Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI Remediation > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

Most cases of diarrhea, infectious or nah

A

Infectious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most cases of infectious diarrhea, viral or bacterial?

A

Viral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most common cause of infectious viral diarrhea

A

Norovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most cases of severe diarrhea etiology?

A

Bacterial.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What bug causes most cases of bacteria?

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Infectious diarrhea consists of three classes, what are they

A

Viral
Bacterial
Parasitic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Two mechanisms of diarrhea from a water standpoint

A

IMpaired water absorption or increased water secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Two types of diarrhea (pathologically)

A

Enterotoxic or invasive/inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acute diarrhea timeline and likely etiology

A

<14 days, likely infectious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Persistent/subacute diarrhea timeline and etiology

A

14-30 days. Could be inflammatory (IBD) or infectious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Chronic diarrhea timeline

A

> 30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

3 types of chronic diarrhea

A

Osmotic, secretory, and inflammatory vs non inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Role of large bowel (bc you always forget this one)

A

Absorbs fluid and salt. Not really nutrients, except potassium!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When to consider non infectious etiology for diarrhea

A

When the course becomes more persistent and chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Most common causes of acute viral diarrhea

A

Norovirus, rotavirus, adenovirus, astrovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most common causes of acute bacterial diarrhea

A

Salmonella, campylobacter, shigella, e coli, C diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common cause of protozoa diarrhea

A

Cryptosporidium, giargia, cyclospora, entamoeba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diarrhea is pretty normal. But when do we get nervous and do an acute evaluation of someone w/ diarrhea?

A 
Persistent fever
Bloody diarrhea
severe abd pain (Toxic MC)
Hypovolemia sx
Hx of IBD
Possible outbreak
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Small bowel diarrhea typical sx

A 
Watery
Large volume
Abd cramping
Bloating
gas
Weight loss if persistent
No fecal leukocytes, fever!!!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Large bowel diarrhea sx

A 
Frequent, regular
Small volume
Painful BM
Fever
Bloody/mucoid stools
Inflammatory and RBC seen on microscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Large bowel diarrhea is typically invasive or enterotoxic

A

Invasive bacteria (salmonella, shigella, campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Enteric viruses that love to cause large bowel diarrhea

A

CMV or adenovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What post abx organism loves to cause large bowel diarrhea

A

C diff!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Difference between enterotoxic and invasive infectious diarrhea

A

Enterotoxic is when the bug creates a toxin. No fever, no WBC, no Fleuk

Invasive is when the bug bores into the gut barrier. FEVER, LEUKOCYTOSIS, + FECAL LEUK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

No Fever, no wbc, no fecal leukocytes

A

Enterotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fever, leukocytosis, + fecal leukocytes

A

Invasive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Bugs typically associated with enterotoxic

A

C diff, e coli, staph aureus, cholera, giardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

You ate some weird food and within 6 hours you’re puking up a storm. What two bugs is it probably? What if you’re vomiting?

A

Preformed toxin via staph aureus or bacillus cereus.

Vomiting makes bacillus cereus look likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

You ate some weird food within 8-16 hours, what do you probably have?

A

Clostridium perfringens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

> 16 hours ago you ate some funky food?

A

Probably caused by something else. Norovirus. Usually norovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which bug is associated with exposure to animals?

A

Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What bugs are associated with daycare centers?

A

Shigella, cryptosporidium and giardia. Oh and rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Travel indicates which kinds of diarrhea?

A

Bacterial or parasites. Think of e coli (travelers) or something funky and weird

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Sx concerning for inflammatory diarrhea

A

Bloody diarrhea
Passage of many small volume stools containing blood or mucous
Temp >101.3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When to get a stool culture

A

1) Severe illness w/ sx of hypovolemia. Should be hospitalized
2) Concerned for Inflammatory diarrhea
3) High risk host features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

High risk features (like the kind of patient that would make you want to get a stool cx)

A 
>70yo
Comorbid CVD, DM
IC
IBD
Pregnant
Symptoms >1wk
Public health crisis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What kind of bacterias can stool cx diagnose

A

Campylobacter, shigella, salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Wanna order a c diff toxin?

A

Gotta make that real clear, needs to be ordered seperately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Role of fecal leukocytes and fecal lactoferrin

A

Support the diagnosis of inflammatory diarrhea. Fecal lactoferrin is more sensitive for detecting inflammation in the intestines due to bacterial infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Most common cause of death from diarhrea

A

Dehydration. Always assess and correct hydration status and electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Severe diarrhea likely needs IV ___ or ____

A

Potassium or sodium bicarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Diarrhea and lactose intolerance

A

Diarrhea can be caused by transient lactase deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Norovirus sx

A

Acute onset (12-48hr)
N/V
Watery, non bloody diarrhea
Abdominal cramps.

