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GIGU 2 Exam 1 > Acute Infectious Diarrhea - Dr. McGowen > Flashcards

Acute Infectious Diarrhea - Dr. McGowen Flashcards

1
Q

pathogens effecting SI

pathogens effecting LI

A
  1. Watery D, WL, dehydration, malabsorption

2. Bloody D, fever, fecal leukocytes

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2
Q

Infectious Diarrhea what bacteria

A

shigella, Giardia, Cryptosporidium, rotavirus

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3
Q

Infectious Diarrhea SX

A
  1. fever, hypotension, tachy, brady,
    = MILD : thirst, dry mouth, decreased, axillary, decreased urine output
    = MODERATE : above , orthostatic BP, skin tenting, sunken eyes
    = SEVERE : lethargy, feeble pulse, hypotension –> shock
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4
Q

Infectious Diarrhea DX

A

fecal stool cultures

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5
Q

stool cultures include what

A
  1. salmonella
  2. shigella
  3. E. Coli
  4. Campylobacter
    = 24hr -48hrs for results
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6
Q

acute Diarrhea support includes

A
  1. IV hydration + electrolytes

2. anti-motility (if no blood, fever, C.diff or EHEC

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7
Q

Staphylococcus Aureus
type
from what
sx

A

Gram +
= cream pastries, potatoes salad, mayo, eggs, dairy, ham
= WATERY D, after 6hrs of ingestion

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8
Q

Bacillus Cereus
type
from what
sx

A

= gram +
= fried rice (sometimes meats, veggies, dried beans, cereal)
= V(1hr-5hr) + WATERY D(6hr-18hr)

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9
Q

Clostridium Perfringens
type
from what
sx

A

= gram +
= beef, ham, poultry, legumes (Heat resistant spores* not cooked all the way)
= WATERY D (no v,f)

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10
Q

Shigella
type
from what
sx

A

= gram - (enterotoxin shiga)
= lettuce, raw veggies (fecal oral)
= BLOODY + PUS D, starts as watery, fever
(can be infected with very little organisms)

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11
Q

Shigella DX and TX and complications

A
  1. shiga toxin
  2. ABs ampicillin, fluoroquinolone
  3. reactive arthritis, and hemolytic uremic syndrome
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12
Q

Salmonella non-typhoidal
type
from what
sx

A

= salmonella enteritidis + salmonella typhimurium penetrating Peyer Patches
= non-typhoidal leads to gasteroenteritis
= eggs, poultry, milk, beef, shellfish, reptiles(turtles), Ducks, Birds
= Bloody + Pus D, begins watery, fever

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13
Q

Salmonella non-typhoidal
risk in
TX
complications

A
  1. Sickle Cell, immunocompromised (HIV, Leukemia)
  2. self limited (dont give ABS)
  3. septic arthritis, abscess, osteomyelitis
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14
Q

Salmonella Typhi
type
from what
sx

A

= gram - invading Peyer Patches + colonizes in the gallbadder**
= fecal oral, poor sanitation, travel
= 1. fever + RUQ pain(typhiod fever)
2. red salmon coler maculopapular rash (rose color spots*)
3. pea soup : green foul smelling D leading to BLOODY D

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15
Q

Salmonella typhi
DX
TX
complications

A
  1. stool and blood test
  2. vaccine, ABs
  3. Intestinal hemorrhage leading to death
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16
Q

Campylobacter jejuni
type
from what
sx

A

= gram -
= raw met poultry, raw milk
=watery to BLOODY D, fever, erythma nodosum

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17
Q

Campylobacter jejuni DX and tx and complications*

A
  1. Campy blood agar for stool culture
  2. no ABS
  3. Guillian barre syndrome **, toxic megacolon, reactive arthritis
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18
Q

Vibrio Cholerae
type
from what
sx

A

= gram -, cholera toxin
= raw oyters (seafood), poor sanitation, waterborne illness (SALT WATER)
= WATERY (rice water) D a lot, dehydration

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19
Q

Vibrio cholerae
dx
tx
complications

A
  1. stool microscopy and culture gram stain
  2. rehydrate, vaccine, sanitation
  3. dehydration–> hypotension –> shock + electrolyte imbalance –> AKI_-> death
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20
Q

Vibrio parahemolyticus
type
from what
sx

A

= gram -
= sea food (oysters, shellfish, shrimp, mollusks)
= watery to BLOODY D, n, v (self limited)

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21
Q

Vibrio vulnificus
type
from what
sx

A

= gram -
= costal salt water, warm shallow, shellfish (oysters)
= V, D, Bullous Skin Lesion** —-> if open wound in water

