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GI/GU II Exam 1 > DSA 3. Acute Infectious Diarrhea > Flashcards

DSA 3. Acute Infectious Diarrhea Flashcards

1
Q

In the US, what are 5 high risk groups for diarrhea

A

travelers

immunodef ppl

daycare workers/kids & families: shigella, giardia, cryptosporidium, rotavirus

institutionalized pt: nursing home assisted living, hospitals

consumers of certain foods

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2
Q

What is important Hx/RF to consider if pt presents with diarrhea

A
  • recent ABx
  • ill contacts
  • travel
  • drinking unclean h2o
  • daycare/nursing home
  • animal exposure
  • Immunocompromised
  • unpasteurized dairy
  • raw/undercooked meat, fish, or shellfish
  • pregnancy (listeriosis)
  • swim/drink untreated h2o (lakes/rivers)
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3
Q

What is one of the most imp PE findings in a pt presenting w/ diarrhea

A

signs of dehydration - bc can cause death

  • mild: thirsty, dry mouth, decreased sweat or urine output, slight wt loss
  • moderate: orthostatic fall in BP, skin tenting, sunken eyes (infants = sunken fontanelle
  • severe: lethargy, obtundation, feeble pulse, hypotension, shock
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4
Q

besides dehydration, what are other PE findings for diarrhea

A

vitals - fever, hypotension, increase HR

Abd exam: tenderness, peritoneal signs, bowel sounds (increase- diarrhea; decrease - ileus/toxic megacolon)

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5
Q

describe acute infectious diarrhea

A

fecal-oral transmission

mild & self-limited - dont need further workup

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6
Q

what indications of further work up in pt presenting w/ diarrhea

A
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7
Q

What labs should be included in the work-up for diarrhea

A

1. Blood​: CBC, electrolytes, BUN, Cr, Blood culture

2. Stool

  • Fecal leukocytes: (infxn or inflam)
  • Fecal calprotectin: (IBD)
  • Fecal lactoferrin (= enzymes found in leukocytes; inflam like IBD
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8
Q

when ordering a stool culture, which bactera are included & which ones arent

A

included = salmonell, shigella, e. coli, campylobacter (some places) => take 24-48 hrs

not included:

  • enterohemorrhagic & other e. coli (ask for shigella-like detection for O157:H7 EHEC)
  • vibrio spp
  • yersinia
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9
Q

besides blood/stool labs/culture, what are other tests you can use to evaulate the cause of diarrhea?

what are they used for?

A

Stool immunoassay: C.Diff bacterial PCR/toxin

Ova/parasites: if Hx relevant - obtain 3 samples sequentially

Stool Protozal Ag- giardia, cryptosporidium, E. histolytica

Stool Viral Ag: rotovirus, norovirus

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10
Q

If stool studies dont show anything, what can you use to further investigate the cause

A

endoscopy

lower: flexible sigmoidoscopry w/ Bx
upper: EGD w/ duodenal aspirates & Bx

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11
Q

What radiology tests can be used to access diarrhea complaints

A

plain x-ray - detect free intraperitoneal air (ileus or toxic megacolon)

abd CT (usually w/ PO/IV contrast) - more sensitive for air - nonspecific identification of colitis

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12
Q

when do you suspect food poisoning

A

multiple illnesses after shared meal

summer time - food was in temp ideal for microorganism prolif

local health dept isolate organism of contaminated food

routine test not completed

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13
Q

What are common food poisoning pathogens?

what foods are they associated w/?

