diarrhea

Question 1

definitions

Answer 1

> 3 liq stools in 24 hrs

Question 2

classifications

Answer 2

acute: <2 wk
Persistent: 2-4 wk
Chronic: >4 wks

Question 3

classification

Answer 3

noninflammatory and inflammatory

Question 4

noninflammatory description

Answer 4

water, nonbloody
mild self limiting
caused by virus or noninvasive bacteria
no systemic symptoms

Question 5

inflammatory description

Answer 5

inflam of gi: invasive patho, chronic inflammatory bowel dz and bld or pus
systemic symptoms: fever

Question 6

pathogens

Answer 6

virus, bacteria, protozoa, parasites

Question 7

acute diarrhea causes

Answer 7

noninflammatory
watery stools: associated with vomiting: norovirus or rotavirus
contaminated foods

Question 8

timing of contaminated stools offers clues

Answer 8

6 hr= staphylococcus
8 hrs= clostridium
16 hrs= enterotoxigenic e coli

Question 9

S&S fo acute diarrhea

Answer 9

inflammatory: bldy/mucousy stool, severe abd pain, fever

Question 10

what causes contaminated foods diarrhea

Answer 10

salmonella

Question 11

what causes contaminated water

Answer 11

giardia

Question 12

abx causes

Answer 12

cdiff

Question 13

S&S of mild dehydration

Answer 13

thirst

Question 14

S&S of moderate dehydration

Answer 14

dry mucous membranes, sunken eyes, low urine output, tachypnea, tachycardia

Question 15

S&S of severe dehydration

Answer 15

very dry mucous membranes, decreased skin tugor, cool limbs, anuria, significant tachypnea and tachycardia, hypotension, loc

Question 16

diag test

Answer 16

severe:
electrolytes, creatinine, urea nitrogen, CBC- thrombocytopenia, anemia, increased wbc in cdiff

immunocompromised: bld: fecal cultures, fecal leukocytes, cdiff toxins assays

Question 17

fluid tx

Answer 17

fluid repletion: oral/ng/iv 1-3 l of isotonic crystalloids

Question 18

diet tx

Answer 18

diet: liq, simple food, avoid dairy

Question 19

empiric tx abx for severely ill, risk factors for complications, travel associated

Answer 19

azithromycin 500 for 3 days
fluoroquinolones (ciprofloxacin) 500 bid for 3-5 days
antimotility drugs

Question 20

when to admit

Answer 20

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)