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GI II Final DF > Acute Diarrhea DSA Powerpoint > Flashcards

Acute Diarrhea DSA Powerpoint Flashcards

1
Q

what does schistosoma mansoni cause

A

bloody stools
bladder cancer
liver cysts

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2
Q

most common cause of acute infectious diarrhea (2 bacteria)

A

salmonella

campylobacter

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3
Q

commoin in tropical and subtropical areas of the world
acute non bloody watery diarrhea
in immunosupp pts diarrhea can be severe
caused by coccidian parasite
malabsoprtion and weight loss bc can last 4 weeks

A

cystoisospora belli (formerly isospora belli)

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4
Q

shigella

A 
children
potato or egg salad, lettuce, raw veggies
blood disarrhea
fecal leukocytes positive
lactrose negative
reactive arthritis and HUS
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5
Q

mutation for FAP

A

APC or MUTYH

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6
Q

child diarrhea defined as

A

> 20/g/kg/day stool

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7
Q

cryptosporidium 2 main clinical symptoms

-type of diarrhea
outbreaks involving what

A

self limited diarrhea in immunocompetent pts
-no treatment

life threatetning intractable in immunosupp pts
-AIDS cd4 count below 200, antivirals to increase CD4 count

  • watery diarrhea large volume (over 20L a day)
  • outbreaks involving swimming pools
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8
Q

motile S shaped gram neg rod

A

campylobacter

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9
Q

HUS

A

shigella most common
EHEC next most common
happens in children more that are treated with antibiotics

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10
Q

yersiniosis may lead to

A

autoimmune type thyroiditis, pericarditis, GN

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11
Q

shigella treatment

A

bismuth, amp, fluoroquin, trimeth/sulfa

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12
Q

chronic diarrhea cuases

A 
SSRI
cholinesterase inhib
NSAIDs
PPI
ACEI
metformin
allopurinol
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13
Q

what is recommended to person with IBS

A

low FODMAP diet

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14
Q

yersinia enterocolitica

  • higher risk in
  • type of diarrhea
  • complications
  • treatment
A 
iron overload syndromes
bloody and non bloody
mimics appendicitis
hemochromatosis
supportive care
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15
Q

for celiac and pt with IgA defeiicency check what

A

anti-DGP

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16
Q

treatment of constipation/fecal impaction

diagnose too

A

diagnose with DRE

tx: enema, digital disruption

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17
Q

short bowel syndrome increased chance of

A

oxylate kidney stones
give clacium supplemntation
increawsed cholest gallstones

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18
Q

treatment for salmonella typhimurium

A

antiobiotics are usually not indicated

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19
Q

genetic defect Familial juvenile polyposis

A

18 and 10

MADH4 and BMPR1A

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20
Q

get from produce from endemic areas

  • lettuce, fresh basil, imported raspberries
  • travel to endemic area
  • watery diarrhea
  • indefinite in immunosupp and 21 days in immunocomp
A

cyclospora cayetanesiss

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21
Q

treatment for EHEC

A

supportive

antibiotics only in severe cases

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22
Q

traveler’s diarrhea risk factor

A

H2 blocker/PPI

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23
Q

secretory diarrhea

  • sodium
  • osmotic gap
A

high, normal

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24
Q

SBS: colon removed need at least ___ cm of prox jejunum for oral nutriotino

A

200 cm

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25
Q

2nd most common cause of gastroenteritis in children
watery diarrhea and vomiting
conjunctivitis
pharyngitis

A

adenovirus

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26
Q

etiology of bacterial overgrowth

A

PPI
gastric surgery of small bowel
SI motility disorder
gastrocolic or coloenteric fistula

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27
Q

which organisms do you use immunoassays for

A

c diff
rotavirus
giardia
e histolytica

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28
Q

painless rectal bleed

A

diverticulosis bleed

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29
Q

whipple disease finding

A

PAS (+) macrohages with gram + bacilli

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30
Q

screening for lynch

A

colonscopy every 1-2 yrs starting at 25 or 5 yrs younger than age of youngest affect family member at diagnosis

-pelvic exam, transvag US, endometrial samp for women at 30-35
upper endoscopy every 2-3 yrs at 30-35
prophylatic hysterectomy with oophorectomy age 40 or once done childbearing

