Diarrhea DSA and Small Bowel CIS - McGowan

Question 1

Produce imported from endemic areas and travel to those areas that causes water diarrhea may contain what?

Diarrhea lasts how long in healthy?
Immunosuppressed?

Answer 1

Cyclospora cayetanesis

21 days
Indefinitely

Question 3

What are alcoholic gels ineffective against?

Answer 3

Norovirus

C diff

Question 4

E. histolytica is most common cause of what?

Can cause what?

Diagnose?

Answer 4

Dysentery in the world

Toxic megacolon or penumatosis coli

Stool Ag (PCR for DNA)

Question 5

What tapeworm is obtained from sheep, dogs and form cysts in liver or lungs?

Looks like what on CT?

Answer 5

Echinococcus granulosus

hydatid sand

Question 9

What does MEN2B produce?

Answer 9

Mucosal neuromas
Marfanoid body
Medullary thyroid carcinoma
Pheochromacytomas

Question 10

People w/HTLV-1 are more susceptible to getting what?

What kind of organism is it?

What is seen in stool?

Answer 10

S. Stercoralis

Roundworm

Rhabditiform larvae and eosinophils

Question 11

What is the gold standard to detect polyps?

Answer 11

Colonoscopy

Question 12

What gives you tea-colored urine, acolic stools, and RUQ pain?

Answer 12

Cholecystitis

Question 13

What causes persistent diarrhea in children?

Infantile watery or blood diarrhea?

Answer 13

EAEC

EPEC

Question 14

What does MEN2A cause?

Answer 14

Parathyroid hyperplasia
Medullary thyroid carcinoma
Pheochromacytoma

Question 16

Turcot’s syndrome features?

Inheritance?

Answer 16

Polyps
Brain tumors
CRC before age 40 (100%)

AD

Question 17

What confirms lactase deficiency?

Answer 17

Hydrogen breath test

Question 19

What bacteria causes a rapid onset watery diarrhea w/N/V usually within 6 hours?

Answer 19

S. Aureus

Question 21

Diarrhea definition in adult and child?

Answer 21

Adult > 200 g/day

Child > 20 g/kg/day

Question 22

What test detects human globin?

Answer 22

FIT

Question 23

How to tx diverticulitis?

Answer 23

Antibiotics w/NPO diet

Question 27

What bacteria causes bullous skin lesions, found in warm, shallow, coastal salt water, especially in cirrhosis patients?

Answer 27

V. Vulnificus

Question 28

What gene defects in familial juvenile polyposis?

Inheritance pattern?

At risk for what?

Answer 28

MADH4 and BMPR1a

AD

adenocarcinoma

Question 29

What is Cowden disease?

Answer 29

PTEN multiple hamartoma syndrome

Polyps and lipomas throughout GI tract

Trichilemmomomas (benign)

Question 30

What travelers diarrhea occurs in Russian visitors, campers, backpackers, and swimmers in wilderness areas?

Visitors to Nepal?

Answer 30

Giardia

Cyclospora

Question 33

If a pt is IgA deficient and has Celiac’s, how can you diagnose them?

Answer 33

anti-DGP

Question 34

What is the main sx of shigella?

What is found in stool culture?

May cause what post-infectious complications?

Answer 34

Bloody diarrhea (dysentery)

Fecal leukocytes

Reactive arthritis and HUS

Question 35

What causes esophageal varices due to ingestion of contaminated freshwater snails and causes bloody stool, bladder cancer, liver cysts?

Answer 35

Schistosoma mansoni

Question 36

Cowden disease has increased rate of malignancy to where?

Answer 36

Thyroid
Breast
urogenital tract

Question 38

Increased chance of what in short bowel syndrome?

Answer 38

Oxalate kidney stones (tx: Ca) Cholesterol gallstones Bile salt and B12 malabsorption

Question 39

What is the bethesda criteria used for?

Answer 39

ID 70% mutation(+) of Lynch Syndrome

Question 40

What requires total parenteral nutrition in short bowel syndrome?

Answer 40

No colon and less than 100-200cm of prox jejunum

Question 41

What causes watery diarrhea in large volumes and seen in outbreaks at swimming pools?

Answer 41

Cytptosporidium

Question 42

What is g(-), non-spore former, rod-shaped, facultatively anaerobic, motile w/flagellum?

Answer 42

Aeromonas hydrophila

Question 44

Malabsorption of autoimmune conditions can cause what? what imaging used?

Answer 44

Osteoporosis DEXA scan

Question 45

What causes relative bradycardia with enteric fever and rose spots? Positive for what antigens?

Answer 45

S. Typhi O and H

Question 46

What gene defect causes pituitary adenoma, parathyroid hyperplasia and pancreatic tumors?

Answer 46

MEN1

Question 49

What breast test confirms bacterial overgrowth?

Answer 49

Glucose Lactulose 14C-xylose

Question 50

What test needs predietary restrictions and is guaiac-based?

Answer 50

FOBT

Question 51

What histology shows chronic inflammation w/lymphocytes and plasma cells?

Answer 51

Lymphocytic microscopic colitis

Question 53

How to diagnose Listeria?

Answer 53

Blood culture

Question 55

What is usually asymptomatic but can be dx on colonoscopy and have complications of GI bleed?

Answer 55

Diverticulosis

Question 56

What worm enters bare feet through the soil?

