Gastrointestinal/Nutrition Flashcards
(69 cards)
1
Q
What is the condition associated with vitamin C deficiency?
A
Scurvy
2
Q
Scurvy clinical manifestations (6)
A
- Malaise
- Weakness
- Vascular fragility (due to abnormal collagen production)
- Recurrent hemorrhages in gums, skin (perifollicular)* and joints
- Impaired wound healing
- Hyperkeratotic papules
3
Q
3 “H’s” of scurvy
A
- Hyperkeratosis
- Hemorrhage
- Hematologic (anemia)
4
Q
What is the name of the condition(s) associated with vitamin D deficiency?
A
- Rickets (children)
- Osteomalacia (adults)
5
Q
Management of vitamin D deficiency
A
Ergocalciferol (vitamin D)
6
Q
Vitamin A deficiency clinical manifestations (7)
A
- visual changes (especially night blindness)
- Impaired immunity
- Squamous metaplasia (conjunctiva, respiratory epithelium, urinary tract)
- Bitot spots (white spots on conjunctiva)
- Xeropthalmia (dry eye)
- Alopecia
- Taste loss
7
Q
What are the three conditions associated with vitamin B1 (thiamine) deficiency?
A
- Beriberi
- Wernicke’s encephalopathy
- Korsakoff’s dementia
8
Q
“Dry” Beriberi symptoms (4)
A
- Peripheral neuropathy
- Symmetric impairment of sensory, motor & reflexes
- Anorexia
- Muscle cramps and wasting
9
Q
“Wet” Beriberi symptoms (3)
A
- High output failure
- Dilated cardiomyopathy
- Edema
10
Q
Triad of Wernicke’s encephalopathy
A
- Ophthalmoplegia
- Ataxia
- Global confusion
11
Q
Korsakoff’s dementia
A
- Memory loss (especially short-term)
- Confabulation
- IRREVERSIBLE
12
Q
What is the name of the condition associated with vitamin B2 (Riboflavin) deficiency?
A
Oral-ocular-genital syndrome
13
Q
Oral-ocular-genital syndrome: Oral (4)
A
- Lesions of the mouth
- Magneta colored tongue
- Angular cheilitis
- Pharyngitis
14
Q
Oral-ocular-genital syndrome: Ocular (2)
A
- Photophobia
2. Corneal lesions
15
Q
Oral-ocular-genital syndrome: Genital (1)
A
- Scrotal dermatitis
16
Q
What is the name of the condition associated with niacin/nicotinic acid (B3) deficiency?
A
Pellagra
17
Q
“3 D’s” of Pellagra
A
- Diarrhea
- Dementia
- Dermatitis
18
Q
Etiologies of Pyridoxine B6 deficiency
A
Alcoholism, isoniazid, OCPs
19
Q
Clinical manifestations of Vitamin B6 (Pyridoxine) deficiency) (7)
A
- Peripheral neuropathy*
- flaky skin
- HA
- Anemia
- Sore tongue
- Stomatitis
- Seizures
20
Q
What type of genetic disorder is PKU?
A
Autosomal recessive
21
Q
Children with PKU typically have what characteristics?
A
Blonde, blue-eyed with fair skin
22
Q
Which foods are high in phenylalanine?
A
Cheese, nuts, fish, meats, eggs, chicken, milk, legumes, aspartame
23
Q
Opioid agonists used in diarrhea (but not with acute dysentary)
A
- Diphenoxylate/Atropine (Lomotil)
2. Loperamide (Immodium)
24
Q
Anticholinergic used in diarrhea
A
Phenoarbital/hyoscyamine/Atropine/scopolamine (Donnatal)
25
What is the most common cause of gastroenteritis in adults?
Norovirus
26
What is the most common cause of gastroenteritis in children?
Rotavirus
27
What are the most common sources of food seen with staphylococcus infection?
Dairy products, meats, eggs, mayonnaise
28
Bacillus Cereus incubation period
1-6 hours
29
What type of food is most associated with bacillus cereus infection?
Fried rice
30
Clinical manifestations of bacillus cereus infection
Vomiting*, cramps, diarrhea
31
Vibrio cholera characteristics (3)
1. Transmitted via contaminated food and water esp. abroad
2. Gram negative rod
3. May be associated with outbreaks during poor sanitation and overcrowding conditions
32
Vibrio parahemolyticus and V. vulnificus characteristics (2)
1. Associated with raw shellfish esp. in Gulf of Mexico
| 2. Exotoxin causes hyper secretion of water and chloride ions leading to severe dehydration
33
Virbrio cholerae and vibrio parahemolyticus clinical manifesetations (2)
1. Copious watery diarrhea "rice water stools" that may rapidly produce severe dehydration
2. If fatal it usually results from hypovolemia
34
Vibrio cholerae and vibrio parahemolyticus management (3)
1. Often self-limited
2. Fluid-replacement mainstay*
3. If ill, high fevers, medical problems --> Fluoroquinolones (Cipro), doxycline, bactrim, choramphenicol
35
What is the most common cause of traveler's diarrhea?