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31
Q

salmonella typhimurium

A 
gram negative, non lactose fermenting, motile, rod shaped
blood diarrhea
fecal leukocytes +
eggs and poultry
reptile exposure
complications are septic arthitis, osteomyelitis
increased risk sicle cell pts
non typhoidal--> gastroenteritis
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32
Q

short bowel syndrome from what disease

A

crohns ,mesenteric infarction, radiation enertiis, volvuus, tumor resetion and trauma

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33
Q

diarrhea defined clinically

A

3 or more loose or watery stools/day
or
decreaes in consistency and increase in frequency of BM of individual

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34
Q

undercooked foods, lunch meat, soft cheeses

A

listeria

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35
Q

alcohol gels are ineffective aginast

A

norovirus and c dif

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36
Q

lynch syndrome inherit

A

auto dom

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37
Q

TD in nepal

A

cyclospora

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38
Q

gene mutaiton lynch

A

MLH1, MSH2

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39
Q

microscopic colitis presentation

A 
idiotpathic or from meds
women in 50s,60s
chronic or intermittent watery diarrhea
normal mucosa on endoscopy
-histo: chronic inflammation, thickened band subep collagen
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40
Q

need to asks for specific labs for

A

c diff pcr/toxin
ova parasites
giardia and cryptosporidium stool antigen

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41
Q

fever, abdominal pain, bloody diarrhea in immunosuppresed pts under 200 CD4

A

CMV

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42
Q

seafood especially if raw

A

vibrio species mainly

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43
Q

watery diarrhea that occurs in immunocompromised host that can be found on a modified acid fast staining of the stool

A

cystoisorpora belli

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44
Q

MEN2A

A

PTH hyperplasia
Medullary throid carcinoma
pheochromocytoma

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45
Q

antimotility agents should not be used with

A

C diff or EHEC infection

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46
Q

pathogen typically affects large bowel presents with

A

frequent
small volume stools
pain in lower abd or rectum

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47
Q

adult diarrhea defined as

A

greater than 200g/day of stool weight

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48
Q

how do you detect norwalk

A

PCR

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49
Q

short bowel syndrome

A

removal of significant segment of SI
TI resection
bile salt and vit b12 malabsorption
B12 injectables, bile salt binding resins low fat diet, fat soluble vitamin replacement

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50
Q

autoimmune gastritis

A

desrution of fundic glands
achlorhydria
pronounced hypergastrinemia
hyperplasia gastric enterochromaffin like cells
development of small multicentric carcinoid tumors

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51
Q

cowden diseae

A

lipoma, harmartomas, and benign hair follicle tumors

hair follicle tumor on the skin and face

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52
Q

strongyloides stercoralis

how get, where, what type parasite, what pts more susceptible, how diagnose, treat

A 
bare feet on contaminated soil
roundworm
rural areas
HTLV-1 pts are more susceptible 
rhabditiform larvae in stool, eosinophils in stool

treat: ivermectin

53
Q

EIEC

A

fever, abd pain, watery bloody diarrhea with leukocytes

dysnetery

54
Q

diverticulitis tx

A

antibiotics and npo/clear liquid diet

55
Q

protozoa that can penetrate bowel and into portal circulation and cause liver lung or brain abscess

A

e histolytica

56
Q

osteoma of mandilble, skull, and long bones
-95% develop colorectal polyps (adenomatous)

supernumerary teeth
thydoid adrenal tumors
desmoid tumors
auto dom

A

gardner’s syndrome

57
Q

fish tapeworm, can get long (30 ft), raw/undercooked fish

A

diphyllobothrium latum

58
Q

vibrio cholera
get from what
treatment

A

waterborne illness
raw oysters
rehydration/electrooyte replacement

59
Q

echinococcus granulosus

what is parasite
get from what
complications
image on CT

A

tapeworm
unsanitary livestock slaughter especially sheep
dogs main carrier
form cysts in liver or lungs
looks like free flowing hydatid sand on CT

