Diarrhea

Question 1

Child with abdominal pain and currant jelly stool

Answer 1

intussusception

Question 2

‘Rice water stools’

Answer 2

Vibrio cholerae; Tx Tetracycline if severe

Question 3

Hospital admission

Answer 3

C. difficile (clindamycin #1 culprit)

Question 4

Camping

Answer 4

Giardia; tx metronidazole

Question 5

Travel, most common- Afebrile, abdominal pain with bloody diarrhea (Travelers diarrhea)

Answer 5

ETEC Enterotoxic E. Coli. If severe tx

Fluoroquinolones

Question 6

Cruise ship diarrhea

Answer 6

Norovirus #1 cause of gastroenteroitis in adults

Question 7

Day care centers

Answer 7

Rotavirus #1 cause of diarrhea in children (vaccine on market for kids.

Question 8

Treatment of C. diff

Answer 8

1st line metronidazole; 2nd line PO vancomycin

Question 9

C. diff complications

Answer 9

Toxic megacolon

Question 10

Staph Aureus diarrhea

Answer 10

Comes on like lightening- < 6 hours incubation; classically from contaminated dairy products, mayonaise.

Question 11

Contaminated fried rice

Answer 11

Bacillus B. Cereus. (Be Serious)

Question 12

Raw shellfish

Answer 12

Vibrio parahaemolyticus

Question 13

Potato salad on hot summer day

Answer 13

Staph Aureus

Question 14

Invasive mucosal diarrhea sx

Answer 14

Damage of mucosa due to cytotoxins; fever, bloody diarrhea, vomiting is NOT common. NEVER give motility agents for invasive diarrhea
1) Campylobacter 2) Shigella 3) Salmonella 4) Yersinia 5) Enterohemorrhagic ecoli (EHEC)

Question 15

Undercooked poultry

Answer 15

Campylobacter

Question 16

post-infectious Guillain-Barré think of this agent

Answer 16

Campylobacter

Question 17

Fecal oral contamination, highly contagious

Answer 17

Shigella (assoc with reiter’s syndrome); severe TMP sulfa

Question 18

Reiter’s syndrome manifesations

Answer 18

Can see, can’t pee, can’t climb a tree. Conjunctivitis, urethritis, arthritis

Question 19

Poultry products, pet turtles

Answer 19

Salmonella

Question 20

Who is at high risk for salmonella

Answer 20

Pts who are immune compromised. Post splenectomy, sickle-cell disease, osteomyelitis

Question 21

Pea soup stools, Very high fever, abdominal pain

Answer 21

Salmonella typhi

Question 22

Contaminated pork, contaminated milk and water or TOFU

Answer 22

Yersinia; if severe treat with cipro

Question 23

Undercooked beef, unpasturized milk

Answer 23

Enterohemorrhagic ecoli (EHEC) 01587- Shiga-Toxin E. coli This is the one that can cause bleeding.

Question 24

Diarrhea from entamoebas. Fecally contaminated soil or water

Answer 24

Entamoeba histolytica; Dx ova & paracytes; Tx metronidazole

Question 25

Common in pt with AIDS

Answer 25

Cryptosporidium

Question 26

3 types of protozoan diarrheas

Answer 26

Giardia, Entamoeba histolytica; Cryptosporidium

Question 27

Frothy greasy diarrhea

Answer 27

Giardia

Question 28

osmotic - increased osmotic load- increased particles within the GI lumen- seen in celiac disease, pancreatic insufficiency, bile salt insuficiency, lactose intolerance

Answer 28

Improves with fasting

Question 29

secretory diarrhea- normal osmotic gap - Zollinger-Elson syndrome, laxative use, carcinoid syndrome

Answer 29

Does not improve with fasting