Diarrhea DSA and Small Bowel CIS - McGowan Flashcards
Produce imported from endemic areas and travel to those areas that causes water diarrhea may contain what?
Diarrhea lasts how long in healthy?
Immunosuppressed?
Cyclospora cayetanesis
21 days
Indefinitely
What are alcoholic gels ineffective against?
Norovirus
C diff
E. histolytica is most common cause of what?
Can cause what?
Diagnose?
Dysentery in the world
Toxic megacolon or penumatosis coli
Stool Ag (PCR for DNA)
What tapeworm is obtained from sheep, dogs and form cysts in liver or lungs?
Looks like what on CT?
Echinococcus granulosus
hydatid sand
What does MEN2B produce?
Mucosal neuromas
Marfanoid body
Medullary thyroid carcinoma
Pheochromacytomas
People w/HTLV-1 are more susceptible to getting what?
What kind of organism is it?
What is seen in stool?
S. Stercoralis
Roundworm
Rhabditiform larvae and eosinophils
What is the gold standard to detect polyps?
Colonoscopy
What gives you tea-colored urine, acolic stools, and RUQ pain?
Cholecystitis
What causes persistent diarrhea in children?
Infantile watery or blood diarrhea?
EAEC
EPEC
What does MEN2A cause?
Parathyroid hyperplasia
Medullary thyroid carcinoma
Pheochromacytoma
Turcot’s syndrome features?
Inheritance?
Polyps
Brain tumors
CRC before age 40 (100%)
AD
What confirms lactase deficiency?
Hydrogen breath test
What bacteria causes a rapid onset watery diarrhea w/N/V usually within 6 hours?
S. Aureus
Diarrhea definition in adult and child?
Adult > 200 g/day
Child > 20 g/kg/day
What test detects human globin?
FIT
How to tx diverticulitis?
Antibiotics w/NPO diet
What bacteria causes bullous skin lesions, found in warm, shallow, coastal salt water, especially in cirrhosis patients?
V. Vulnificus
What gene defects in familial juvenile polyposis?
Inheritance pattern?
At risk for what?
MADH4 and BMPR1a
AD
adenocarcinoma
What is Cowden disease?
PTEN multiple hamartoma syndrome
Polyps and lipomas throughout GI tract
Trichilemmomomas (benign)
What travelers diarrhea occurs in Russian visitors, campers, backpackers, and swimmers in wilderness areas?
Visitors to Nepal?
Giardia
Cyclospora
If a pt is IgA deficient and has Celiac’s, how can you diagnose them?
anti-DGP
What is the main sx of shigella?
What is found in stool culture?
May cause what post-infectious complications?
Bloody diarrhea (dysentery)
Fecal leukocytes
Reactive arthritis and HUS
What causes esophageal varices due to ingestion of contaminated freshwater snails and causes bloody stool, bladder cancer, liver cysts?
Schistosoma mansoni
Cowden disease has increased rate of malignancy to where?
Thyroid
Breast
urogenital tract
Increased chance of what in short bowel syndrome?
Oxalate kidney stones (tx: Ca)
Cholesterol gallstones
Bile salt and B12 malabsorption
What is the bethesda criteria used for?
ID 70% mutation(+) of Lynch Syndrome
What requires total parenteral nutrition in short bowel syndrome?
No colon and less than 100-200cm of prox jejunum
What causes watery diarrhea in large volumes and seen in outbreaks at swimming pools?
Cytptosporidium
What is g(-), non-spore former, rod-shaped, facultatively anaerobic, motile w/flagellum?
Aeromonas hydrophila
Malabsorption of autoimmune conditions can cause what?
what imaging used?
Osteoporosis
DEXA scan
What causes relative bradycardia with enteric fever and rose spots?
Positive for what antigens?
S. Typhi
O and H
What gene defect causes pituitary adenoma, parathyroid hyperplasia and pancreatic tumors?
MEN1
What breast test confirms bacterial overgrowth?
Glucose
Lactulose
14C-xylose
What test needs predietary restrictions and is guaiac-based?
FOBT
What histology shows chronic inflammation w/lymphocytes and plasma cells?
Lymphocytic microscopic colitis
How to diagnose Listeria?
Blood culture
What is usually asymptomatic but can be dx on colonoscopy and have complications of GI bleed?
Diverticulosis
What worm enters bare feet through the soil?
