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AII Week 4 > GI Infections > Flashcards

GI Infections Flashcards

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1
Q

Viral Gastroenteritis

A

US most cases viral, brief, self-limited; vaccine avail (roto)

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2
Q

Viral Gastroenteritis Signs/Sx

A

Diarrhea (w/N/V); absence of fever, severe abd pn, bloody stool

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3
Q

Viral Gastroenteritis Etiology

A

Diff causes (roto; noro - explosive sx; astro; adeno - illness first, then GI sx); fecal-oral route

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4
Q

Viral Gastroenteritis Diag workup

A

Stool cultures after sev days to R/O bact gastroenteritis (high costs)

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5
Q

Viral Gastroenteritis Management

A

Antiemetics, antipyretics, hydration; antidiarrheal (not for bact)

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6
Q

Viral Gastroenteritis Prog/Comp/Prevent

A

Hand washing

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7
Q

Typhoid Fever

A

Common in travel

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8
Q

Typhoid Fever Signs/Sx

A

Fever, malaise, arthralgia, myalgia, HA, delirium; GI symptoms delayed (abd pn and constipation > “pea soup” diarrhea)

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9
Q

Typhoid Fever Etiology

A

Caused by salmonella typhi and paratyphi; systemic infection following 1-2 weeks incubation

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10
Q

Typhoid Fever Diag workup

A

Bradycardia, HSM, LAD, macular rash (rose spots); stool cx

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11
Q

Typhoid Fever Management

A

Quinolones, 3rd gen cephalosporins; corticosteroids; cholecystectomy considered if not cleared

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12
Q

Typhoid Fever Prog/Comp/Prevent

A

Recurrent bacteremia is common

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13
Q

Cholera Signs/Sx

A

“Rice water” stools; rapid/severe dehydration (mortality high)

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14
Q

Cholera Etiology

A

Contam seafood (shellfish); water, food contam w/human feces

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15
Q

Cholera Diag workup

A

Look for vibrio cholerae w/dark field microscopy w/wet mount

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16
Q

Cholera Management

A

Rehydration salts; abx can decrease duration: tetra/doxycycline

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17
Q

Cholera Prog/Comp/Prevent

A

Death from profound hypovolemia; vaccine available but not cost effective; 20-50% fatality if untreated

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18
Q

Giardiasis

A

Camping, wells (for drinking water); most common parasite in US

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19
Q

Giardiasis Signs/Sx

A

Asxatic, steatorrhea, bloating, flatus, fever uncommon, sulf belch

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20
Q

Giardiasis Etiology

A

Drinking water, contact cysts, attach to duodenum and jejunum

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21
Q

Giardiasis Diag workup

A

O&P, antigen testing

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22
Q

Giardiasis Management

A

Metronidazole (don’t take with EtOH)

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23
Q

Giardiasis Prog/Comp/Prevent

A

Causes lactose intolerance (avoid x 1 month); boil water while camping/iodine treatment for water

