Diarrhea Flashcards

Question

Whaat infectious diarrhea mimics appendicitis or Crohn’s disease with RLQ pain?

Answer 1

Yersinia enterocolitica with mesenteric adenitis, that is what causes the RLQ pain

Answer 2

``` Arthritis Ankylosing spondylitis Skin manifestations with erythema no do sum and multi force Thyroid: Grave’s, Hashimoto Multiple liver abscess and granulomas ``` Treated with aminoglycosides or Bactrim

Answer 3

Mimics UC Associated with:GBS, HUS, Post-infectious arthritis

Answer 4

Trauma Burn victims Aeromonas also associated with medical leech therapy

Answer 5

Yes , stool Ova and Parasite has low sensitivity. Note Upper GI sampling has high sensitivity but is invasive The best test to use is Stool antigen test and serology

Answer 6

IgA and IgA tissue transglutaminase Antideaminated gliadin peptided (DGP) antibodies IgA These screening test are done while patient is consuming normal diet

Answer 7

T Cell Lyhoma

Answer 8

Celiac disease

Answer 9

Tropical sprue is associated with Klebsiella and E.Coli Patients present with diarrhea Folate and B12 deficiency. Small bowel biopsy shows blunted villi like celiac

Answer 10

``` Weight loss Hyperpigmentation Infection with tropheryma whipped PAS positive Polyarthritis LAD Enteric involvement STEATORRHEA CNS ```

Answer 11

1. Eosinophilic gastroenteritis - Associated with allergies - Lab shows elevated eosinophils , iron def anemia, and protein losing enteropathy with or without STEATORRHEA Small bowel imaging shows folds and filling defects - Bx revealed Eosinophilic infiltration - Parasites have to be rules out Rx: steroids 2. Intestinal Lymphangiectasia - due to lymphatic obstruction, which leads to hypoplastic lymphatics so lymph get dumped into the intestine. - protein losing enteropathy plus STEATORRHEA - UNILATERAL lyphedema of the leg is characteristics - CHYLOUS PERITONEAL OR PLEURAL EFFUSION CAN OCCUR - Lab shows lymphopenia and low serum protein - Small bowel biopsy shows dilated lacteals and lymphatics Treatment: low fat diet and medium chain triglycerides

Answer 12

Usually present in the 6th decade of life in women with recurrent watery diarrhea, abdominal pain, weight loss 2 types: Collagenous colitis=Thick supepithelial collagen in biopsy (Collagenous band) Lymphocytic colitis=intraepithelial lymphocytes on Bx The colon will appear normal on imaging and colonoscopy, it has to be diagnosed through Bx Microscopic colitis is associated with celiac disease with 72 fold increase of microscopic colitis in patients with celiac

Answer 13

First line is Budesonide If intolerant to budesonide treatment is prednisone, Mesalamine, bismuth subsalicylate

Answer 14

``` NSAIDS (can also exacerbate it) Aspirin A car Bose Ranitidine Sertraline Lanzoprazole ```

Answer 15

1. Toxin should not be tested alone 2. Do not repeat test within 7 days of same diarrhea episode Testing include: 1. NAAT 2. Glutamate dehydrogenase test + toxin (if values are discordant then perform NAAT) 3. NAAT+ Toxin

Answer 16

48 hours after diarrhea stops, but can continue until discharge if CDI rates are high

Answer 17

Non=severe -WBC <15,000; Cr <1.5=PO Vanc or Fidaxomycin Severe WBC >15,000; Cr >1.5= PO vanc or Fidaxomycin ``` Fulminant -Hypotension/shock -Ileus -Megacolon Rx: PO Vancouver 500 mg QID or through NG plus IV Flagyl; if ileus present add rectal vanco ```

Answer 18

During first recurrence: - If flagyl was used first then treat with PO vanc 125 - if PO vanc was used then treat with tapering dose of PO vanc (125 for 14 days, then 2 times.week for 1 week, 1 time per day for 1 week, then once every 2-3 days for 2-8 weeks) - another option if PO vanc was used is PO Fidaxomycin Second recurrence (or the 3rd episode) 1. Give tapering or pulsed regimen PO vanc 2. PO vanc for 10 days and then Rifaximin for 2o days 3. Fidaxomycin for 10 days 4. Poop transplant

Answer 19

Diverting Loop ileostomy with intraoperative lovage with polyethylene glycol + 500 mg vancomycin every 8 hours

Answer 20

Bezlotoxumab

Diarrhea Flashcards

(44 cards)