60
Q

what can develop in peutz heghers syndrome

A

GI malignancy or breast cancer

also gonadol or pancreati cancer

61
Q

what kind of toxins does staph have and what type of diarrhea

A

preformed enterotoxins
watery diarrhea
rapid onset wtithin 6 hours

62
Q

causes of osmotic diarrhea

A

mg antacids, sorbitol, lactose intolerance, laxatives

63
Q

MEN1

A

pituitary adenoma
PTH hyperplasia
pancreatic tumors

64
Q

95% of cases of colon adenocarcinoma believed to come from

higher risk

A

adenomas and serrated polyps

higher risk if over 1 cm or 1 cm

65
Q

most common cause of chronic diarrhea

stool osmotic gap

A

meds
IBS
lactose intolerance

SOG = normal

66
Q

special cultures for

A

EHEC
virbrio
yersinia
others

67
Q

cyclospora cayetanensis

treament of water or food with chlorine or iodine is ____ to kill cyclospora oocysts

how detect cysts
treatment

A

unlikely

stool sample

trimethoprim/sulfamethoxazole

68
Q

anaerobic toxin forming gram + bacillus

A

C diff

69
Q

widal test positive with O and H antigens

A

salmonella typhi

70
Q

multiple myeloma is associated with what

A

impaction and hypercalcemia

71
Q

what does FIT detect

A

human globin

72
Q

TD in asia

A

campylobacter jejuni

73
Q

pathogen typically affects small bowel presents with

A 
large volume 
watery stool
abdominal cramps 
weight loss
pain is mid abdomen or diffuse
74
Q

whipple disesae present

A

fever, arthralgias, LAD
weight loss
malabsroption, chronic diarrhea
encephalitis

75
Q 
causes of constpiation
diet
thryoid
drug
supplement
A

inadequate fiber and fluid intake
hypothryroidism
CCB use
calcium supplementation

76
Q

routine stool culture includes

A

salmonella
shigella
e coli (ask for shiga toxin)
most detect campylobacter

77
Q

diagnosis lynch:

besthesda criteria

A

CRC under 50

CRC or lynch syndrome associated tumor at any age

CRC with with one or more 1st degree relations with CRC or lynch syndrome related cancer with one of the cancers before

CRC with two or more second degree relative with CRC or lynch syndrome related cancer at any age

tumors with infiltrating lymphocytes, mucious.signet ring diff or medullary growth pattern in pts younger than 60

78
Q

C diff description

A

anaerobic, gram positive, spore forming bacillus

79
Q

vibrio vulnificus

how you get it
associated with
life threat in

A 
warm shallow coastal salt water
raw shellfish (oysters)
open wound in water
bullous skin lesions
life threatening in cirrhosis pts
80
Q

other risk factors for C diff

A

chemo
PPI
IBD
enteral tube feeding

81
Q

protozoa that can cause toxic megacolon or pneumatosis coli
how to diagnose this infection
and treatment

A

e histolytica
stool antigen to diagnose
metronidazole treatment

82
Q

watery diarrhea

pear shaped 4 flagella 2 nuclei protozoan

A

giardia

83
Q

treatment for salmonella typhi

A

fluorquin
ceftriaxone
azithromycin

84
Q

profuse watery diarrhea that doesn’t improve with fasing, episodes of getting hot and her face turns red
what tumor and whats elevated

A

carcinoid tumor secreting serotonitn

5-HIAA

85
Q

most common form of TD

A

ETEC

86
Q

cytoisospora belli negative stool exam then what

-treatment

A

duodenal specimen by biopsy
also modified acid-fast stain

treat: trimeth/sulfameth

87
Q

sign that goes with colon ancer which is lesions all over the skin

A

sign of lesar-trelat

88
Q

clostridium perfringens

toxin
diarrhea
onset
cause

A

preformed enterotoxin
watery diarrhea
rapid onset 8-16 hrs
beef, ham, poultry, legumes, gravy

89
Q

lynch syndrome associated with

A

HNPCC

associated with endometrial, bladder, ovarian, rneal, and SI cancer

90
Q

MEN 2B

A

mucosal neuromas

marfanoid body habitus

medullary thryoid carcinoma

pheochromocytoma

91
Q

hook worm, fecal oral transmission, can get long, can cause bowel obstruction

A

ascaris lumbricoides

92
Q

cerebellar lesions
trichilemmomomas
hamartromatous polyps and lipomas
PTEN syndrome

A

cowden disease

93
Q

suspect HNPCC in

A

personal early onset CRC

FH CRC, or assocaited cancers

94
Q

osmotic diarrhea

  • stool sodium
  • osmotic gap
A

low, increased

95
Q 
worldwide problem (africa), 2nd most common cause of esophageal varices behind alcohol in africa
get from contaminated freshwater snails
A

schistosoma mansoni

96
Q

pt has rash on knees and elbows which is ___ associated with malabsorption disease which can lead to ___ so check with ___

