Diarrhea (Small Group Session 17) Flashcards
Describe a general approach to acute diarrhea and the three broad categories of acute diarrhea.
Compare and contrast the characteristics of small bowel vs. large bowel diarrhea in regards to the following:
- Volume
- Frequency
- Blood
- Pain-Location
- Rectal Symptoms
- Steatorrhea
- Weight Loss
- Effect of Fasting
- Nutritional Deficiency
Small bowel or large bowel organism?
Gram positive or negative?
Clostridium perfringens
Clostridium perfringens
- Small bowel organism
- Gram positive
Small bowel or large bowel organism?
Gram positive or negative?
Shigella
Shigella
- Large bowel organism
- Gram negative
Small bowel or large bowel organism?
Gram positive or negative?
Escherichia coli 0157
Escherichia coli 0157
- Large bowel organism
- Gram negative
Small bowel or large bowel organism?
Gram negative or gram positive?
Escherichia Coli (Toxigenic)
E. Coli (toxigenic)
- Small bowel organism
- Gram negative
Small bowel or large bowel organism?
Gram negative or gram positive?
Yersinia
Yersinia
- Small bowel organism
- Gram negative
Small bowel or large bowel organism?
Gram negative or gram positive?
Vibrio cholera
Vibrio cholera
- Small bowel organism
- Gram negative
Small bowel or large bowel organism?
Gram negative or gram positive?
Campylobacter
Campylobacter
- Large bowel organism
- Gram negative
Small bowel or large bowel organism?
Gram negative or gram positive?
Clostridium difficile
Clostridium difficile
- Large bowel organism (colon, but watery diarrhea 95% of the time)
- Gram positive
Small bowel or large bowel organism?
Gram negative or gram positive?
Salmonella
Salmonella
- Found both in the small and large bowel
- Gram negative
What is the mode of transmission?
Campylobacter
Campylobacter is transmitted via uncooked poultry, raw milk, and cheese.
What is the mode of transmission?
Clostridium difficile
Clostridium difficile is transmitted as a result of disruption in the normal intestinal flora, post hospital stay, post antibiotic use.
What is the mode of transmission?
Enterotoxigenic Escherichia coli (ETEC)
ETEC is transmitted via salad, cheese, meat and water. Pts who have travelled to undeveloped countries are at risk for ETEC. Travel risk: Mexico
What is the mode of transmission?
Yersinia
Yersinia is food/water borne.
What is the mode of transmission?
Salmonella Nontyphi
Salmonella nontyphi is transmited via undercooked poultry and eggs.
What is the mode of transmission?
Enteroinvasive Escherichia coli (EIEC)
Enterohemorragic Escherichia coli (EHEC)
EIEC and EHEC are transmitted via underooked meat.
EHEC = undercooked beef (H for Hamburger)
EIEC = poultry
Which of the following bacterial infections are treated?
Campylobacter
Clostridium difficile
ETEC
Yersinia
Salmonella Nontyphi
Shigella
EIEC
EHEC
Treatment is given for the following:
Clostridium difficile
Yersinia
Shigella
What is the treatment for C. difficile?
C. difficile treatment:
- Metronidazole
- Oral rehydration therapy
- Vancomycin
- Fecal transplant
What is the MOA of Metronidazole? What bacterial coverage does it provide?
Metronidazole
- Nitroimidazole class
- MOA: disrupts DNA & NA synthesis
- Production of free radicals
- Coverage:
- Potent against anaerobes
- Active against C. diff
- Activity against intestinal protozoa including Entamoeba, Giardia