Classic small bowel diarrhea but with vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How long does norovirus last

A

24-72 hours.

FECAL ORAL ROUTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Most common cause of acute diarrhea

A

Norovirus

46
Q

What causes c diff?

A

Antibiotic associated colitis. 20% chance after completing a broad spectrum abx

Signigicant cause of MM among older hospitalized patients

47
Q

C diff is enterotoxic, what are two major complications that can occur?

A

Pseudomembranous colitis and toxic megacolon

48
Q

Abx most freq implicated with C diff

A

FQ
Cephs
PCN

49
Q

When would we see the dvlpment of C diff symptoms

A

either while on the abx or even 5-10 days after completion

50
Q

Tx for C diff

A

500mg q8hr Flagyl or PO Vanco (EXPENSIVE)

51
Q

Most common cause of acute bacterial diarrhea

A

Campylobacter

52
Q

Sx of campylobacter

A

Abrupt onset abd pain and diarrhea (bloody or mucoid)

Can sometimes have a prodrome of fever, chills and aches

53
Q

Campylobacter, invasive or enterogenic?

A

Invasive. Think about the bloody diarrhea

54
Q

What can campylobacter mimic

A

Appendicitis

55
Q

Tx for campylobacter is usually supportive, but who gets abx? What abx?

A

IC and severe disease.

FQ and Azithromycin

56
Q

Leading cause of foodborne disease in the US.

What food?

A

Salmonella. Associated with poultry, milk, eggs

57
Q

Salmonella invasive or enterotoxic

A

Invasive!

58
Q

Classic features of salmonella

A

N/V
PEA SOUP DIARRHEA- not grossly bloody despite invasive
Abd cramping
fever w/ chills

59
Q

Salmonella and the effect of bacteria burden

A

Higher the bacteria burden, the worse the symptoms are

60
Q

Salmonella is self limiting. How long does it take for the GI sx to go away?

A

4-10 days

61
Q

Abx therapy indications for salmonella?

A

Not in healthy patients, they just get supportive.

FQ for severe dx, IC

62
Q

Salmonella and viral shedding. Short term carriage vs long term

A

Short term: Normal shedding of virus post infection.

Long term: Shedding of virus for >1yr post infection. Remember typhoid mary? Salmonella susie

63
Q

E coli sx

A

Abdominal pain and bloody diarrhea.

NO FEVER

64
Q

Abx and E coli/Shigella?

A

NOT RECOMMENDED. These two bugs have a high risk of Hemolytic uremic syndrome.

65
Q

Hemolytic uremic syndrome triad

A

Acute RF
Hemolytic anemia
Thrombocytopenia

66
Q

Shigella gram? Invasive or enterotoxic?

A

Gram negative anaerobe. INVASIVE

67
Q

What’s our classic day care bug

A

Shigella. Fecal oral route

68
Q

Shigella Sx

A

It’s invasive, so classic invasive.

High fever
Diarrhea
Abd cramping
Tenesmus

69
Q

The bacterias we can get stool cultures on are all

A

INVASIVE

Shigella, campylobacter, salmonella

70
Q

Shigella tx

A

Supportive, it’s self limiting. Abx is not indicated dt high risk of HUS, but if someone is dying or IC give FC/azith/bactrim

71
Q

How do we make the diagnosis of botulism

A

Serum toxin

72
Q

Botulism sx

A

N/V/D
Abd pain/cramping
dry mouth/sore throat
Bilateral cranial nerve involvement/palsies

BOTULISM WILL GO FOR NERVES AND THROAT

73
Q

Botulism therapy

A

Antitoxin.

Equine serum antitoxin for most people.

If <1yr we give Botulism immune globulin

74
Q

Is cholera enterotoxic or invasive

A

Enterotoxic. Think about how watery that diarrhea is

75
Q

Bacteria that causes cholera

A

Vibrio cholerae

76
Q

Hallmark sign of cholera

A

Non bloody, liquid grey rice water diarrhea.

Profound fluid/e loss, can turn into hypovolemic shock in a day

77
Q

Tx for cholera

A

Hydration and abx (Tetra, ampi, azith, bactrim , FQ)

78
Q

Intestinal entomoeba’s kinda cool. They exist in cyst form and trophozoite. Tell me about that

A

Cyst: Infective form. You consume the cysts (Fecal oral) and they make their way down to your stomach. The stomach acid causes them to open and release trophozoites. The trophozoites are the invasive part, and that’s where we see symptoms.

79
Q

Intestinal entomoeba sx

A

The trophozoites invade and penetrate the mucous barrier of the colon, which leads to bloody diarrhea.

This can be a range, from mild diarrhea to severe dysentery.

80
Q

How long does intestinal entomoeba take to kick in?