A

(picnic, banquet, restaurant)

chicken: salmonella, campylobacter, shigella

undercooked hamburger: EHEC (O157:H7)

fried rice: bacillus cereus

potato salad, mayo or cream pastries: staph aureus

eggs: salmonella

uncooked foods, lunch meat, soft cheese: listeria

seafood (esp raw): virbrio spp**, salmonella, acute hep A, norovirus, campylobacter

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14
Q

What causes watery diarrhea

A
  1. staph aureus
  2. bacillus cereus
  3. clostridium perfingens
  4. vibrio cholerae (rice water)
  5. aeromonas hydrophila (rice water, w/ bloody mucoid stool)
  6. ETEC
  7. C. diff
  8. rotovirus
  9. adenovirus
  10. norovirus
  11. giardia lamblia
  12. cryptosporidium parvum (LARGE Vol: 20 L/day)
  13. cyclospora cayetanensis
  14. cystoisospora belli
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15
Q

which pathogens begin w/ watery diarrhea and transition to bloody diarrhea

A

shigella

salmonella typhimurium

C. jejuni

vibrio parahemolyticus

EHEC

EIEC

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16
Q

Staph Aureus:

Microbio:

Sxs:

Tx:

RF:

A

Microbio: gram (+) cocci (grape clusters; preformed endotoxins

Sxs: N/V, watery diarrhea, rapid onset (w/i 6 hrs)

Tx: rapid resolution (24-48 hrs)

RF: ham, poultry, dairy, eegs, cream pastries, potato salad, mayo

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17
Q

Bacillus Cereus

Microbio:

Sxs:

Tx:

RF:

A

Microbio: gram (+) rod; preformed enterotoxins

Sxs: rapid onset (w/i 6 hrs); main = vomiting; watery diarrhea

Tx: rapid resolution (w/i 24-48 hrs)

RF: Fried rice;

occasionally =meats, veggies, dried beans, cereals

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18
Q

Clostridium perfingens

Microbio:

Sxs:

Tx:

RF:

A

Microbio: gram (+) (heat resistant) spore-forming rod; preformed enterotoxins

Sxs: watery diarrhea; crampy abd pain (no fever/vomit)

rapid onset (w/i 8-16 hrs)

Tx: rapid resolution (w/i 24-48 hrs)

RF: beef, ham, poultry, legumes, gravy
(heat resistant spores inadequately cooked)

need to ingest large quantity of organisms

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19
Q

Shigella (several types)

Microbio:

Sxs:

Tx:

RF:

A

Microbio: gram (-) rods (enterobacteriaceae fam); No flagella (no H antigens)–> non-motile

Toxin mediated (enterotoxin shiga toxin)

Sxs:: Only 100 organisms needed to be infected

Bloody diarrhea: (watery diarrhea –> intense colitis w/ fever and freq small-vol stools w/ blood and pus); abd cramps, fever (3-4 days)

Tx: bismuth, ampicillin, fluoroquinolone, or trimethoprim/sulfamethoxazole

RF: potato or egg salad, lettuce, raw veggies

Person-person under poor sanitary conditions (fecal-oral)

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20
Q

How do you Dx Shigella?

what are some complications?

A

Dx: fecal leukocytes (+); stool culture (difficult to differentiate from IBD), lactose (-)

Complications: after infxn - reactive arthritis & HUS

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21
Q

Salmonella typhimurium

Microbio:

Sxs:

Tx:

RF:

A

Microbio: gram (-), non-lactose fermenting, motile, rod

  • Orgnaism penetrate SI mucus layer & traverse the intestnal epithelium thu M cells overlying peyer’s patches
  • MC in US = non-typhoidal –> gasteroenteritis

Sxs: watery –> bloody diarrhea; fever, abd cramp, N/V

Tx: self-limited (5-10 days); ABx NOT indicated (non-typhoid)- give for disseminated dx, immunocompromised, infants

RF:

  • contaminated food (at least 100,000 needed) eggs, poultry, milk/dairy, beed, shellfish
  • animal exposure: reptile (turtle), ducks, birds
  • immunocompromised pt: HIV, leukemia, sickle cell pt, osteomyelitis
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22
Q

How do you Dx salmonella typhimurium

what are complications

A

Dx: stool culture; fecal leukocytes (+)