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24
Q

Shigella Signs/Sx

A

Fever, malaise, abd pn, watery/bloody diarrhea, resp sx common

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25
Shigella Etiology
S sonnei or s dysenteriae; person-to-person; diarrhea may decrease and become bloody with mucus/pus
26
Shigella Diag workup
Stool culture
27
Shigella Management
Self-limiting; hydration and do not give anti-motility agents; high risk: Cipro
28
Shigella Prog/Comp/Prevent
Toxic megacolon, HUS, reactive arthritis (abx inc risk)
29
Salmonella
Cause gastroenteritis to typhoid fever
30
Salmonella Signs/Sx
N/V followed by inflammatory/bloody diarrhea, cramps; fever, RLQ tender
31
Salmonella Etiology
Summer or fall; undercooked/raw poultry, pets, person-person
32
Salmonella Diag workup
Test for S typhi in blood, bone marrow, rose spots, stool
33
Salmonella Management
Fluids, rest; avoid anti-motility agents; old/young/immunocompromised: abx
34
Salmonella Prog/Comp/Prevent
5-10% develop bacteremia, leads to: meningitis, pulm infs, osteomyelitis, reactive arthritis
35
Amebiasis
Entamoeba histolytica, most common parasite worldwide
36
Amebiasis Signs/Sx
Bloody diarrhea, abn pn, tenesmus (90% asxmatic)
37
Amebiasis Etiology
Transmission occurs thru ingestion of cysts from fecally contam food/water; can be person-to-person; flies/arthropods as vectors
38
Amebiasis Diag workup
Stool sample (3 samples because not sensitive); stool antigen test avail and more sensitive; exam of fresh ucer
39
Amebiasis Management
Metronidazole
40
Amebiasis Prog/Comp/Prevent
Can cause abscess (sp liver) -> tissue destruction; safe water supplies
41
C diff
Causes: abx-assoc colitis
42
C diff Signs/Sx
Watery diarrhea, abd pn/tenderness; (severe) loss of appetite, fever, blood in stool, weight loss
43
C diff Etiology
Gen iatrogenic (abx use - quinolone, clinda, PCN, cephs); fecal-oral route; disruption of normal intestinal flora
44
C diff Diag workup
Enzyme immunoassay available; colonoscopy
45
C diff Management
Vancomycin or flagyl (metronidazole)
46
C diff Prog/Comp/Prevent
Relapse common (add probiotic in tx); sx flare up in IBD
47
Campylobacter
2nd most common foodborne illness in US
48
Campylobacter Signs/Sx
Fevers, myalgias, malaise, abd pn, HA x up to 1 week
49
Campylobacter Etiology
Diarrhea begins later (profuse watery - bloody)
50
Campylobacter Diag workup
Stool culture
51
Campylobacter Management
Risk categories: <3 days erythromycin or quinolones (later)
52
Campylobacter Prog/Comp/Prevent
Hemolytic uremic syndrome, reactive arthritis, Guillain-Barre syndrome; thoroughly cook chicken
53
Bacillus cereus
Foodborne illness
54
Bacillus cereus Signs/Sx
N/V/D
55
Bacillus cereus Etiology
Toxins produced by Bacillus cereus causing sx
56
Bacillus cereus Diag workup
Culture from implicated food
57
Bacillus cereus Management
Self-limiting; symptomatic tx
58
Bacillus cereus Prog/Comp/Prevent
Avoid undercooked foods; prognosis good
59
E coli (Enterohemorrhagic -EHEC)
Many types
60
EHEC Signs/Sx
Abd pn, myalgia, HA, N/V, no fever, grossly bloody diarrhea (event)
61
EHEC Etiology
E. coli O157:H7 (an EHEC): produces Shiga toxin; incubation of 3-5 days
62
EHEC Diag workup
Does not show up on normal stool culture (let lab know)
63
EHEC Management
AVOID abx; avoid anti-motility/narcotics; replace water/electrolytes
64
EHEC Prog/Comp/Prevent
Caused by undercooked meat, unpasteurized milk (cattle feces); HUS, EHEC can appear like ischemic colitis (esp in elderly)
65
E coli (Enteroinvasive - EIEC)
Enteroinvasive E coli
66
EIEC Signs/Sx
Profuse diarrhea, vomiting, malaise, abd cramps, high fever/chills
67
EIEC Etiology
Occurs within 12-72 hours of eating contam food
68
EIEC Diag workup
Culture from infected food, but not usually needed
69
EIEC Management
Usually self-limiting
70
EIEC Prog/Comp/Prevent
Avoid undercooked food
71
E coli (Enterotoxigenic - ETEC)
“Traveler’s diarrhea”
72
ETEC Signs/Sx
Watery diarrhea, bloating, fatigue, cramps, fever uncommon
73
ETEC Etiology
Affects 40-60% of travelers to high-risk areas; bact 80-90%
74
ETEC Diag workup
Hx: where traveled
75
ETEC Management
Usually self-limiting; abx prophylaxis not rec; cipro or bismuth, rehyd
76
ETEC Prog/Comp/Prevent
Avoid undercooked foods, local water (ice), unpasteurized drinks

AII Week 4 (7 decks)

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