A

1-3 weeks after ingestion

81
Q

Complications of intestinal entomoeba

A

Fulminant colitis w/ bowel necrosis. This can lead to perforation and peritonitis

82
Q

Tx for intestinal entomoeba

A

Flagyl, and then the “azole”

83
Q

Most common cause of parasitic foodbourne diarrhea in the US

A

Cryptosporidium

84
Q

Tx for cryptosporidium

A

Antiparasitic, nitazoxanide. Good for kids bc it’s liquid

85
Q

What does giardia look like on microscope?

A

Flagellated protozoan parasite

86
Q

Sx of giardia

A

Watery, yellow, foul smelling diarrhea w/ soft greasy stools. Pretend it’s like deer poop!

Can cause crazy weight loss

87
Q

Causes of giardia

A

Daycare center, CAMPING HISTORY, drinking funny water.

88
Q

Tx for giardia

A

Flagyl & antiparasites. Even after txing though you can have recurrent episodes for 6 weeks

89
Q

When to suspect travelers diarrhea

A

Dvlps during or within 10 days of returning from travel.

90
Q

Most common bug for traveler’s diarrhea

A

E coli- NOT THE HORRIFYING BLOODY ONE

91
Q

Most common travelers diarrhea cause for kids (or in jamaica!)

A

Rotavirus

92
Q

Tx for travlers diarrhea

A

FQ

93
Q

Tx for traveler’s diarrhea

A

Self limited, consider loperamide.

94
Q

When to consider diarrhea being foodbourne

A

N/V/D.

Things tend to like to go out the same mode they came in. Eating something toxic will make you vomit

95
Q

Name some non infectious causes of diarrhea!

A 
IBD
Irritable bowel syndrome
Partial SBO
Pelvic abscess in rectum
Fecal impaction
Ingestion of poorly absorbably sugars (lactulose &amp; acute alcohol)
96
Q

Irritable bowel syndrome definition

A

Recurrent abd pain or discomfort 1 day per week for >3 months. Must have 2 of following:

1) Improvement w/ defecation
2) Change in frequency of stool (C)
3) Change in form of stool (D

97
Q

Four types of IBS

A

IBS w/ constipation
IBS w/ diarrhea
Mixed IBS
Unclassified- this seems flakey

98
Q

When should IBS get an endoscopy?

A 
Moderate rectal bleeding
Weight loss
Unexplained Fe anemia
Nocturnal sx
fhx of CRC/IBD
celiac
99
Q

Mainstay of IBS tx

A

Dietary modification & inc physical activity.

Low gas producing foods, no lactose, low fermentable foods, no gluten

100
Q

Rx therapy for patients with IBS-C

A

Polyethylene glycol

Lubiprostone: (works on chloride & enhances intestinal fluid secretion) PRO-CHLORIDE

Linaclotide: Guan agonist, stimulates fluid secretion and transit

101
Q

Hallmark for malabsorption

A

STEATORHHEA

> 30g of fat per day

102
Q

Conditions that may cause malabsorption

A

Celiac
Bacterial overgrowth
Lactase deficiency

103
Q

Gold standard for diagnosing steatorrhea (malabsoorption)

A

QUANTITATIVE (HOW MUCH FAT) stool fat test. Stool is collected for 3 days. Patient eats a high fat diet for 2 days before and during the collection.

104
Q

Other methods for diagnosing steatorrhea/malabsorption

A

QUALITATIVE (IS THERE FAT)
Sudan stain, determines the percentage of fat in the stool. (because sudan doensn’t have a lot of fat)

Acid steatocrit- cheap and reliable. Not the best though

105
Q

Sweat replacement drinks are not suitable replacements for ORS. It’s an osmolarity thing. Too high. We want a lower osmolarity. Lower osmolarity ORS are associated with what good things?

A

Decreased stool output
Dec vomiting
Less need for IVF

106
Q

Components or ORS

A

Sodium chloride
Sodium bicarb
Potassium chloride
Glucose

107
Q

Glucose is the biggest ingredient in ORS, why is that?

A

In many S. bowel illnesses, glucose absorption is still active. So if glucose and salt are present, the colon can actually use that transporter to take in some water.

108
Q

Go to IVF for severe dehydration

A

NS and LR

109
Q

Rehydrating in severe dehydration

A

200ml/kg in 24 hours. Ex:

70kg person needs 14,000 mL. Or 14 bags

110
Q

Loperamide is CI with what kind of bacteria

A

INVASIVE. Body is trying to flush out the bacteria with the diarrhea and you’re just letting it build up

111
Q

Loperamide MOA

A

Slows gut motility, decreasing the number of stools and the watery consistency of the diarrhea

112
Q

When to consider using BAS for diarrhea

A

Persistent diarrhea despite antidiarrheal use. 50% of those IBS-D patients have bile acid malabsorption, and all that extra bile acid causes diarrhea by stimulating the colon.

GI Remediation (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions