp well water)?
SIS of diverticulitis
LLQ abdominal pain
are NSAIDs responsible for more gastric or duodenal ulcers?
vs 10% duodenal
classic symptom of GERD? when does it occur? what position makes it worse?
substernal burning and/or regurgitation, often after eating, worse when supine
what is the most sensitive and specific lab test for ZE? how does it work?
secretin stimulation test
secretin normally reduces gastrin release from G cells, but in ZE pts, gastrin dramatically increases
what labs indicate hepatocellular liver injury?
elevated AST and ALT
tx for mild/uncomplicated diverticulitis
fluids initially; lower fiber until better, then high fiber
abx: metronidazole + ciprofloxacin
what's the clinical presentation of hepatitis A?
1. very high AST/ALT
2. RUQ pain
the most common cause of upper GI bleed is ?
how does it usually present?
describe the shape of h.pylori
5 year survival rate for stage IV colon cancer?
tx for crohn's/UC
1. 5 ASA
2. corticosteroids (acute flares)
3. immune modifying agents
4. anti-TNF agents
dx of gastric cancer modality?
EGD with biopsy
how do you treat pilonidal disease?
I and D
MC presenting sx for PUD
epigastric pain AKA dyspepsia
(often wakes pt up at night 2-3am)
3 approaches to colon cancer screening
1. high sensitivity fecal occult blood testing/ FIT test: annually
2. colonoscopy every 10 years from age 50-75
3. flexible sigmoidoscopy: every 5 years
what is Barrett's?
esophageal squamous epithelium replaced by precancerous metaplastic columnar cells
where does colon cancer most commonly metastasize?
liver then lung
microperforation of the diverticulum resulting in intra abdominal infection/inflammation
the principal inhibitor of HCl production is
in addition to rome criteria, other sxs that can support the dx of IBS include: (3)
abnormal stool passage (straining, urgency, etc), passage of mucus, bloating
intermittent, stead epigastric, RUQ pain that radiates to right scapula is often
+hepatitis A IgM antibody vs +hepatitis A IgG antibody
which indicates an acute infection?
what is the test for celiac dz?
hep B core Ab indicates what?
active or prior infection (NOT positive with immunization)
what is a common clinical manifestation of esophageal cancer?
dysphagia of solid food that progresses into liquid
SIS of encephalopathy
iron deficiency anemia in a male over 50 is _____ until proven otherwise?
what are some lifestyle risk factors for colon cancer?
1. diets in high red meat
2. physical inactivity
3. obesity and T2DM
5. heavy EtOH
what's the primary transmission for hep C?
blood (very little sexual); IVDU primarily in US
how much fiber should pts eat/day?
sudden, severe epigastric pain that radiates through the entire abdomen is often
what is the main risk factor for zollinger-ellison syndrome?
MEN1 syndrome (20-25%) (parathyroid, pancreas, pituitary tumors)
what is charcot's triad
fever, RUQ pain, jaundice
both types of esophageal cancers are more common in what gender?
what are the two categories (and signs) of cirrhosis consequences?
1. portal hypertension (ascites, varices, splenomegaly)
2. synthetic dysfunction (encephalopathy, elevated INR, jaundice)
what are the two basic patterns of liver injury
hepatocellular (cells busting open) and cholestatic (congestion)
how do you treat infectious esophagitis based on what the endoscoping findings are?
1. linear yellow-white plaques = 1st line: fluconazole
2. ulcers = ganciclovir (CMV), acyclovir (HSV)
reynold's pentad suggests what
imaging of choice for chronic pancreatitis? what does it show?
hepatitis A is transmitted primarily via __
what are the 4 types of esophagitis?
3. infectious (candida, CMV, herpes, HIV)
4. drug induced (NSAIDs, abx (tetra, doxy), bisphosphonates, K+ chloride)
gold standard for h.pylori testing?
EGD with biopsy
- + rapid urease test
gold standard dx method for colon cancer?
three pharm tx for IBS-C?
1. osmotic laxatives (polyethylene glycol)
2. chloride channel activator (lubiprostone)
3. guanylate c agonists (linaclotide)
crampy, periumbilical pain that radiates to the back is often
anti-mitochondrial antibody is positive in what liver biliary dz
primary biliary cholangitis
gold standard for SIBO dx
hydrogen breath testing
when is FODMAPs used
used for IBS
what tumor marker is good to follow for colon cancer but is not necessarily initially diagnosis?
name 4 causes of cholestatic liver injury
1. biliary obstruction (stones, cx)
what is the MC cause of acute lower GI bleeding?
which type of esophageal cancer is more common in AAs?
