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GI 2 > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

Bloody diarrhea can be caused by:

A
  1. Salmonella
  2. Shigella
  3. E Coli - O157H7 or STEC producing
  4. Campylobacter
  5. Yersinia
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2
Q

Chinese food or fried rice.. Vomiting (4hrs post eating) or non-bloody diarrhea (6-24hrs post).

A

Bacillus cereus

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3
Q

Drinking freshwater from mountain streams.

A

Giardia lamblia

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4
Q

Outbreak of non-bloody diarrhea in daycare

A

Giardia lamblia

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5
Q

Drinking contaminated (dead animal) water from a well

A

Giardia lamblia

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6
Q

Chronic foul smelling, fat filled diarrhea.

A

Giardia lamblia

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7
Q

4-6 hrs after a picnic with contaminated food.

A

Staphylococcus aureus.

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8
Q

Gram negative, comma shaped bacteria with polar flagellum

A

Vibrio cholera

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9
Q

Voluminous non-bloody diarrhea, person gets dehydrated after consuming contaminated food.

A

Vibrio cholera

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10
Q

Rice water stool

A

Vibrio cholera

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11
Q

Person with pre-existing liver disease/failure or hepatitis eats raw seafood. Gets non-bloody diarrhea and septic shock.

A

Vibrio vulnificus

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12
Q

Person with open cut swims in salt water and gets a blistering/scalding skin lesion/cellulitis.

A

Vibrio vulnificus

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13
Q

Comma shaped organism, corkscrew motion.
Chicken.
Cow, unpasterized milk

A

Campylobacter

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14
Q

In what season does campylobacter often occur?

A

summer

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15
Q

Pseudo-appendicitis is the presentation of what?

A

Yersinia (bloody diarrhea)

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16
Q

Person is REALLY SICK and has bloody diarrhea

A

Shigella

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17
Q

Most common form of traveler’s diarrhea, all ages.

A

EnteroPathogenic E. Coli (EPEC)

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18
Q

Gram negative rod that attaches to enterocytes of small bowel and causes decreased fluid absorption.

A

EnteroPathogenic E. Coli

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19
Q

Is EPEC acute or chronic?

A

Can be longer-term, i.e. 12 weeks.

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20
Q

Class of students, football team with watery diarrhea

A

Norwalk

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21
Q

Less than 2yo with non-bloody diarrhea.

A

Rotavirus

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22
Q

E coli is gram negative or positive? What shape and what toxin does it release?

A

gram negative, rod shaped, shiga

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23
Q

Organism penetrates into epithelium of small intestine, invasion into Peyer’s patches, invades host macrophages and lives in Lymph Nodes.

A

Salmonella

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24
Q

Salmonella is gram negative or positive?

A

Gram negative enteric bacillus

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25
Q

Rose spots

A

Salmonella typhi

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26
Q

Widal test positive with O and H antigens = ____

A

Salmonella typhi

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27
Q

Bacteremia (spikey fever, colicy pain), multiplies with RES organs (LYMPH NODES, liver, spleen)

A

Salmonella

28
Q

CD4 less than 50, think?

A

MAC

29
Q

In anyone HIV+ (CD4 >50) with no-bloody diarrhea, think what two bugs?

A

Isospora

Cryptosporidium

30
Q

In anyone HIV+ (CD4 >50) with no-bloody diarrhea, what test should you do for the two most common bugs?

A

Acid Fast stain (both are mildly staining)

31
Q

Mexico vacation. amoeba

A

Entamoeba histolytica

32
Q

Antibiotics, hospitalized, diarrhea.

A

Clostridium difficile.

33
Q

Pear shaped trophozoite with four flagella with two nuclei. Use antigen test.

A

Giardia

34
Q

What type of bacteria is Clostridium Difficile?

A

Gram positive rod

35
Q

What does C. diff secrete? What test to diganose?

A

Secretes enterotoxin and cytotoxin, forming a pseudomembrane. Get a stool sample for stool antigens.

36
Q

Gram negative nonlactose fermenting rod that produces a potent cytotoxin.

A

Shigella

37
Q

Gram negative lacatose fermenting rod that secretes and adenylate cyclase activating toxin?
Characerize the diarrhea and fecal test.