A

dermatitis herpatitis with celiac
can lead to vitamin D deficiency
check with DEXA scan

97
Q 
aeromonas hydrophila
description
environment
eating what
other transmission
2 types
treatment
A

gram negative, non spore forming rod, facultatively anaerobic bacteria, motile with flagellum

fish or shellfish

wounded in fresh water or open wounds, foot and ankle most common

necrotizing faciitis aka flesh eating bacteria

  • choleral like
  • bloody mucoid stools
  • ampicillin
98
Q

risk factor diverticular disease of colon

A

older

CT disease

99
Q 
c diff toxin
type of diarrhea
other risk factor
treatment
complication
A

toxin A and B (PCR to detect)
pseudomembranes
recent hospitalization, PPI use, antibiotic use
-clindamycin, cephalosporins, fluorquin risk factors
treatment: metronidazole or oral vancomycin
complication: toxic megaclon, need surgery

100
Q

EAEC

A

persistent diarrhea in children

101
Q

what do you get malabsoprtion of in whipples

A

ADEK

102
Q

vibrio parahemolyticus

A 
cytotoxin production
bloody diarrhea
from seafood consumption
positive fecal leukocyte
non-O1 and non O139 variants
103
Q

organism that is assciated with sinus bradycardia, neutropenia, and enlarged spleen
-invades peyers patches

A

salmonella typhi

-carrier state in GB

104
Q

lactose intolerance test

A

hydrogen breath

105
Q

test for bacterial overgrowth

A

breath test: glucose, lactulose, or C-xylose

106
Q

most common cause of dysentery in the world

A

e histolytica

107
Q

what do you lose in diarrhea

A

bicarb

potassium

108
Q

treatment for campylobacter

A

supportive bc self limited

109
Q

ROME III criteria for IBS dx

A

ab discomfort or pain 3/days month for past 3 months with symptom onset over 6 months before diagnosis and at leas 2/3:

  • relieved with defecation
  • onset associated with change in frequency of stool
  • onset associated with a change in form (appearance) of stool
110
Q

blood in urine, haptoglobin decreased, hemolysing (elevated indirect bilirubin), schistocytes

A

HUS

111
Q

confirmation of listeria

A

blood culture

112
Q

treatment for microscopic colitis

A

stop offending meds, loperamide, budesonide, bile-salt binding agents or 5-ASA

113
Q

treatment C diff

A

metronidazole

vancomycin

114
Q

motile comma shaped gram negative bacillus

A

cholera

115
Q

watery diarrhea in infants under 2

wagon wheel appearance on electron microscopy

A

rotavirus

116
Q

B cererus toxin is ___
main symptom
onset
presenttation

A 
preformed enterotoxin
vomiting
rapid within 6 hrs
fried race consumption
watery diarrhea
117
Q

TD with Russia visit, especially st. petersburg

A

giardia

also campers

118
Q

SBS: colon and 100 cm prox jejunum preserved

A

oral nutrition with low fat and high complex carb diet

119
Q

reactive arthritis following infection by

A

salmonella
campylobacter
shigella
yersinia

120
Q

adenomatous colon polpys
brain tumor
CRC 100% over 40
auto dom

A

turcot’s syndrome

121
Q

taenia solium

A

pork tape worm
most asymptomatic
rare serious cases of seizures and muscle or eye disease

122
Q

pernicious anemia from

increase risk of

A

autoimmune gastritis

increased risk of gastric adenocarcinoma

123
Q

causes of secretory diarrhea

A

hormones (tumors)
laxative abuse
villous adenoma
bile salt malabsorption

124
Q

no colon and less than 100-200 cm of prox jejunum

A

TPN

125
Q

what does a medullary thyroid carcinoma secrete

A

calcitonin

126
Q

toxic shock syndrome bateria most common and second most

A 
staph aureus 1
strep pyogenes (group A) 2
127
Q

pt had all small bowel resected except 50 cm of proximal jejunum what should be diet

A

TPN

low fat if still had colon and 100 cm of jejunum

128
Q

EPEC

A

infantile watery or bloody diarrhea

129
Q

familial juvenil polyposis

A

hamartomatous polyposis syndrome
auto dom
>10 juvenile hamartomous polyps mainly in colon
increased risk adenocarinoma

GI II Final DF (9 decks)

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