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Rosen's GI > 84. Gastroenteritis > Flashcards

84. Gastroenteritis Flashcards

1
Q

RFs

A 
Travel
camping
recent abx
daycare
raw seafood
anal sex
HIV +
outbreaks
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2
Q

Indications to order labs

A

o fever
o bloody
o severe abdo pain
o persistent diarrhea

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3
Q

indications for stool Cx

A 
o	fever > 38.5
o	dysentery
o	> 14 days
o	Recent Abx
o	Immunocompromised
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4
Q

Indication for O+P

A

persistent diarrhea

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5
Q

4 most common bacteria

A

campylobacter, salmonella, STEC, shigella

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6
Q

signs of invasive infection

A

o Fever
o Blood
o Tenesmus
o Severe abdo pain

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7
Q

source of campylobacter

A
  • More common in summer
  • Gr- bacteria
  • Undercooked poultry
  • Wilderness water
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8
Q

MGMT campylobacter

A
  • No empiric Abx if otherwise healthy
  • Exception is traveler
  • If not improving
    o Erythro or azithro
    o Cipro has high resistance now
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9
Q

source of salmonella

A
  • Contaminated food
    o Poultry and beef
  • Must ingest large amount of bacteria
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10
Q

MGMT salmonella

A
  • No empiric Abx if otherwise healthy
    o Possible for <3mon and > 50yo
  • Cipro or azithro
  • If require hospitalization, then ceftriaxone
  • No food handling until carrier state eradicated
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11
Q

source of shigella

A
  • Most common in poor sanitation countries
  • Penal and nursing homes
  • <5yo are 30% of cases
  • MSM
  • Requires very few bacteria
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12
Q

MGMT shigella

A
  • Fluids and lyte correction
  • No need to Abx unless public health risk
  • Abx shorten clinical course within 48 hours
    o Cipro is drug of choice
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13
Q

source of yersina

A
  • Gr- bacterium
  • More common in children
  • Invades mucosa and localizes to lymphoid tissue
  • Invasive in 2/3
  • From contaminated food or milk
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14
Q

MGMT yersina

A
  • Usually self limited
  • No anti-peristaltic unless abx
  • No Abx if uncomplication
  • Usually susceptible to TMP-SMX
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15
Q

source of vibrio

A

raw fish in tropical waters

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16
Q

MGMT vibrio

A

Most need none

no antimotility agents

17
Q

source of STEC

A

undercooked hamburger

18
Q

complication of STEC

A 
o	TTP
	Neuro findings predominate
	Renal failure uncommon
o	HUS
	Renal failure
19
Q

MGMT STEC

A
  • Symptomatic
  • Abx not helpful and can worsen risk of HUS
  • Only Abx if fever > 38.5
20
Q

source of staph

A
  • Most protein rich food have some
  • Large outbreaks common worldwide
  • Bacteria killed above 60C, but toxin is heat stable
21
Q

MGMT staph

A
  • Rapid recovery is the rule
  • Antiemetics
  • IVF
  • No Abx
22
Q

source of clostridium

A
  • Common in large groups
  • Meat or poultry
  • Usually cooked food that was rewarmed poorly
  • Illness caused by toxins
23
Q

mgmt clostridium

A

supportive

24
Q

source of baccilus cereus

A 
-	2 forms
Emetic
	Heat stable toxin
	Fried rice
Diarrheal
	Meat and veggies
25
Q

MGMT cereus

A

supportive

26
Q

source of ETEC

A

fecal contamination of food

27
Q

MGMT ETEC

A

nothing for most

single dose cipro+loperamide

28
Q

complications for cdiff

A

pseuodmembrane
toxic megacolon
perfs

29
Q

MGMT c diff

A
  • DC Abx
  • Flagyl for 10-14 days for mild to moderate
  • Vanco for severe
30
Q

labs signs for toxic megacolon

A

older, immunosuppressed and have WBC >20

31
Q

source of norovirus

A

fecal oral

highly infectious

32
Q

MGMT of rotavirus

A

supportive

vaccine

33
Q

MGMT norovirus

A

supportive

34
Q

source of giardia

A
  • Both active and inactive forms
  • Infection through active form, spread through inactive form
  • Contaminated food and water
  • Common in hikers
35
Q

MGMT giardia

A

flagyl

36
Q

source of amebiasis

A
  • Developing countries and poor sanitation
  • Cysts can survive in environment for months
  • Fecal oral food or anal-oral sex
37
Q

MGMT amebiasis

A

flagyl

Rosen's GI (6 decks)

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