Diarrheal Diseases Flashcards
Watery Diarrhea: _______ or more _______ or _______ stools in _______
Dysentery: Presence of _______ and/or _______ in stools
Persistent Diarrhea: Diarrhea lasting for ____________ or more
3 ; liquid ; watery ; 24 h
blood ; mucus
14 days
Diarrhoea is a leading cause of death among children under five globally.
5
faeco-oral
Season: Tropics
Throughout; dry
rainy
Temperate climate
winter
warm
Predisposing factors
breastfeed exclusively ; 6 months ; 2 years.
feeding ; wash hands
contaminated ; Malnutrition
Aetiology of diarrhea
Watery diarrhea :???
Dysentery: ??
Persistent diarrhea:???
Rota virus
E.coli
Cholera
Shigelliosis
Ameobiasis
Causes are mostly unknown
Transmission
Most of the diarrheal agents are transmitted by the _______ route
Some viruses (such as rotavirus) can be transmitted through _________
Nosocomial transmission is (possible or impossible?)
Shigella (the bacteria causing ________) is mainly transmitted _________________
fecal-oral
air; possible
dysentery; person-to-person
PERSON-AT-RISK
Cholera: ______ years and above, (common or uncommon?) in very young infants
Shigellosis: more common in young children aged _________ years
Rotavirus diarrhea: more common in young infants and children aged __________
E. coli diarrhea: can occur at ______ age
Amebiasis: more common among ________
2 years ; uncommon
below 5 years
1-2 years
any ; adults
Types of Vibrio Cholera
Two major biotypes of Vibrio cholera that
cause diarrhea are:
__________
__________
Two common serotypes of Vibrio cholera
that cause diarrhea are:
Inaba Ogawa
Classical
ElTor
Vibrio Cholerae O139
Vibrio cholerae in _____-group ____ was first isolated in 1992 and by 1993 had been found throughout the ______ subcontinent. This epidemic expansion probably resulted from a single source after a _______________ event that changed the serotype of an epidemic V. cholerae O1 El Tor strain to O139.
O-group 139
Indian subcontinent.
lateral gene transfer (LGT)
TYPES OF SHIGELLA
The major serotypes of Shigella that cause
diarrhea are:
Dysenteriae type 1 or __________________
Shigella __________________
Shigella __________________
Shigella __________________
Shigella shiga
Shigella flexneri
Shigella sonnei
Shigella boydii
TYPES OF E. COLI
Six major types of Escherichia coli cause
diarrhea:
List them
Enterotoxigenic E. coli (ETEC)
Enteroinvasive E. coli (EIEC)
Enteropathogenic E. coli (EPEC)
Enterohemorrhagic E. coli (E. coli O157:H7) Enteroaggregative E. coli (EAggEC)
Diffuse adherent E. coli (DAEC)
History for diarrhea
Diarrhea
duration; number; blood
fever, cough
feeding practices
Urine output
CLINICAL FEATURE: CHOLERA
__________ stool
Marked __________
__________ vomiting
_______ fever or abdominal pain
Muscle cramps
__________ shock
__________ urine
Rice-watery
dehydration
Projectile
No
Hypovolemic
Scanty
CLINICAL FEATURE: E. COLI DIARRHEA
__________ stools
__________ is common
Dehydration
__________ Fever
__________ abdominal pain
Watery
Vomiting
moderate to severe
Mild
CLINICAL FEATURE: ROTAVIRUS DIARRHEA
__________ onset
Prodromal symptoms, including _______, __________, and __________ precede diarrhea
Stools are __________ or __________; the color is greenish or yellowish– typically looks like ____________________
_______ to _______ dehydration
Fever– __________ grade
Insidious
fever ; cough ; vomiting
watery ; semi-liquid;
yoghurt mixed in water
Mild to moderate
moderate grade
CLINICAL FEATURE: SHIGELLOSIS
(Frequent or Rare?) passage of ________ amount of stools, mostly mixed with ________ and ________
________ to ________ grade fever
(Mild, moderate , or Severe?) abdominal cramps
__________ – pain around anus during defecation
Usually _______ dehydration
Frequent ; scanty
blood ; mucus
Moderate to high
Severe; Tenesmus–
no
CLINICAL FEATURE: AMEBIASIS
_________ and _________ stools containing mostly _________ and sometimes _________
(Upper or Lower?) abdominal cramp
_______ grade fever
_______ dehydration
Offensive ; bulky stools
mucus ; blood
Lower ; Mild
No
LABORATORY DIAGNOSIS
________ microscopy
_________ microscopy of stool for cholera
Stool ________
_______ for rotavirus
Immunoassays, bioassays or DNA probe
tests to identify E. coli strains
Stool microscopy
Dark field microscopy
cultures
ELISA
Clinical Assessment
Dehydration
dehydration
prevent ; treat
Assessment of dehydration in a malnourished child
Reliable parameters are
History of ________
______ mucous membranes
Rapid and weak _______
History of ________
diarrhea
Dry; pulse
urine output.
Investigations:
Acidic
Treatment of Doarrhea
__________
_____________
_________________
Rehydration
Medication
Nutrition
Treatment plan A- For patients with no sign of dehydration
50-100
100-200
as much as desired
Treatment plan B: for patients with Mild and Moderate dehydration
oral rehydration salt solution
1-2min
75; IV fluid
4hours
100-200
Treatment plan C: for patients with severe dehydration - Give ________mls/kg IV.
100
Probiotics
live microbial; lactobacilli
yogurt, milk, soy drinks.
Nutrition
6; one extra
2weeks; continue
Micronutrients
duration
two; formula feed
lactose free
COMPLICATIONS: WATERY DIARRHEA
List 6
Dehydration
Electrolyte imbalances
Tetany
Convulsions
Hypoglycemia
Renal failure
COMPLICATIONS: DYSENTERY
Electrolyte imbalances
Convulsions
Hemolytic uremic syndrome (HUS) Leukemoid reaction
Toxic megacolon
Protein losing enteropathy
Arthritis
Perforation
Shshsh
Prevention
________ and __________ vaccinations
Promotion of early and exclusive ___________ and __________ supplementation
Promotion of hand washing with ———-
Improved water supply quantity and quality, including treatment and safe storage of household water
Community-wide ________ promotion.
Rotavirus and measles
breastfeeding ; vitamin A
soap; sanitation
VACCINES
An oral cholera vaccine is available, which gives immunity to 50-60% of those who take the vaccine, and this immunity lasts ________________.
No vaccines are available against ________
A vaccine against ___________ diarrhea has been withdrawn recently from the market.
only a few months.
shigellosis; rotavirus