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22
Q

Vibrio vulnificus complications

A

life threatening in the pt with cirrhosis and hemochromatosis

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23
Q

Aeromonas Hydrophila
type
from what
sx

A 
= gram - 
= fresh water, open wound in this water (foot and ankle,  eating fish/shellfish, 
= 1. Cholera like : WATERY D
2. BLOODY mucoid stools 
and necrotizing wound
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24
Q

E Coli : Enterotoxigenic -ETEC
type
from what
sx

A

= gram -
= risk in PPI use, traveling = TRAVELERS D (contaminated food and water)
= N,V, WATERY D

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25
Q

ETEC DX + prevention

A
  1. fecal leukocytes : -

2. eat only hot, cooked, boiled, avoid raw unpeeled fruit, avoid ice,, only boiled water

26
Q

E. Coli : Enterohemorrhagic - EHEC
type
from what
sx

A

= gram -, shiga like toxin (O157 : H7)
= undercooked beef (hamburger)**, raw veggies, raw milk, animal contact
= watery to BLOODY D can casue ishemic colitis, NO FEVER

27
Q

E. Coli : Enterohemorrhagic - EHEC
DX
TX
complications

A
  1. shiga like toxin
  2. rehydraitons, (AB only if severe becuz it can cause hemolytic uremic syndrome)
  3. HUS —-> more likely in children and if ABs used, Acute hemorrhagic colitis
28
Q

Yersenia Enterocolitica
type
from what
sx

A

= gram -
= per poop, DAIRY*
= BLOODY D, fever, N/V, PHARYNGITIS, RIGHT SIDE PAIN** (terminal ileum), can look like appendicitis, chrons disease)

29
Q

Yersenia Enterocolitica

risk in who

A

if iron metabolism is not normal

= FE overload, aplastic anemia, thelassemia, DM, cirrhosis)

30
Q

Yersenia Enterocolitica
DX
TX
Complications

A
  1. BLOOD in stools cultures, (looks salmonella or shigella)
  2. rehydrate and support
  3. Erythma nodosum , reactive arthritis*, MI, Kidney problem
31
Q

Listeria Monocytogenses
type
from what
sx

A

= gram + (can grow is refrigerator)
= pregnant women : immunosuppressed, hemochromatosis ** BAD
however from raw milk, deli meats, and veggies in refrigerator
= Fever, WATERY D,

32
Q

Listeria TX + complications

A
  1. Ampicillin, Gentamicin, Meropenem

2. Liver abscess, meningioencephalitis, Listeria Placentitism —-> neonatal listeriosis

33
Q

Tropheryma Whipplei
type
from what
sx

A

= rare multi system Disease gram + (not fast acid)
= no knows where from only no human to human TR
= WLm Malabsorp from X albumin + peripheral edema, CHRONIC D

34
Q

Whipplei DX

A

EGD or Duodenal biopsy

PAS stain is + M with bacillus

35
Q

Whipplei TX and complications

A
  1. ABs (dramatic improvement only need to continue for a year)
  2. fatal is untreated
36
Q

C. Diff
type
from what
sx

A

= gram +, spore forming, anaerobic, Cytotoxic A + B produciton
= common in hospitilized, mnay ABs tx, PPI
= foul smelling greenish WATERY D (5-15 times a day) = pseudomembranous colitis volcanic eruptions ((colonoscopy))

37
Q 
Rotavirus 
type 
from what
sx
dx
tx
A
  1. dsRNA fecal oral = gasteroenteritis (stomach flu)
  2. infants younger then 2yo**, immunocompromised, WINTER usually
  3. V WATERY D, low fever
  4. Wagon-wheel appearance on microscopy
  5. vaccine
38
Q 
Anenovirus 
type 
from what
sx
DX
TX
A
  1. dsRNA
  2. airbourne, fecal oral = gasteroenteritis 2nd higherst cause
  3. FEVER, WATERY D*, CONJUNCTIVITS** = PINK EYE**
  4. viral PCR
  5. Vaccine
39
Q 
Norwalk Norovirus 
type 
from what
sx
dx
A
  1. ssRNA
  2. fecal oral, person to person, very contagious OUTBREAKS, CRUISE (gasteroenteritis), nursing homes, child care (usually older adults)
  3. V, WATERY D
  4. stool PCR
40
Q

CMV
type
from what
sx

A
  1. dsDNA
  2. immunocompromised (CD4 < 200)
  3. Feval BLOODY D,
  4. EGD = ulcerative lesions (take biopsy of them) , platau valleys
41
Q

Hep A
type
from what
sx

A
  1. ssRNA
  2. fecal oral, poor sanitation, crowding, travel, contaminated water and food, shellfish
  3. ACUTE, jaundice, F, V, more severe in adults, RUQ pain
42
Q