Strogyloides stercoralis
What is a PAS (+) w/marcophages and bacillus, g (+)?
T. Whipple I
What is the 2nd most common cause of gastroenteritis in children and produces watery diarrhea and high fever?
Adenovirus
Gardner’s syndrome involves what?
Inheritance?
Adenomatous colon polyps
Osteomas of mandible, skill, and long bones
Extra teeth, thyroid and adrenal tumors
AD
What gi problem can happen in CFTR pts?
Rectal prolapse
What diet should IBS pts be on?
Low FODMAPS
What bacteria is seen when infected with eggs, poultry, reptiles (turtles), and sickle cell pts increased risk?
S. typhimurium
What bacteria / virus commonly occurs in seafood (esp. if raw)?
Vibrio species Salmonella Norwalk Acute HepA Campylobacter
Lynch syndrome inheritance and gene mutation?
Increased risk of what?
Screening?
AD, MLH1 and MSH2
CRC, endometrial cancer
Colonoscopy every 1-2 yrs, at age 25
Toxin assay for C diff reveals what?
TcdA –> enterotoxin
TcdB –> cytotoxic
AE - vowels
BC - consonants
What are the types of mucosal serrated polyps?
Hyperplastic
Sessile serrated
Traditional serrated adenoma
Multiple myeloma leads to what in the bowel?
What lab value?
Constipation and fecal impaction
Hypercalcemia
What is a spiral shaped, oxidase (+), motile w/flagellum g(-) curved rod?
Campylobacter jejuni
What is the ROME III Criteria for IBS Dx?
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
Peutz-Jeffers has a defect in what gene?
Ser Threonine kinase II
What are the types of mucosal adenomatous polyps?
Tubular
Tubulovillous
Villous
What causes cysticercosis and seizures/eye disease?
Get from where?
T. Solium
Pig tapeworm
What histology shows chronic inflammation w/thickened bands of subepithelial collagen?
Collagenous microscopic colitis
Give pertinent characteristics of Peutz-Jeghers?
Hamartomatous polyps
AD inheritance
Pigmented macules on lips, buccal mucosa or skin
Can cause breast, pancreatic and gonadal cancer
What is a pear shaped, 4 flagella, 2 nuclei protozoan?
How to detect?
Acquired how?
G. Lamblia
Stool Ag
Water (lakes/streams) while hiking or camping
What medication causes microscopic colitis?
Occurs in whom?
What sx?
5 pounds 5LBB
5-ASA, loperamide, budesonide, bile salts
Women 50-60
Chronic or intermittent watery diarrhea
C. Diff causes what complication?
Megacolon in cecum (> 10cm) and other parts of colon > 7cm
What bacteria is more common in iron-overload syndromes, DM, preexisting GI disorder?
Can cause what complications?
Y. Enterocolitica
Rash, reactive arthritis, hemochromatosis
What causes blood diarrhea (colonic) with fecal leukocyte (+) due to consumption of seafood?
V. Parahemolyticus
B. Cereus has what kind of infectious pathogenesis?
What kind of diarrhea?
Preformed enterotoxins
Watery
What is stained modified acid-fast that causes water diarrhea, eosinophilia present, and commonly occurs in (sub)tropical areas of the world?
Cystoisospora belli
What tapeworm is found in undercooked fish?
D. Latum
What hook worm that gets long can cause BO?
A. Lumbricoides
What has a wagon-wheel appearance on EM?
Causes acute diarrhea in whom?
Rotavirus
Children under 2
What bacteria causes watery diarrhea, crampy abdominal pain and has an onset of 8-16 hours after ingestion of beef, ham, legumes, gravy?
Clostridium perfingens
C. Diff causes what diarrhea?
How to diagnose?
What Abs cause it?
How to treat?
Watery
PCR for toxin A and B
Clindamycin, cephalosporins/, fluoroquinolones
Metronidazole, oral Vanco, Fidaxomicin
What bacteria is curve/comma shaped, anaerobic g(-) with flagellum?
What common reservoir?
V. Cholera
Raw oysters (seafood)
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?
Aeromans hydrophila
Bloody mucoid
How to treat S. Typhi?
Fluoroquinolones, ceftriaxone, azithromycin
What is a g(-), non-lactose fermenting, motile, rod-shaped bacteria?
Salmonella