Complication: septic arthritis, abscess, osteomyelitis, reactive arthritis, endocarditis

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23
Q

Salmonella typhi

Microbio:

Sxs:

A

Microbio: gram (-), rod, anaerobic

  • organism penetrate SI mucus layer & traverse the intestinal epithelium thru M cells overlying peyer patches
  • lives only in humans - healthy carrier (gallbladder colonization) - asymp carriers

Sxs:

  • typhoid fever, 7-14 days after ingestion,
  • 2 phases seperated by asymp phase
    • systemic sustained febrile illness
    • sometimes erythematous “salmon-colored” maculopapular rash of flat rose-colored spots & pea-soup green-yellow foul smelling diarrhea –> bloody diarrhea
  • encephalopathy, splenomegaly, conjunctivitis
  • relative bradycardia
  • intestinal perforation; hemorrhage –> death
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24
Q

Salmonella typhi

Dx

Tx

RF

A

Dx: stool culture; blood culture; fecal leukocytes

Tx: prevent - good food prep, hand wshing, vaccine; fluoroquinolone (becoming resistant), ceftriaxone & azithryomycin

RF: international tavel, poor sanitation

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25
Q

Campylobacter jejuni

Microbio:

Sxs:

Dx:

A

Microbio: gram (-); motile w/ flagellum; host = wild birds (include ducks)

Sxs: watery –> bloody diarrhea; fever, crampy abd pain, erythema nodosum

Dx: fecal leukocyte, stool culture: have to order Campy Blood Agar

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26
Q

Campylobacter jejuni

Tx

RF

Complications

A

Tx: self limited (7 days); supportive

RF: ingest raw/undercooked meat (poultry), dairy (raw milk); cross-contamination; contaminated water, Traveler diarrhea

Complications: reactive arthritis, guillan-barre’s syndrome

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27
Q

Vibrio cholerae

Microbio:

Sxs:

Dx:

A

Microbio: gram (-) bacilli, anaerobric w/ flagellum (toxin production)

Sxs: watery diarrhea (rice water); Profuse (1 L/hr); dehydration (electrolyte imbalance) –> hypotension –> renal failure –> death

Dx: Stool microscopy & gram stain

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28
Q

Vibrio cholerae

RF

Tx/Prevention

A

RF: waterborne illness (saltwater), raw oyster (sawfood); underdeveloped nation

Tx/Prevention: rehydration/electrolyte, ABx may shorten duration; vaccination. sanitation

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29
Q

Vibrio Parahemolyticus

Microbio

Sxs

Dx

RF

A

Microbio: gram (-) bacilli, cytotoxin production

Sxs: watery –> bloody diarrhea; N/V/abd cramps

Dx: fecal leukocytes, stool culture

RF: seafod (shellfish, oysters, shrimp)

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30
Q

Vibrio vulnificus

Microbio

Sxs

RF

A

Microbio: gram (-) bacillus

Sxs: vomit, diarrhea, abd pain w/i 16 hrs; bullous skin lesion

RF: open would in water (life threatening in immunocompromised - esp cirrhosis & hemochromatosis)

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31
Q

Aeromonas Hydrophila

Microbio

Sxs

Tx

RF

A

Microbio: gram (-), non-spore forming, rod-shaped, facultative anaerobic, motile w/ flagella

Sxs: type 1: cholera-like: water rice water diarrhea; type 2: bloody mucoid stool

Tx: ampicillin

RF:

  • Fresh water or brackish water
  • eating fish or shellfish
  • MC: foot & ankle wound in water ==> rapidly become necrotizing fascitis
  • Scuba divers - swallow small amount fresh water –> gastroenteritis
32
Q

What is the epidemiology & RF for traveler’s diarrhea (TD)

how does it present

A

travel - asia, africa, south & central america, mexico (3 days-2 wks after travel)

ingest contaminated food/water

RF: travel to deveoping countries; H2 blocker or PPI (bc lower pH)

sxs: N/V, watery diarrhea, bloating, abd cramp, fatige, malaise, loss of appetite