MC histological type of gastric carcinoma?
what is the key to characterization of liver masses?
if high indirect bilirubin but normal or low direct bilirubin, what type of injury?
ABOVE the liver (i.e., hemolysis issue)
what labs indicate cholestatic liver injury
elevated bilirubin and alk phos
inflammation, infxn of bile duct
what is a fistula?
tunnel between anal gland from which the abscess arose, can occur with frequent abscesses, often seen with Crohn's or other underlying problem
is ibs more common in men or women?
whites or blacks?
how do you treat a perianal abscess
I and D (CANNOT give abx as an alternative, will not penetrate the fluid within an abscess)
what type of hemorrhoid has a classification system?
CD vs UC
which can affect any portion of the GI tract (mouth to anus)?
what type of hemorrhoid is usually painful?
what is the #1 indication for liver transplant?
hep B surface antigen indicates what?
hep B infection
what is zollinger-ellison syndrome?
tumor of gastrin-secreting G cells in pancreas, duodenum, ectopic site (gastrinoma)
what is carcinoid syndrome?
when is it seen?
after carcinoid metastasizes
what is important in the prevention of hep C?
avoid sharing needles, birth cohort screening (1945-1965), use barrier protection if multiple sex partners
CD vs UC
which is transmural (ie involves the entire thickness of the bowel wall)?
what labs are found in celiac dz
endomysial IgA Ab and transglutaminase Ab
management of cirrhosis?
1. encephalopathy: lactulose or rifaximin
2. ascites: Na+ restriction (spironolactone, furosemide) +/- paracentesis
celiac patients should avoid
wheat, rye, barely
what is seen on histology for Whipple's dz?
periodic acid-schiff (PAS)- positive macrophages AND dilated lacteals
SIS of malabsorption
diarrhea steatorrhea abdominal bloating
gas wt loss amenorrhea
hep C antibody indicates what?
present OR cleared infection
wt loss is more commonly associated with what type of ulcer?
what type of esophageal cancer is associated with Barrett's/GERD?
is heliobacter pylori gram + or -?
what predisposes someone to liver cx?
1. cirrhosis, advanced fibrosis
2. chronic hep b or c
3. biliary dz
red flags in IBS
wt loss, new onset in pt >50, nocturnal sxs, family hx of cancer/IBD, anbronal exam, + fecal occult blood test, anemia, fevers, leukocytosis, inflammatory markers
what is trousseau's malignancy sign?
migratory phelbitis associated with malignancy
= pancreatic carcinoma
how is e.coli is primarly transmitted?
undercooked beef, unpasteurized juices, spinach
crampy, steady periumbilical, RLQ pain that radiates to back is often
mc benign tumor of the liver?
risk factors for cholethiasis
5 F's! female, fat, fertile (preggers), age>forty, family hx
what is the frequency of CRC surveillance in patients with UC/CD
start surveillance at 8 years from onset of symptoms, should occur every 1-2 years
what can pinworms cause? tx?
pruritus ani, avoid further damage (avoid moisture, soap, etc)
what supplies blood to the liver
what is cholecystitis
how much greater is the risk of esophageal cancer in barrett's?
30-60x > general population
what is the funky, board favorite cause of acute pancreatitis
hep C RNA indicates ?
the MC cause of functional constipation is
low fiber diets
MC cause of diarrhea in pediatrics, what diarrhea-causing virus has a vaccine?
herniation/outpouching of upper esophagus on posterior wall is called ?
risk factors associated with squamous cell esophageal cancer?
caustic induced esophageal injury
head and neck cancers
risk factors for gastric cancer include the standards (fam hx, tobacco, obesity) and what 3 other main things?
1. h pylori
2. atrophic gastritis/intestinal metaplasia
3. diet: smoked foods, processed meats, red meat, nitrates/nitrites
SIS of celiacs
IBS-like bloating/flatulence/ discomfort
Others:fatigue, depression, arthritis, osteopenia/porosis, iron deficiency anemia, dermatits herpetiformis
your patient has dysphagia to both solids and liquids. what are you thinking, and what is your next dx step?
esophageal manometry (gold standard) = shows increased LES pressure
a low FODMAP diet means:
limited fermentable oligo, di, monosaccharides and polyolys
LLQ pain is often
constipation can be caused by what endocrine dz
squamous cell vs adenocarcinoma esophageal cancer in terms of location?
squamous = upper 2/3 of esophagus
adeno = lower 1/3 of esophagus
what is reynold's pentad?
charcot's triad + hypotension (shock) and altered mental status
sister mary joseph nodes are associated with what? what are they?
hepatocellular carcinoma tx
resection, embolization, radiofrequency TRANSPLANT! = curative
MC pancreatic cx histology
adenocarcinoma: ductal MC (>90%)
cd vs uc
fecal urgency is seen in what disease?
