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Clinical Medicine II > Diarrheal Illnesses > Flashcards

Diarrheal Illnesses Flashcards

1
Q

Acute Diarrhea first assessment?

A

Mild to moderate dehydration = ORT

Severe Dehydration = IV Hydration (Esp Elderly)

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2
Q

1, #2 and #3 causes of foodborne illness?

A

1 Norovirus

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3
Q

Examples of Enteric Infections ?

A
  • Campylobactor jejuni
  • Salmonellosis
  • Shigellosis
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4
Q

Whats the best way to Dx diarrheal illnesses?

A

Good Pt history

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5
Q

What does a PE for diarrhea consist of?

A
  • Vitals
  • Skin Turgor

Peritoneal signs

  • Orthostatic hypotension
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6
Q

What is the leading cause of acute diarrhea and Systemic illness world wide ?

A

Campylobactor jejuni bacteria

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7
Q

Campylobactor jejuni bacteria can be transmitted by?

A
  • Raw/ Under cooked poultry
  • Food contaminated by raw or under cooked poultry
  • Unpasteurized dairy products, contaminated water, or produce
  • Contact with the feces of a dog or cat
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8
Q

What is the peak incidence time frame and demographic affected by Campylobactor jejuni bacteria?

A

Summer months

Early childhood
Early Adulthood

Males > Females

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9
Q

Earliest S&S of Campylobactor jejuni bacteria infection?

A
  • Abrupt onset
  • Ab pain & Diarrhea
  • 33% of Pt’s can have a Prodromal period (Sign that the diseases will be much worse)
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10
Q

Acute Illness of Campylobactor disease includes?

A
  • 10 plus bowel movements
  • Bloody stools (Day 2 or 3)
  • Nausea very common
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11
Q

Population at higher risk of severe disease with Campylobactor?

A
  • Elderly

- Immunocompromised (HIV)

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12
Q

What are some local complications (rare) of Campylobactor disease?

A

Pseduoappendicitis

Colitis

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13
Q

What are some late onset systemic complications of Campylobactor jejuni disease?

A
  • Guilian Barre Syndrome (40% of pt’s)

- Reactive Arthritis (Self limiting, seen in Pt’s with HLA-B27 antigens)

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14
Q

How do you Dx Campylobactor jejuni disease?

A
  • Stool culture
  • Usually self limiting
  • Maintain Hydration and Electrolytes
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15
Q

When do you treat with antibiotics for Campylobactor jejuni disease?

A

Pt’s with severe disease

  • Bloody stools
  • High fever (>101.5 F)
  • Extraintestinal infection
  • Worsening or relapsing symptoms
  • Symptoms > 1 week
  • Infants
  • Elderly
  • Pregnant
  • Immunocompromised
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16
Q

Antibiotic Tx for severe Campylobactor jejuni disease?

A
  • 7 to 10 days
  • Azithromycin
  • Erythromycin
    NOT to be given if patient on a drug that inhibits CYP3A4
17
Q

What antibitoics is Campylobactor jejuni resistant to?

A
  • Quinolones
  • Ampicillin
  • Amoxicillin
  • Cephalosporins
18
Q

Salmonella most commonly transmitted by?

A
  • Food products contaminated with animal products or waste
  • Eggs and Poultry MC
  • Undercooked meat
  • Unpasteurized dairy
  • Seafood
  • Fresh produce
19
Q

Major cause of food borne illness in US?

A
  • Chicken eggs infected with Salmonalla Entertitdis

- Cook eggs until yolk is solidified

20
Q

Other sources of transmission of salmonella?

A
  • Processed foods
  • Fresh veggies and fruit contaminated by manure
  • Reptiles
    Fecal carriage up to 90%
21
Q

What are the two type of Salmonella?

A
  • Typhoidal

- Non Typhoidal (more common)

22
Q

What is another name for typhodial salmonella?

A

Enteric fever

  • Salmonella typhi (S. typhi)
  • Salmonella paratyphi (S.paratyphi)
23
Q

How is enteric fever transmitted?

A

-Close contact Acutely infected individual

or

  • Chronic carrier
  • Most cases ingestion of contaminated food
24
Q

Two most common strains of Non-Typhodial salmonella?

A

S. typhimurium

S. entertitdis

25
Q

When is the incidence higher for Non-thyphodial salmonella?

A
  • Rainy season in tropical climates

- Summer months

26
Q

S&S of Salmonella illness?

A
  • Nausea
  • Vomiting
  • A lot of Diarrhea (Loose non bloody)
  • 6-48 hours after ingestion of contaminated food and water
27
Q

When does fever and diarrhea resolve with acute salmonella?

A
  • Fever 72 hours
  • Diarrhea 3 to 7 days
    High risk of dehydration
28
Q

Can you develop Ostemyelitis with a salmonella illness?

A

Yes

Bones joint & Soft tissue (Femur, Tibia, Humerus, Vertebra)

29
Q

How do you Dx Salmonella?

A
  • Stool culture
30
Q

How do you Tx salmonella?

A
  • Self limiting

- IV fluids or ORT

31
Q

How do you Tx severe Salmonella illnesses?

A

Fluoroquinolone
(Ciprofloxin)

3rd Gen Cephlosporin
(Cefriaxone)

Clinical Medicine II (9 decks)

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