33
Q

what is the most common cause of travelers diarrhea

A

enterotoxigenic E. coli (ETEC)

affect SI

found in contaminate h2o, salads, meats, cheese

enterotoxin production

34
Q

what are causes of traveler’s diarrhea

A

MC = ETEC

(asia) camylobacter jejuni

salmonella

shigella

aeromonas

EAEC

norovirus

coronavirus

35
Q

Giardia associated diarrhea may present in..

A

visitors to russia

campers

backpackers, swimmers

36
Q

E. Coli (ETEC)

Microbio

Sxs

Dx

Tx

RF

A

Microbio: gram (-) *single most imp agent for TD*

Sxs: watery diarrhea, N/V, occasional fever, sudden onset (3-6 days long)

Dx: fecal leukocyte NEGATIVE, diagnose clinically (cant differentiate btn ETEC and normal strains)

Tx: ABx may reduce infxn by 1-2 days (bactrim, doxycycline, ciprofloxin); bismuth may help

RF: kids, elderly, travelers - ingested contaminated food/water

37
Q

E. Coli (EHEC - O157:H7) (aka shiga-toxin producing e. coli (STEC)

Microbio

Sxs

Dx

A

Microbio: gram (-), produces shiga-like toxin

Sxs:

  • watery –> bloody diarrhea (–> ischemic colitis)
  • MCC = acute hemorrhagic colitis
  • abd tenderness, NO FEVER

Dx:

  • CBC- peripheral leukocytes (+) (increased WBC), anemia, thrombocytopenia
  • fecal leukocytes & lactoferrin
  • stool culture: shiga-like toxin
38
Q

E. Coli (EHEC - O157:H7) (aka shiga-toxin producing e. coli (STEC)

Tx:

RF:

Complications:

A

Tx: supportive, rehydration, (ABx ONLY in severe cases - BC it can INCREASE RISK OF HUS)

RF: food (under-cooked hamburger), raw veggies, milk, unpasteurized apple cider, roast beef; animal contact

Complications: HUS- occurs 5-10 days into course ( > chance in children &/or if EHEC treated w/ ABx)

39
Q

Besides ETEC and EHEC, what are the other strains of e. coli and how does it present

A

EAEC: persistent diarrha in kids, non-bloody, afebrile

EPEC: infantile watery or bloody diarrhea

EIEC: fever, abd pain, water –> bloody diarrhea w/ leukocytes

40
Q

Yersinia enterocolitica

Microbio

Sxs

Dx

A

Microbio: gram (-) coccobacilli, contaminated food/water OR DAIRY, contaminated domestic animal feces

Sxs: bloody diarrhea, fever, N/V, abd cramps + phayngitis, R-sided abd pain (mimic appendicitis or crohns

Dx: stool/blood culture; clinically indistinguishable from salmonella or shigella; fecal leukocytes

41
Q

Yersinia enterocolitica

Tx

RF

complications

A

Tx: supportive

RF: derangement of Fe metabolism enhance virulence -Fe-overload syndrome, cirrhosis, hemochromatosis, aplastic anemia, thalssemia; diabetes, pre-existing GI disorder

complications: reactive arthritis, erythema nodosum, myocarditis, kidney dz

42
Q

listeria monocytogenes

Microbio

Sxs

Dx

Complications

A

Microbio: gram (+)

Sxs: non-bloody diarrhea, fever, HA, N/V; pregnant pt - nonspecific (mild fever & malaise)

Dx: blood culture or CSF

Complications: meningoencephalitis & listeria placentitis

43
Q

What are the RF for Listeria monocytogenes

A

pregnant women (–> listeria placentitis)

extremes of ages, immunosupressed, pt w/ hemochromatosis

contaminated food: raw milk, unpasteurized dairy, deli meats

44
Q

Tropheryma whipplei

Etiology:

Hx/PE

Dx

Tx/Prognosis

A

Etiology: whipple dz, rare multi-system dz, gram (+) bacillus, not acid fast (white men 40-60s); source unknown

Hx/PE: fever, LAD, arthralgia, wt. loss, malabs, chronic diarrhea, hypoalbuminemia & edema, HF, vascular regurg, CNS symps, late hypotension

Dx: Endoscopy w/ duodenal Bx - periodic acid Schiff (+) macrophages w/ characterisitc bacillus; labs - evidence of malabs & steatorrhea

Tx/Prognosis: ABx - prolonged tx for at least 1 yr; drugs that cross BBB; goal- prevent progression untreated = fatal

45
Q

Clostridium difficile

Microbio

Sxs

Dx

Rf

A

Microbio: anaerobic, gram (+), spore forming bacillus; cytotoxin production

Sxs: _watery-_diarrhea, abd pain, fever

Dx: stool assay - PCR for toxin (A & B); peripheral leukocytes (+), fecal leukocytes (+/-), pseudomembranes on colonic mucosa (sigmoidoscopy)

RF: w/i last 2 months = hospitalized/ill contact, ABx: clindamycin, cephalsporin, fluoroquinolones, PPI

46
Q

What are Tx and complications for C. diff

A

Wash hands w/ soap & water

po/iv metronidazole; po vancomycin

Complications: toxic megacolon (50% mortality rate) - aggressive tx & SRG consult for colesctomy

47
Q

What are nosocomial infxns

A

= hospital & long-term care facilities

infxous diarrhea is one of most freq categories –> foul smelling & WBC > 1,500

MC = C. diff

Norovirus

48
Q

Rotovirus

Virology

Sxs

Dx

Tx/Prevention

A

Virology: ds-RNA, spread fecal-oral

Sxs:

  • MCC of acute diarrhea in infants (<2); esp winter months
  • watery diarrhea, vomiting
  • w/i 72 hrs; last 2-3 days
  • death - dehydration

Dx: fecal leukocytes (-); viral culture/PCR -“Wagon wheels”

Tx/Prevention: supportive care/vaccine

49
Q

Adenovirus (serotypes 40 & 41)

Virology

Sxs/population

Dx

Tx

A

Virology: ds-DNA

Sxs/population

  • children
  • watery diarrhea & vomiting
  • fever, chills, myalgias, sore throat
  • MCC: viral Conjucntivitis in children
  • Pharyngitis- exudate

Dx: viral culture- can shed for months after resolution

Tx: supportive care

50
Q

Norkwalk virus (Norovirus)

Virology

Sxs/population

Dx

Tx

A

Virology: small non-enveloped RNA

Sxs/population

  • older children/adults ; outbreak via contaminate food, water, person-to-person (nursing home, child care centers, cruise ships)
  • watery- diarrhea, vomit
  • w/i 24-48 hrs & lasts 3 days

Dx: fecal leukocytes (-), routine viral culture- UNREVEALING

Tx: supportive care

51
Q

CMV

Population

Virology

Sxs

Dx

A

Population: immunosuppressed pt (AIDS, organ transplant pts, CD4 count < 200)

Virology: herpes fam- ds-DNA linear

Sxs: bloody-diarrhea, fever, abd, pain; lasts several weeks

Dx: Endoscopy w/ Bx of ulcerated lesions using CMV specific stains

52
Q

Entamoeba histolytica (=trophozoite)

Sxs

Dx

A

Sxs:

  • MCC of dysentery in the world
  • most = asymp BUT need Tx if found
  • bloody diarrhea
  • fever, tenesmus, abd pain
  • penetrate bowel & into portal circulation –> liver abscess

Dx:

  • “flask-shaped ulcer” on histolgy
  • check stool for ova & parasite
  • Stool Ag
  • fecal leukocytes (+)
53
Q