CD vs UC
which affects the colon and starts in the rectum?
your pt has an acute GI bleed and presents with melena. what is your next step? if that test is negative, what do you do?
next step: EGD
If negative: colonoscopy
if negative: bowel studies
is amylase/lipase elevated in chronic pancreatitis?
+hepatitis A IgM antibody vs +hepatitis A IgG antibody
which indicates a prior infection OR vaccination?
4 notorious groups of medications that cause esophagitis
what is another name for conjugated bilirubin
___% of gastric ulcers and __ - ___% of duodenal ulcers are attributed to h.pylori
70% of gastric ulcers
80-95% duodenal ulcers
when a patient progresses to cirrhosis, what tends to happen to the labs with regards to total protein, albumin, globulin, ALT, AST
total protein decreased
ALT/AST not >300
AST > ALT
severe, diffuse periumbilical pain that radiates to the entire abdomen is often
#1 cause of pancreatitis
#1 - stones
#2 - EtOH (years)
what two biliary liver diseases can cause elevated bili and ALP?
1. primary sclerosing cholangitis
2. primary biliary cholangitis
what is the #1 symptom of pancreatitis?
epigastric pain: RUQ, midepigastric, radiates to back
what is hemolytic uremic syndrome? what causes it?
acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia, complicates 10% of cases in those <10 yo
caused by e.coli
burning/gnawing paid associated with DU ulcers is typically ____ with
when should CRC screening start?
age 50 (consider 45 if AA) every 10 years
describe familial adenomatous polyposis
1. APC gene mutation
2. autosomal dominant
3. greatest risk factor for colon cancer (colon is removed as ppx)
test of choice for diverticulitis
CD vs UC
which tends to skip areas in the intestine?
which of the viral hepatitis(es) are considered chronic infections?
medical management for variceal bleeds?
octreotide drip, PPI drip, ABX
what are the five alarm symptoms for GI?
1. altered bowel habits
4. early satiety
5. wt loss
treatment of thrombosed hemorrhoids
how do you diagnose and treat schatzki's ring?
dx: barium esophagram (swallow)
tx: endoscopic dilation
what is the MC overall cause of gastroenteritis in US adults?
what do you commonly see on imaging for pancreatic adenocarcinoma?
double duct sign is classic
acquired herniation or saclike projection of the intestinal mucosa through the muscularis propria
what is the main treatment for acute pancreatitis?
supportive: IV fluids is first
hep B surface Ab indicates what?
immunity against hep B infection (prior infection OR immunization)
name 5 SIS of gastric carcinomas
3. early satiety
5. wt loss
bile duct stones
presence of hep C RNA indicates what?
if you pt has PUD but is h.pylori neg, what can you give them?
misoprostol (synthetic prostaglandin E1 analog)
(NOT FOR PREGGERS)
reynold's and charcot's are associated with what dz
acute cholangitis (biliary tract infection 2ry to obstruction)
h. pylori is associated with gastric carcinoma and what other cancer?
MALT (mucosa associated lymphoid tissue) lymphoma
what should you do if you suspect gastrinoma (ZE)?
check serum gastrin
what disorder commonly involves dysphagia, regurgitation, and halitosis?
when should you consider a blood transfusion for GI bleed?
Hgb < 7 OR unstable/rapid bleed
what is tenesmus and in what dz is it seen?
feeling of incomplete evacuation of rectum;
what 3 proteins does the liver make?
what will show up on manometry in a patient with achalasia?
incomplete relaxation of LES (normal relaxation is 90% of basal pressure, achalasia is less than 50%)
can you use loperamide or other anti-motility agents in pts with inflammatory diarrhea (shigella, c diff, e coli)?
Murphy's sign positive in
Charcot's triad in what?
dark, "tarry" stool is called what? and what can it indicate?
