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gi ii exam 3 > Infectious Diarrhea Unrein > Flashcards

Infectious Diarrhea Unrein Flashcards

1
Q

pt has been on abx, what kind of diarrhea did they probably get?

A

c difficile

especially if clindamycin

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2
Q

what do we order to check for c diff?

A

PCR

toxins A & B are 63-94% sensitive

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3
Q

how do we treat c diff?

A

metronidazole is the drug of choice due to cost
vancomycin, fidaxomicin other choices

refractory? fecal transplant. 1/3 right colon, 2/3 left colon

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4
Q

prevent spread of c diff?

A

hand washing, not just alcohol (spore-forming)

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5
Q

etiology of bleeding in c diff

A

gut flora makes vitamin K, coagulation factors go down

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6
Q

guy with hodgkin’s on chemotherapy, what kind of diarrhea does he have?

A

cryptosporidium parvum- opportunistic infection for immune compromised

other immune compromised ones: Isospora and cyclospora, CMV, mycobacterium.

Anything that can normally cause diarrhea too.

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7
Q

how to diagnose cryptosporidium?

A

acid fast stain OR stool antigen

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8
Q

no medical problems, 2 days of watery diarrhea
no blood
mild abdominal cramping, afebrile.

Most appropriate next step?

A

nothing, it will probably resolve on its own

not an inflammatory diarrhea. If severe cramping or tenesmus, fever or blood– likely inflammatory, work up higher yield

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9
Q

kids in daycare have diarrhea, no respiratory problems. What kind of diarrhea likely?

A

rotavirus

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10
Q

rice water stools, shape of bacteria?

A

vibrio cholera

comma shapped gram positive

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11
Q

does cholera recur?

A

it can. Antibodies wear off after about 6 months or so.

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12
Q

most common cause of diarrhea in the country?

A

campylobacter

causes a bloody diarrhea

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13
Q

daycare, bloody diarrhea, high fever

A

shigella; most viral illnesses don’t cause fever that high

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14
Q

management options of shigella

A

abx, reduces shedding and duration

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15
Q

pneumonia, nursing home, amoxicillin/ clavulanate. What kind of diarrhea?

A

abx-induced diarrhea.

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16
Q

bloody diarrhea, fever, HUS. What kind of E Coli?

A

0157:H7 EHEC enterohemorrhagic

17
Q

guy ate hamburger and raw oysters. watery diarrhea without blood. What organism do we suspect?

A

Vibrio, because it’s non bloody

18
Q

trip to India, liver mass, diarrhea. What organism?

A

entamoeba histolytica

19
Q

schistosomiasis

A

causes malaise, diarrhea, weight loss and hepatosplenomegaly, but not a hepatic abscess

20
Q

giardia

A

non bloody diarrhea

prolonged diarrhea of weeks to months, malabsorption with weight loss

21
Q

entamoeba histolytica

A

common in developing countries

liver is most common site for extraintestinal disease

22
Q

how to treat entamoeba?

A

metronidazole

no booze.

23
Q

restaurant, recent trip back from Vietnam, enlarged spleen, fever 103, relative bradycardia, bloody and mucousy diarrhea, malaise, maculopapular rash over chest and abdomen

A

salmonella typhi

Don’t give abx! Prolong the carrier state and shedding.

24
Q

watery diarrhea, intestinal cramping without blood. Ate a hamburger 3 days ago, ate at her parents’ asian food restaurant yesterday. causeative organism, pick one:

bacillus cereus
E Coli EHEC o157:H7
Vibrio vulnificus
Norovirus
Giardia lamblia
A

bacillus cereus- rice

12-48 hour incubation period

25
Q

bloody diarrhea, raw hamburger. Shape of organism?

A

E. Coli

Gram negative rods

26
Q

gram positive rods, what?

A

clostridia

27
Q

Phenolphthalein

A

in a lot of laxatives
laxative abuse is a weight loss thing

can be attention-seeking behavior

diagnosis of exclusion easy to miss

28
Q

staph aureus

A

does not cause bloody diarrhea

disease results due to preformed toxin with an onset of 2-6 hours

29
Q

meds that can cause diarrhea

A

PPIs (also increase risk of c diff due to lack of acid, affect vitamin D absorption)

antidepressants

30
Q

watery diarrhea, trip to mexico, chinese restaurant, no fever or blood. Likely cause?

A

ETEC

traveller’s diarrhea

31
Q

weeks ago camping trip foul smelling diarrhea now, anorexia and weight loss

A

giardia

32
Q

how to prevent giardia

A

boil water 3-5 minutes, or use iodine treatment, or bottled water

associated with beavers

33
Q

how to dx giardia

A

look at stool for ova and parasites

34
Q

unpasteurized goat milk. What diarrhea?

fever, sore throat, bloody diarrhea and RLQ pain

A

yersinia enterocolitica

mimics appendicitis

35
Q

HIV
low CD4 count
basophilic intranuclear inclusion bodies

A

CMV

gi ii exam 3 (14 decks)

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