What are RF, Tx & Complications for Entamoeba histolytica

A

RF: crowded living (fecal-oral) - mental health institutions, poor sanitation, ingested contaminated food/water

endemic areas, africa, central/south america

Tx: eliminate invading trophozoites; eradicate intestinal carriage or organism

Complications: toxic megacolon or pneumatosis coli (air in lining of colon)

54
Q

Giardia lamblia

Parasitology

Sxs

Dx

A

Parasitology: pear shaped, 4 flagella, 2 nuclei protozoan (trophozoite); fecal-oral transmission; interfere w/ fat abs

Sxs: could be asymp

  • watery malodorous diarrhea; common cause for persistent diarrhea
  • steatorrhea, flatulence, abd pain, belching, wt loss, nausea, malaise, cramps, anorexia, bloating

Dx: fecal leukocytes (-); check stool for ova parasites; stool Ag detection

55
Q

What are RF and Tx for Giardia lamblia

A

RF:

  • water (lake/streams) - hiking/camping
  • zoonosis: beaver, cattle, dogs, rodents, big horn sheep
  • person-to-person (daycare)
  • contamincated water in Russia
  • IgA def

Tx: supportive, tinidazole/metronidazole

56
Q

Cryptosporidium parvum

Parasitology

Sxs

Dx

A

Parasitology: oocyte w/ 4 motile sporozoites; person-to-person

Sxs

  • self limited diarrhea - immunocompetent pts (7-14 days)
  • life-threatening intractable in immunosuppressed pt (can be indefinite)
  • watery diarrhea -large volumes! –> can lead to dehydration

Dx:

  • stool Ag detection or direct microscopy
  • -modified acid-fast staining, direct fluorescent Ab
  • fecal leukocytes (-)
57
Q

What are RF and Tx for Cryptosporidium parvum

A

RF: water-borne - contaminated food/water

outbreaks involve: swimming pool, daycare, unsanitary milk production, municipal water supply

Tx: resistant to chlorine tx

immunocompetent- supportive/hydrate

immunosuppressed- antivirals to increase CD4 count & boost immune system

58
Q

Strongyloides stercoralis

Parasitology

Sxs

RF

A

Parasitology: nematode-roundworm; enter via exposed skin (bare feet on contaminated soil) –> Larvae travel & grow in lungs–> cough–> then swallowed –> travel to SIs

  • all continents except for Antarctica: (MC tropical/subtropical)

Sxs: often asymp

Abd pain, vomiting, bloating, diarrhea, cough, SOB, Perianal urticaria, migratory rash

RF

  • socioeconomic disadvantaged, institutionalized populations, and in rural areas
  • associated w/ agricultural activities
  • Risks for hyperinfection: immunocompromised (Chemo/steroid use) –> pt w/ HTLV-1 are more susceptible (not tru for HIV/AIDS pts)
59
Q

Strongyloides stercoralis

Dx

Tx

A

Dx: rhabditiform larvae in stool; eosinophils in stool

Tx: anti-helmintic

60
Q

Cyclospora cayetanensis

RF

Sxs

Dx

Tx

A

RF:

Produce from endemic areas- lettuce, fresh basil, and imported raspberries (chlorine or iodine is CANT kill these)

Travel - endemic areas (MC tropical/subtropical)

Sxs:

  • Malaise, anorexia, nausea, low-grade fever
  • Watery diarrhea
  • last up to 21 days in immunocompetent
  • Indefinitely in immunosuppressed

Dx: fecal leukocytes (-); oocysts in stool

Tx: Bactrim

61
Q

Cystoisospora belli

RF

Sxs

Dx

Tx

A

RF: MC tropical/subtropical; ingest contaminated food/water

Sxs:

