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FUN MED SPRING 2018 > 11. Infectious Diarrheas And Intussusception > Flashcards

11. Infectious Diarrheas And Intussusception Flashcards

1
Q

Clinical definition of diarrhea.

A

Abrupt onset of 3 or more loose stools/day, no longer than 14 days.

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2
Q

Mechanism of NON-INFLAMMATORY

A

Enterotoxin

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3
Q

Location of NON-INFLAMMATORY

A

Proximal small bowel

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4
Q

Stool findings in NON-INFLAMMATORY

A

No fecal leukocytes or fecal lactoferrin

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5
Q

Mechanism of INFLAMMATORY

A

Invasion or cytotoxic

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6
Q

Location of INFLAMMATORY

A

Colon or distal small bowel

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7
Q

Stool findings in INFLAMMATORY

A

Fecal leukocytes and elevated fecal lactoferrin

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8
Q

Mechanism of PENETRATING

A

Systemic invasion

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9
Q

Location of PENETRATING

A

Distal small bowel

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10
Q

Illness of PENETRATING

A

Enteric Fever

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11
Q

Stool findings in PENETRATING

A

Fecal Leukocytes

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12
Q

Pathogens causing PENETRATING

A

Salmonella typhi (typhoid fever)

Y. Enterocolitica

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13
Q

People w/ blood group _____show inc. susceptibility so specific diarrheal diseases

A

O

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14
Q

Stool pH of ______suggest viral etiology for acute diarrhea.

A

<5.5

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15
Q

Fecal leukocytes in acute diarrhea suggest______

A

Enteroinvasive etiology

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16
Q

What lab test would you use for Rotavirus or Adenovirus?

A

Enzyme immunoassay and latex agglutination assay

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17
Q

What test would you use for C. diff?

A

Rapid enzyme immunoassay, latex agglutination tests, or PCR

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18
Q

What antibiotics might you give for inflammatory diarrhea?

A

Fluoroquinolone or macrolide

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19
Q

Two exceptions to giving antibiotics in inflammatory diarrhea

A

1) Salmonellosis-can prolong intestinal prolongation
2) Enterohemorrhagic E. coli infection-many antibiotics cause inc. toxin production, may lead to hemolytic-uremic syndrome and renal failure

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20
Q

When should infants get their first dose of the RotaVirus Vaccine?

A

Before 15 weeks

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21
Q

What vaccine is recommended for travels in high risk areas?

A

Salmonella typhi

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22
Q

A major complication of acute diarrhea.

A

Hemolytic Uremic Syndrome

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23
Q

Hemolytic uremic syndrome is damage to the vascular endothelial cells by __________, released by enterohemorrhagic _____and _______organisms.

A

Verotoxin

E. Coli

Shigella

24
Q

The most common pathogens of bacterial food poisoning:

A 
E. Coli
Salmonella
C. Perfringens
Campylobacter
Staphylococcus aureus
25
Q

Main care objective for bacterial food poisoning.

A

Hydration and Electroylte supplementation

26
Q

To prevent bacterial food poisoning keep refrigerated food ______and hot items______.

A

<40

>140

27
Q

Where is E.coli found?

A

Leafy green vegetables and sprouts

28
Q

If dysentery is absent in E. Coli what should you do?

A

DO NOT ADMINISTER ANTIBIOTICS until microbiologic diagnosis confirmed.

E.coli 0157: H7 is ruled out.

29
Q

Where could you find salmonella?

A

Poultry, peanut butter, sprouts

30
Q

What is a complication of Campylobacter?

A

Guillain-Barre

31
Q

This results from a disturbance of the normal bacterial flora of the colon> releasing toxins that cause mucosal inflammation and damage.

A

C. Did

32
Q

The most commonly diagnosed diarrheal illness acquired in the hospital.

A

C. Dif

33
Q

Clinical criteria for C. Dif:

A

Diarrhea

Toxin A or B in stool

Toxin-producing C Dif

34
Q

C. Dif is a gram (+ or -),_______-forming bacillus that is an ________anaerobe.

A

Positive.

Spore

Obligate

35
Q

A patient has diarrhea and was recently hospitalized and on strong antibiotics, what should you suspect?

A

C. Dif

36
Q

Sx of C. Dif

A

Diarrhea-rarely bloody

*Characteristic odor

37
Q

Gold standard test for C. Dif.

A

Stool Culture:

  • Toxins A and B
  • C. Dif gene toxin
  • EIA-enzyme made by C. Dif
38
Q

Imaging of choice for C. Dif colitis?

A

CT

*used when complications suspected

39
Q

Definition of pseudomembranes:

A

Raised, yellow white, 2 to 10 mm plaques overlying and erythematous and edematous colonic mucosa

40
Q

Tx for mild,antibiotic associated diarrhea WITHOUT fever etc.

A

Stop antibiotics

41
Q

Tx for mild to moderate diarrhea or colitis:

A

Metronidazole 500mg P.O. TID
OR
Vancomycin (oral) for 10 days

42
Q

Tx for SEVERE C. Dif

A

Vancomycin-faster symptom resolution

43
Q

Once a pt. has 1 C. Dif relapse _____% chance for a second.

A

45%

44
Q

Tx for 1st relapse of C. Dif

A

Antibiotic based on severity

45
Q

Tx for 2nd+ relapse of C. Dif

A

Vancomycin or Fidaxomicin

46
Q

Do pt’s have diarrhea in fulminant colitis?

A

No-have acute surgical abdomen, lieu’s, fever, and leukocytosis.

47
Q

An acute toxic colitis with dilation of the colon.

A

Toxic megacolon

48
Q

The most common location for intussusception is _______

A

Ileocolic

49
Q

Males are ______more likely to get intussecption than females.

A

3X

50
Q

The most common cause of bowel obstruction in the first 2 years of life.

A

Intussusception

51
Q

“Currant jelly” stool

A

Intussusception

52
Q

A 2 year presents with lethargy and palpable abdominal mass.

A

Intussusception

53
Q

What is the “dance sign”?

A

Sausage-shaped mass that is drawn cephalad and leaves the RLQ looking empty and flat

54
Q

The most sensitive and specific diagnostic tool for intussusception.

A

Abdominal Ultrasonogrphy

55
Q

The most reliable way to make a diagnosis of intussusception in children.

A

Barium and Air enema

56
Q

When should you not use a barium enema?

A

Signs of strangulated bowel, perforation, or toxicity.

FUN MED SPRING 2018 (14 decks)

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