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GI 2015 > Infectious Diarrhea > Flashcards

Infectious Diarrhea Flashcards

(54 cards)

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1
Q

Definition of diarrhea

A

More than 3 bms per day
Acute = less than 14 days
Chronic = more than 30 days

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2
Q

4 most common viruses

A

Norovirus
Rotavirus
Adenovirus
Astrovirus

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3
Q

6 Associated with beef poultry pork

A 
Staph
Clostridium
Salmonella
Campylobacter
Yersinia
Bacillus cereus
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4
Q

2 if hospitalized

A

C diff

Bacteroides fragilis

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5
Q

6 with fever

A 
Salmonella
Shigella
Campylobacter
C diff
Listeria
Entamoeba histolytica
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6
Q

Reheated rice

A

Bacillus cereus

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7
Q

4 Unpasteurized cheese, milk

A

Listeria
Ehec
Eiec
Campylobacter

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8
Q

5 with bleeding

A 
E. coli 0567:h7
Shigella
Campylobacter
Salmonella
Vibio parahemoliticus
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9
Q

Jaundice and increased lfts

A

Hep A

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10
Q

Pregnancy

A

Listeria

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11
Q

Pet lizard, turtle

A

Salmonella

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12
Q

3 with vomiting

A

Norovirus
Bacillus cereus
Staph

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13
Q

3 with veggies/salad

A

Ehec
Shigella
Bacillus cereus

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14
Q

2 seafood

A

Vibrio cholera

Vibrio parahemoliticus

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15
Q

Norovirus recent locations

A

Nursing homes, day area, cruise ships, hospitals

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16
Q

Norovirus long term consequences

A

Post viral gastroparesis

Irritable bowel

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17
Q

Norovirus rx

A

Supportive - self limited viruses, 48-72 hrs

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18
Q

2 types of salmonella

A

1) typhoid, outside of US, esp Asia and Southern Africa

2) non typhoid, inside US. Most common cause of bacterial food borne illness. Pet transmission.

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19
Q

Typhoid fever progression

A

Week 1 - stepwise fever, relative bradycardia (pulse-temperature dissociation)
Week 2 - abdominal pain and rose spots on trunk and abdomen
Week 3- heptosplenomegaly, GI bleeding, perforation, sepsis (15%)

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20
Q

Where does typhoid fever reside in chronic carriers?

A

Gallstones

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21
Q

Typhoid fever: presents with diarrhea or constipation?

A

Either is equally likely

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22
Q

Non typhoid all disease usually preceded by…?

23
Q

Campylobacter 3 acute and 3 chronic complications

Study These Flashcards
A

Acute: pseudo appendicitis, cholecystitis, pericarditis, myocarditis, septic pseudo aneurysm

Chronic: lymphoma, reactive arthritis, Guillian barre polyneuropathy

24
Q

Shigella is most similar to…?

25
Campylobacter animal association
Commensal in poultry
26
Shigella course of disease
Intense inflammation, ulceration, entry into enterocytes via micropinocytosus, escape from vacuole, lateral spread to neighboring cells
27
Shigella virulence factors
shet2 shet1 Shiga toxin(HUS)
28
EHEC
Bloody diarrhea and deadly systemic illness in U.S.
29
ETEC AND EPEC
Watery diarrhea in young children in developing countries
30
EIEC
Uncommon, similar to shigella (dysentery)
31
HUS triad
Acute renal failure Microangiopathic hemolytic anemia Thrombocytopenia
32
EHEC and abx?
Don't use them - higher risk of HUS
33
ETEC: Heat labile vs heat stable
Labile - related to cholera toxin | Stable - increased chloride secretion and decreased sodium resorption, leading to loss of water and diarrhea
34
EPEC effect
Attaching and effacing, tight junction disruption
35
Cholera toxin
A subunit: cleaved into A1 and A2 in enterocyte. A1 irreversibly activates G protein, increasing cAMP and activating kinases, inhibiting NaCl transport and increasing Cl secretion. B subunit: binds to ganglioside receptor on apical surface of enterocyte a
36
Cholera, clinical
Painless rice water stool with fishy smell, up to 1 L per hour Vomiting Large losses of Na, K bicarbonate
37
C Diff associated with which abx
Clindamycin, fluoroquinolone
38
Two exotoxins in C diff? Which is more potent?
Toxin A - enterotoxin | Toxin B - cytotoxin, more potent
39
C diff clinical findings
Watery diarrhea, cramping, fever, high leukocytosis, pseudomembranes
40
C diff complications
Recurrent disease, toxic megacolon, complicating IBD
41
C diff treatment
Metronidazole, vanco, fecal microbial transplant
42
Clostridium perfringens risk factors and pathogenesis
Consumption of pig guts, sweet potatoes, psychiatric drugs. Produces enterotoxin and cause enteritis necroticans (pig bel)
43
Bacteroides fragilis
Normal component of microbiome Produces enterotoxin (fragilysin) Similar to c diff presentation
44
Yersinia enterocolitica
``` Contaminated pork (chitterlings) Ferrophilic In children, fever, dysentery, pharyngitis, no abdominal pain, pseudo appendicitis ```
45
Listeria monocytogenes
Pregnant women, immunosuppressed. Facultative intracellular Joint pains and headache associated Unpasteurized cheese can lead to bacteremia and meningitis
46
Staph
Heat stable enterotoxin | Vomiting abdominal cramping
47
Bacillus cereus
Spore forming Reheated fried rice Direct ingestion of cereulide toxin
48
Giardia
Most common parasite Lots of people have it Contaminated water Fatty poop, weight loss, lactose intolerance, malabsorption
49
Cryptosporidium
Intracellular protazoa Children and HIV patients Water outbreaks from contaminated reservoirs Profuse watery diarrhea, nausea, abdominal pain, malaise, fever Complication: cholangitis
50
Entamoeba histolytica
90% asymptomatic Invasive disease can cause dysentery and fulminant colitis Rx is metronidazole and paromomomycin
51
HIV extras
Cmb, cyclospora, isospora, microsporidium
52
Scromboid
Histamine poisoning Tuna, Swiss cheese Anaphylaxis
53
Ciguatera
Reef fish Dinoflagellate Weird symptoms
54
Three broad categories of infectious diarrhea
Norovirus Foodborne illness C diff

GI 2015 (1 decks)

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