UGIB (also smells real bad)
hematememsis is ________ and it can indicate __________
bloody vomiting, upper GI bleed
peeps with cholelithiasis OR s/p cholecystectomy should have what type of diet?
low fat diet
(meals with fat cause GB to contract)
encephalopathy should be mainly dx by labs or PE/clinical diagnosis?
ammonia levels does NOT correlate
does gastric cancer affect men or women more?
diverticulosis affects what area of the intestine MC
sigmoid colon (95%)
the MC presentation of a GI bleed is ? what does it look like?
bright red blood from rectum (lower GI bleed)
what is a unique symptom of diffuse esophageal spasm?
anterior chest pain (similar to angina)
Guillain-Barre syndrome is associated with what bacterial etiology of diarrhea?
most important etiologic factors for PUD?
what causes jaundice
too much bilirubin (2.5x normal and up)
besides FAP, what other genetic syndrome puts a patient at risk for colon cancer?
conditions commonly associated with IBS? (5)
diarrhea is considered persistent after ___ days and chronic after ___ days
mc location of carcinoid tumors
small intestine (ileum)
what is the gastrinoma triangle?
place where 90% of gastrinomas are located: pancreas, duodenum, stomach/liver/bone/LN
management of cholecystitis
abdominal pain and altered bowel habits with no organic cause is
irritable bowel syndrome
what specific type of lesion is often seen in the colon of colon cancer?
apple core lesion
describe pathology of sclerosing cholangitis
AI disorder of intrahepatic and extrahepatic bile ducts characterized by inflammation and fibrosis
what disorder will show cork screw contractions/rosary bead on barium swallow?
diffuse esophageal spasm
for abdominal pain and bloating in IBS, what can you consider giving a pt?
amitryptyline or SSRIs/SNRIs
tx for severe/complicated diverticulitis
abx: metronidazole + IV ceftriaxone or IV fluoroquinolone
treatment of mild hemorrhoids
increase the amount of fiber and fluids
hydrocortisone topical tx
what's a special feature of c.diff regarding killing the spores?
alcohol foam does NOT kill the spores (must use soap and water)
what virus is common in familial outbreaks, nursing homes, cruise ships, college campuses? can it be aerosolized?
dermatitis herpetiformis is seen w what dz?
where on the body is it usually?
usually on extensor surfaces (knees, lower back, buttock)
PEx findings for cirrhosis
ascites, edema, jaundice, spider angiomata
what protozoa are bad for immunocompromised people?
4 etiologies of infectious esophagitis
candida, cmv, hsv, hiv
what tumor marker do you follow for pancreatic adenocarcinoma?
what is Courvoisier's sign?
palpable, nontender, distended gallbladder
= pancreatic carcinoma
SIS of acute liver failure
lethargic, + asterixis, jaundiced, + liver edge palpable
your pt has glossitis and stomatitis on PEx. what might this suggest?
failure to absorb vitamins
what type of diet s/p bariatric surgery?
full liquid/pureed diet for 2-3 weeks, then soft foods, then regular food
lifelong: B12, calcium/vit D, multivitamin supplements
when is alternate route of nutrition needed? (3)
1. GI/surgical illness more than 3-5 days
2. intubated patients on vent more than 3 days
3. stroke/dysphagia/end of life
Grey Turner's is found on PEx for what? what is it?
bruising around flank/hip due to retroperitoneal hemorrhage
diarrhea that lasts less than 4 weeks is considered ____ and _______
no change in diarrhea when fasting indicates what type of diarrhea (osmotic, secretory, increased motility, inflammatory)
secretory (excess input of electrolytes w H2O following)
malabsorption of stuff can lead to what type of diarrhea?
osmotic (increased presence of poorly absorbed lumnial osmols)
anxiety, hyperthyroid, IBS, viral gastroenteritis is often responsible for what type of diarrhea
fever, abdominal pain, tenesmus, bloody poo and fecal WBCs is associated with
give 3 examples of preformed toxins that lead to food poisoning
>3 BMs per day
> 200 gms/ day
loose or liquid consistency
where is vibrio cholera found? what is the presentation? what is a major concern?
rice- water stools
what is often found on cruise ships and college campuses? is it non-inflammatory or inflammatory?
the MC cause of diarrhea in children? is it noninflammatory or inflammatory?
this parasite is found in contaminated streams and can cause chronic infection in immunocompromised
giardia, non inflammatory
contaminated poultry, eggs, dairy bug
tx for camplobacter
osteomylitis, endocarditis, arthritis are symptoms in 10% of peeps with this bug
important sanitary point about c diff
soap and water ! (alcohol does not kill)
tx for c diff
do you use anti-motility (loperamide) w inflammatory diarrhea?
NO (can be toxic)
ppx therapy for travelers diarrhea