Flashcards in L53 Deck (17)
What is one physical exam technique you want to be sure to take when evaluating a patient with diarrhea?
Orthostatic pulse & BP
Which 3 bacteria are the most likely causes of acute gastroenteritis?
Symptoms of acute gastroenteritis
Sudden onset + short duration
Vomiting may also be seen
Treat acute gastroenteritis
Major causes of acute watery diarrhea
1. ETEC, EAEC, EPEC
2. Vibrio cholerae - cholera
3. Campy, salmonella, shigella, EIEC
Treat acute watery diarrhea
Rehydration w/ glucose & Na - osmotic balance shift via Na/glucose transporter
Major bacteria agents cause acute inflammatory diarrhea
Campy, salmonella, shigella, EHEC. EIEC, yersinia
Complication of acute inflammatory diarrhea
Which patients are you going to get a diarrhea culture for?
Present w/ dysentery
What is the first test you might order on a patient with diarrhea?
Why do you treat shigella patients with anti-microbials?
Decrease shedding - decrease spreading to close contacts
B/c low infectious dose
Beware anti-microbial resistance
What is your first line of therapy for cholera? Second?
1st = oral rehydration
2nd = drugs to shorten duration
Do you treat salmonella and EHEC w/ antimicrobials?
Salmonella = gets WORSE w/ antibiotics
EHEC = linked to HUS
What is your first choice for traveler's diarrhea? 2nd?
1. Oral rehydration
2. Cipro or rifaximin
Do you treat campylobacter with antimicrobials?
NO if been over 3 days infected - no benefit, only work if started early