diarrhea Flashcards
definitions
> 3 liq stools in 24 hrs
classifications
acute: <2 wk
Persistent: 2-4 wk
Chronic: >4 wks
classification
noninflammatory and inflammatory
noninflammatory description
water, nonbloody
mild self limiting
caused by virus or noninvasive bacteria
no systemic symptoms
inflammatory description
inflam of gi: invasive patho, chronic inflammatory bowel dz and bld or pus
systemic symptoms: fever
pathogens
virus, bacteria, protozoa, parasites
acute diarrhea causes
noninflammatory
watery stools: associated with vomiting: norovirus or rotavirus
contaminated foods
timing of contaminated stools offers clues
6 hr= staphylococcus
8 hrs= clostridium
16 hrs= enterotoxigenic e coli
S&S fo acute diarrhea
inflammatory: bldy/mucousy stool, severe abd pain, fever
what causes contaminated foods diarrhea
salmonella
what causes contaminated water
giardia
abx causes
cdiff
S&S of mild dehydration
thirst
S&S of moderate dehydration
dry mucous membranes, sunken eyes, low urine output, tachypnea, tachycardia
S&S of severe dehydration
very dry mucous membranes, decreased skin tugor, cool limbs, anuria, significant tachypnea and tachycardia, hypotension, loc
diag test
severe:
electrolytes, creatinine, urea nitrogen, CBC- thrombocytopenia, anemia, increased wbc in cdiff
immunocompromised: bld: fecal cultures, fecal leukocytes, cdiff toxins assays
fluid tx
fluid repletion: oral/ng/iv 1-3 l of isotonic crystalloids
diet tx
diet: liq, simple food, avoid dairy
empiric tx abx for severely ill, risk factors for complications, travel associated
azithromycin 500 for 3 days
fluoroquinolones (ciprofloxacin) 500 bid for 3-5 days
antimotility drugs
when to admit
severe dehydration
bldy diarrhea
severe abd pain
signs of severe inf or sepsis
severe or worsening diarrhea in pts >70 or immunocompromised
signs of hemolytic uremia syndrome (aki, thrombocytopenia, hemolytic anemia)