Enterotoxogenic E. coli
36
Enterotoxogenic E. coli treatment
Fluoroquinolone (BID x 3 d) to shorten the course; Bactrim, doxycycline, bismuths
37
Shigella clinical manifestations (5)
1. Crampy, lower abdominal pain
2. Explosive, watery diarrhea --> mucoid, bloody*
3. Severe cases may lead to toxic megacolon
4. Neurologic manifestations esp. in young children (FEBRILE SEIZURES)
5. May cause Leukemoid reaction* (WBC >50,000)
38
What does a sigmoidoscopy show with shigella?
Punctate areas of ulceration
39
Shigella treatment
Bactrim is the treatment of choice, fluoroquinolones
40
A yersinia enterocolitica infection may mimic what other condition?
Acute appendicitis (can cause mesenteric adenitis producing abdominal tenderness, guarding)
41
Yersinia enterocolitica management
Fluoroquinolones
42
Which organism causes mucous diarrhea "Pea soup stools"?
Salmonella typhimurium
43
Typhoid (enteric) fever clinical manifestations (3)
1. Caused by salmonella typhi.
2. Cephalic phase: HA, constipation, pharyngitis, cough
3. 2nd week: Diarrhea (PEA SOUP STOOLS)*, intractable fever, relative bradycardia, rose spots
44
Salmonella management
Fluoroquinolones, ceftriaxone x 2 weeks if severe
45
Enterohemorrhagic E coli 0157:H7 management (2)
1. Supportive
| 2. Abx are controversial (increases risk of HUS in children)
46
What is the most common cause of bacterial enteritis in the United States?
Campylobacter Enteritis
47
Campylobacter diarrhea
Initially watery and then turns bloody
48
Campylobacter stool culture
Gram negative "S or Seagull shaped" organisms
49
Campylobacter management
Erythromycin*, fluoroquinolones, or doxycycline if severe
50
What is the usual cause of Giardia infection?
Ingestion of contaminated water from remote streams/wells* aka Beaver's fever or "Backpacker's diarrhea"
51
Giardia diarrhea description
Frothy, greasy, foul diarrhea* (no blood or pus)
52
What does a stool culture show with giardia?
Trophozites/cysts in stool
53
Giardia management
1. Metronidazole*, tinidazole, albendazole, quinacrine
| 2. FURAZOLIDONE in children
54
Amebiasis (Entamoeba histolytica) clinical manifesations (3)
1. GI colitis
2. Dysentary
3. Amebic liver abscess*
55
Amebiasis (Entamoeba histolytica) treatment
Metronidazole (Flagyl), tinidazole, paromycin
56
What is the most common cause of chronic diarrhea in AIDS patients?
Cryptosporidium
57
Isospora belli (3)
1. MC in homosexual men, pts with AIDS
2. Transmitted feco-oral
3. Treatment: bactrim
58
Non-invasive diarrhea: affected area
Small bowel -->large voluminous stools
59
Non-invasive diarrhea: vomiting
Vomiting predominant symptoms
60
Non-invasive diarrhea: examples
Viral, S. aureus, B. Cereus, V. cholera, Enterotoxogenic E. coli
61
Invasive diarrhea: affected area
large bowel--> many small-volume stools, high fevers
62
Invasive diarrhea: vomiting
vomiting not as common
63
Invasive diarrhea: examples
Shigella, salmonella, IBD (UC & CD), enterohemorrhagic E. coli
64
Whipple disease MC in what type of population?
Farmers around contaminated soil
65
Whipple disease clinical manifestations (2)
1. Malabsorption symptoms
| 2. Rhythmic motion of eye muscles while chewing
66
Whipple disease diagnosis
-Duodenal bx: periodic acid-schiff (PAS)-positive macrophages, non acid fast bacilli, dilation of lacteals
67
Whipple disease management
Penicillin** or tetracycline for 1-2 years
68
What is the side effect of osmotic laxatives?
Hypermagnesemia (especially in patients with chronic renal disease)*
69
Stimulant laxatives
1. Bisacodyl (Dulcolax)
| 2. Senna