A

Enterotoxigenic E. Coli - ETEC.

Watery, non-bloody diarrhea that lacks mucous or fecal leukocytes.

38
Q

Use fecal leukocyte test to look for what?

A

Bacterial infection, like salmonella, shigella, campylobacter.

39
Q

Comma shaped organism, microaerophilic and urease negative.

A

Helicobacter

40
Q

Shiga toxin producing bacteria (2)

A

E. coli and shigella

41
Q

Gram positive round organism with long chains (watery diarrhea)

A

Strep pyogenes

42
Q

Clumps of gram positive round organisms (watery diarrhea)

A

Staph auerus

43
Q

Define tenesmus

A

A continual or recurrent inclination to evacuate the bowels, caused by disorder of the rectum or other illness.

44
Q

Associate this disease with pyoderma gangrenosum, uveitis and ankylosing spondylitis

A

Ulcerative colitis

45
Q

What type of anemia is associated with IBD?

A

Hyperchromic Microcytic Anemia

46
Q

What three tests can be used for celiac, which is the best serologic test?

A
  1. Positive antigliadin antibodies.
  2. Postive IgA serum antiendomysial antibody (goes away with gluten free diet).
  3. Positive IgA antitissue transglutaminase (IgA TTG).
47
Q

Dermatitis herpetiformes… what is this?

A

Celiac

-flattened villi and hyperplastic crypts, small intestine, autoimmune

48
Q

longest worm, may come out of nose, oval eggs and abdominal discomfort.

A

Ascaris lumbricoides, 20cm.

49
Q

Worm associated with bare feet

A

Strongyloides stercoralix

50
Q

Worm associated with fish

A

diphyllobothrium latum (fish tapeworm)

51
Q

Fluke with snail/water lifecycle. #2 most common cause of esophageal varices in Africa. Cysts form where in human?

A

Schistosoma mansoni. Cysts form in liver

52
Q

MacConkey agar - what two organisms

A
  1. Shigella - clear growth

2. E. coli - PINK growth

53
Q

What causes this? Petechiae on lower extremities. Schistocytes and decreased platelets on peripheral smear. BR elevated. Elevated LDH.

A
  • EHEC O157H7 causing Hemolytic Uremic Syndrome*
  • Elevated LDH from hemolysis.
  • Petechiae dt low platelets
  • worry about DIC development
54
Q

What does rotavirus look like on transmission electron microscope?

A

Wagon wheel

55
Q

During carrier state, where does salmonella typhi reside? In later stages of the disease, what can occur?

A

gallbladder.

In later stages intestinal bleeding possible

56
Q

Gram negative organism that causes splenomegaly, relative sinus, bradycardia, neutropenia

A

salmonella typhi

57
Q

Painless rectal bleeding and presentation of acute appendicitis in a 3+yo, think:

A

Meckel’s diverticulum - remnant of omphalomesenteric (vitelline) duct

58
Q

free flowing hydatid sand like appearance on CT of abdomen, some icterus, structure resides in RUQ

A

Echinococcus liver cyst

59
Q

Bacterial Rods that cause diarrhea

A

E. coli - Gram negative
Shigella - Gram negative
Clostridium - Gram positive

60
Q

Comma shaped bacteria that cause diarrhea

A

Campylobacter - corkscrew
Vibrio cholera - with flagella
Helicobacter - urease negative

61
Q

100+ slowly evolving colorectal polyps, AD, cancer by 35yo if untreated, defect in APC.
Congenital hypertrophy of retinal pigment on slit lamp

A

FAP

62
Q

AD, SI/LI/endometrium, increased risk of colon CA by 45yo

Look for family history of EARLY cancer

A

“HNPCC” lynch syndrome

63
Q

50yo, 20-100 polyps

A

Attenuated FAP

64
Q

Brain tumors, colorectal CA by 40

A

Turcot’s

65
Q

Freckles, buccal mucosa, AD, young adults, LKB1 mutation on ch19, 3-5% get adenocarcinoma

A

Peutz-Jaeger

66
Q

Osteoma of long bones/skull/mandible, supernumerary teeth, AD, adenomatous colon polyps, 95% with colorectal polyps

A

Gardner’s

GI 2 (9 decks)

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