Hep A
DX
TX

A
  1. elevated AST/ALT = hepatocellular
  2. elevated bilirubin and alkaline phosphate = cholestasis
  3. IgM to Anti-HAV (present)**
    - — vaccine
43
Q 
Rotavirus 
type 
from what
sx
dx
tx
A
  1. dsRNA fecal oral = gasteroenteritis (stomach flu)
  2. infants younger then 2yo**, immunocompromised, WINTER usually
  3. V WATERY D, low fever
  4. Wagon-wheel appearance on microscopy
  5. vaccine
44
Q 
Anenovirus 
type 
from what
sx
DX
TX
A
  1. dsRNA
  2. airbourne, fecal oral = gasteroenteritis 2nd higherst cause
  3. FEVER, WATERY D*, CONJUNCTIVITS** = PINK EYE**
  4. viral PCR
  5. Vaccine
45
Q 
Norwalk Norovirus 
type 
from what
sx
dx
A
  1. ssRNA
  2. fecal oral, person to person, very contagious OUTBREAKS, CRUISE (gasteroenteritis), nursing homes, child care (usually older adults)
  3. V, WATERY D
  4. stool PCR
46
Q

CMV
type
from what
sx

A
  1. dsDNA
  2. immunocompromised (CD4 < 200)
  3. Feval BLOODY D,
  4. EGD = ulcerative lesions (take biopsy of them) , platau valleys
47
Q

Hep A
type
from what
sx

A
  1. ssRNA
  2. fecal oral, poor sanitation, crowding, travel, contaminated water and food, shellfish
  3. ACUTE, jaundice, F, V, more severe in adults, RUQ pain
48
Q

Hep A
DX
TX

A
  1. elevated AST/ALT = hepatocellular
  2. elevated bilirubin and alkaline phosphate = cholestasis
  3. IgM to Anti-HAV (present)**
    - — vaccine
49
Q

Entamoeba Histolytica
risk / from what
sx
dx

A
  1. fecal oral, crowded living, poor sanitation, most common cause of dysentery*
  2. BLOODT D, can penetrate bowel and portal system = liver abscess
  3. EGD : Flask-shaped ulcer, oval and parastie, stool ag
50
Q

Entamoeba Histolytica
TX
complications

A
  1. Metronidazole

2. liver abscess, brain abscess, toxic megacolon, pneumatosis coli (air in colon if SI walls)

51
Q 
Giardia Lamblia 
type
risk / from what
sx
dx
tx
A
  1. pear shaped, 4 flagella, 2 nuclei, protozoan
  2. fecal oral, X fat absorption, Water lakes, hiking, camping, beavers, cattle, dogs, RISK : IgA def
  3. WATERY Malodorous D, Steatorrhea, WL, Flatulence, persistant D
  4. stool Ag detection
  5. Metronidazol
52
Q 
Cryptosporidium paravum 
risk / from what
sx
dx
tx
A
  1. swimming pools
  2. WATERY D
  3. stool Ag detection
  4. chlorine tx
53
Q 
Stronyloides stercoralis 
type 
risk / from what
sx
dx
A
  1. Nematode roundworm
  2. bare feet on contaminated soil*, more in agricultural areas, more at risk (HTLV-1)
  3. asymp, V, adb pain, SOB
  4. ova and parasite
54
Q

Ascaris Lumbricoides
risk / from what
sx

A
  1. Hookworm
  2. soil TR, warm climates, fecal oral, human feces fertilizer
  3. if long can cause SBO
55
Q

Diphyllobothrium Latum
risk / from what
sx

A
  1. fish tapeworm
  2. raw undercooked fish
  3. asyp, absorbs vit12 = vitt 12 deficiency** —-> pernicious anemia, neuro sx, can cause SBO
56
Q

Schistosoma mansoni
risk / from what
sx

A
  1. contaminated freshwater snails* (if your skin contacts the water (more in aftrica)
  2. esophageal varacies**, portal vein obstruction, BLOODY stoolsm bladder cancer, liver cysts
57
Q

Taenia Solium
risk / from what
sx
dx

A
  1. pork
  2. asymp, neurocysticerosis rare** and fatal, muscle and eye disease
  3. ova parasite
58
Q

Taenia Saginata
risk / from what
sx
dx

A
  1. beef
  2. asymp, abd pain
  3. ova parasite
59
Q 
Echinococcus Granulosus
risk / from what
sx
dx
tx
A
  1. Dogs tapeworm, fecal oral, unsanitary livestock, sheep slaughter, infected by dog feces
  2. Liver and Lungs, cysts that slow growing and asymp for years, rupture of cyst can cause allergy or death
  3. X-ray, MRI = hydatid sand, huge poka doted black circle in the liver
  4. surgery
60
Q 
Enterobius Vermicularis 
risk / from what
sx
dx
tx
A
  1. fecal oral, pinworm, children
  2. severe perianal itching
  3. scotch tape test
  4. Mebendazole, wash hands, cut fingers, disinfect

GIGU 2 Exam 1 (12 decks)

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