Answer 56

Strogyloides stercoralis

Question 58

What is a PAS (+) w/marcophages and bacillus, g (+)?

Answer 58

T. Whipple I

Question 59

What is the 2nd most common cause of gastroenteritis in children and produces watery diarrhea and high fever?

Answer 59

Adenovirus

Question 60

Gardner's syndrome involves what? Inheritance?

Answer 60

Adenomatous colon polyps Osteomas of mandible, skill, and long bones Extra teeth, thyroid and adrenal tumors AD

Question 61

What gi problem can happen in CFTR pts?

Answer 61

Rectal prolapse

Question 62

What diet should IBS pts be on?

Answer 62

Low FODMAPS

Question 64

What bacteria is seen when infected with eggs, poultry, reptiles (turtles), and sickle cell pts increased risk?

Answer 64

S. typhimurium

Question 66

What bacteria / virus commonly occurs in seafood (esp. if raw)?

Answer 66

``` Vibrio species Salmonella Norwalk Acute HepA Campylobacter ```

Question 68

Lynch syndrome inheritance and gene mutation? Increased risk of what? Screening?

Answer 68

AD, MLH1 and MSH2 CRC, endometrial cancer Colonoscopy every 1-2 yrs, at age 25

Question 69

Toxin assay for C diff reveals what?

Answer 69

TcdA --> enterotoxin TcdB --> cytotoxic AE - vowels BC - consonants

Question 71

What are the types of mucosal serrated polyps?

Answer 71

Hyperplastic Sessile serrated Traditional serrated adenoma

Question 73

Multiple myeloma leads to what in the bowel? What lab value?

Answer 73

Constipation and fecal impaction Hypercalcemia

Question 74

What is a spiral shaped, oxidase (+), motile w/flagellum g(-) curved rod?

Answer 74

Campylobacter jejuni

Question 75

What is the ROME III Criteria for IBS Dx?

Answer 75

Abdom pain for at least 3 months, sx onset > 6 months before dx and 2 of 3: Relieved w/pooping Change in freq of stools Change in appearance of stools

Question 76

Peutz-Jeffers has a defect in what gene?

Answer 76

Ser Threonine kinase II

Question 78

What are the types of mucosal adenomatous polyps?

Answer 78

Tubular Tubulovillous Villous

Question 79

What causes cysticercosis and seizures/eye disease? Get from where?

Answer 79

T. Solium Pig tapeworm

Question 82

What histology shows chronic inflammation w/thickened bands of subepithelial collagen?

Answer 82

Collagenous microscopic colitis

Question 87

Give pertinent characteristics of Peutz-Jeghers?

Answer 87

Hamartomatous polyps AD inheritance Pigmented macules on lips, buccal mucosa or skin Can cause breast, pancreatic and gonadal cancer

Question 88

What is a pear shaped, 4 flagella, 2 nuclei protozoan? How to detect? Acquired how?

Answer 88

G. Lamblia Stool Ag Water (lakes/streams) while hiking or camping

Question 89

What medication causes microscopic colitis? Occurs in whom? What sx?

Answer 89

5 pounds 5LBB 5-ASA, loperamide, budesonide, bile salts Women 50-60 Chronic or intermittent watery diarrhea

Question 94

C. Diff causes what complication?

Answer 94

Megacolon in cecum (> 10cm) and other parts of colon > 7cm

Question 95

What bacteria is more common in iron-overload syndromes, DM, preexisting GI disorder? Can cause what complications?

Answer 95

Y. Enterocolitica Rash, reactive arthritis, hemochromatosis

Question 101

What causes blood diarrhea (colonic) with fecal leukocyte (+) due to consumption of seafood?

Answer 101

V. Parahemolyticus

Question 102

B. Cereus has what kind of infectious pathogenesis? What kind of diarrhea?

Answer 102

Preformed enterotoxins Watery

Question 104

What is stained modified acid-fast that causes water diarrhea, eosinophilia present, and commonly occurs in (sub)tropical areas of the world?

Answer 104

Cystoisospora belli

Question 111

What tapeworm is found in undercooked fish?

Answer 111

D. Latum

Question 113

What hook worm that gets long can cause BO?

Answer 113

A. Lumbricoides

Question 115

What has a wagon-wheel appearance on EM? Causes acute diarrhea in whom?

Answer 115

Rotavirus Children under 2

Question 117

What bacteria causes watery diarrhea, crampy abdominal pain and has an onset of 8-16 hours after ingestion of beef, ham, legumes, gravy?

Answer 117

Clostridium perfingens

Question 118

C. Diff causes what diarrhea? How to diagnose? What Abs cause it? How to treat?

Answer 118

Watery PCR for toxin A and B Clindamycin, cephalosporins/, fluoroquinolones Metronidazole, oral Vanco, Fidaxomicin

Question 120

What bacteria is curve/comma shaped, anaerobic g(-) with flagellum? What common reservoir?

Answer 120

V. Cholera Raw oysters (seafood)

Question 126

What bacteria is found in fresh water and is usually due to eating fish/shellfish or scuba divers that swallow small amounts of fresh water and then have gastroenteritis? Causes what type of stools?

Answer 126

Aeromans hydrophila Bloody mucoid

Question 130

How to treat S. Typhi?

Answer 130

Fluoroquinolones, ceftriaxone, azithromycin

Question 137

What is a g(-), non-lactose fermenting, motile, rod-shaped bacteria?

Answer 137

Salmonella