Diarrhea Flashcards
Child with abdominal pain and currant jelly stool
intussusception
‘Rice water stools’
Vibrio cholerae; Tx Tetracycline if severe
Hospital admission
C. difficile (clindamycin #1 culprit)
Camping
Giardia; tx metronidazole
Travel, most common- Afebrile, abdominal pain with bloody diarrhea (Travelers diarrhea)
ETEC Enterotoxic E. Coli. If severe tx
Fluoroquinolones
Cruise ship diarrhea
Norovirus #1 cause of gastroenteroitis in adults
Day care centers
Rotavirus #1 cause of diarrhea in children (vaccine on market for kids.
Treatment of C. diff
1st line metronidazole; 2nd line PO vancomycin
C. diff complications
Toxic megacolon
Staph Aureus diarrhea
Comes on like lightening- < 6 hours incubation; classically from contaminated dairy products, mayonaise.
Contaminated fried rice
Bacillus B. Cereus. (Be Serious)
Raw shellfish
Vibrio parahaemolyticus
Potato salad on hot summer day
Staph Aureus
Invasive mucosal diarrhea sx
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)
Undercooked poultry
Campylobacter
post-infectious Guillain-Barré think of this agent
Campylobacter
Fecal oral contamination, highly contagious
Shigella (assoc with reiter’s syndrome); severe TMP sulfa
Reiter’s syndrome manifesations
Can see, can’t pee, can’t climb a tree. Conjunctivitis, urethritis, arthritis
Poultry products, pet turtles
Salmonella
Who is at high risk for salmonella
Pts who are immune compromised. Post splenectomy, sickle-cell disease, osteomyelitis
Pea soup stools, Very high fever, abdominal pain
Salmonella typhi
Contaminated pork, contaminated milk and water or TOFU
Yersinia; if severe treat with cipro
Undercooked beef, unpasturized milk
Enterohemorrhagic ecoli (EHEC) 01587- Shiga-Toxin E. coli This is the one that can cause bleeding.
Diarrhea from entamoebas. Fecally contaminated soil or water
Entamoeba histolytica; Dx ova & paracytes; Tx metronidazole
Common in pt with AIDS
Cryptosporidium
3 types of protozoan diarrheas
Giardia, Entamoeba histolytica; Cryptosporidium
Frothy greasy diarrhea
Giardia
osmotic - increased osmotic load- increased particles within the GI lumen- seen in celiac disease, pancreatic insufficiency, bile salt insuficiency, lactose intolerance
Improves with fasting
secretory diarrhea- normal osmotic gap - Zollinger-Elson syndrome, laxative use, carcinoid syndrome
Does not improve with fasting