  • acute, non-bloody watery diarrhea
  • Crampy abd pain,
  • Can last for weeks –> cause malabs & wt loss.
  • Immunosuppressed pts & infants/kids- diarrhea = severe
  • Dx:
  • Eosinophilia possible
  • oocysts passed in small amounts intermittently –> repeated stool exam & concentration procedures
  • if stool exam (-) –> exam duodenal specimens by Bx
  • oocysts visualized on wet mounts by microscopy with bright-field; stained by modified acid-fast stain

Tx: treatable/preventable; Bactrim Ds

62
Q

What is Ascaris lumbricoides (aka Ascaris or ascariasis)

A

hookworm/whipworm (aka soil-transmitted helminths)
fecal-oral

ingest eggs from soil

can grow long –> bowel obstruction

63
Q

Where can you find Diphyllobothrium latum

what are sxs?

A

=fish tapeworm (raw/undercooked)

can grow long (30 feet)

abd symptoms

abs vit B12 –> B12 def –> pernicious anemia and neurological symptoms

64
Q

Where do you find Schistosoma mansoni (schistosomiasis; trematodes)

what are sxs & Tx

A

Worldwide prob, uncommon USA; Africa -2nd MCC of esophageal varices (1st = Alc)

contaminated freshwater snails –> skin contact w/ contaminated water –> bloody stools, bladder CA, liver cysts

MCC of small portal vein branch obstruction

Tx: Praziquantel

65
Q

Differentiate Taenia solium & Taenia saginata

A

Taenia solium- pork tape worm (hooks); undercooked pork;

mostly asymp; rare serious cases= Cysticercosis (seizures) and muscle or eye disease

Taenia saginata- beef tape worm (suckers); undercooked beef; mostly asymp

66
Q

Where do you find Echinococcs granulosis

how does it present

A

=tapeworm

unsanitary livestock (sheep); dogs= main carriers–> pet infected

fecal-oral

poor sanitation- ingest soil, water &/or veggies contaminated w/ infected dog feces

Form cysts in liver or lungs –> free-flowing: “hydatid sand” on CT

67
Q

What are sxs, dx and tx of Enterobius vermicularis (pinworm)

A

=fecal-oral

Sxs: severe perianal itching

Dx: “scotch” tape test

Tx: medenazole

68
Q

What is the general protocol for Tx of acute infxous diarrhea

A

Hydration (po/iv)

maintain electrolyte balance

Anti-motility agent if no fever & NON-bloody stool; not for C. diff or EHEC

Probiotic maybe helpful

ABx- usually not required

69
Q

What are dietary recommendations for acute infxous diarrhea

A

BRAT diet- banana, rice, applesauce, toast

easily digestable - boiled potatoes, crackers, yogurt, soup

rice water

avoid lactose, high fiber foods, fats, caffeine, alc

70
Q

What are prophylaxis/prevention methods of acute infxous diarrhea

A

wash hands w/ soap & water

(sanitizer ineffective against norovirus & C. diff)

travelers: eat hot foods, bismuth - darken tongue/stool; ABx prophylaxis in certain pts (not usually recommended)

71
Q

What acute infxous agents have a vaccine

A

rotavirus

s. typhi
v. cholera

hep A

72
Q

what infxous agents may lead to reactive arthritis

A

salmonella

campylobacter

shigella

yersinia

(=conjunctivits, urethritis, arthritis; cant see, cant pee, cant climb a tree)

73
Q

What can Yersiniosis lead to

A

reactive arthritis

autoimmune-type thyroidistis

pericarditis

glomerulonephritis

74
Q

Pathogens that affect small bowel, will present with which symptoms

A

large vol, watery stools, abd cramp, wt. loss, dehydration/malabs

=Salmonella, V. cholerae, ETEC, EPEC, Yersinia, Rotavirus, Norovirus, CMV, Adenovirus, Giardia, Cryptosporidium, Cyclospora, Clostridium perfringens, Staph aureus, Bacillis cereus

75
Q

Pathogens that affect large bowel, will present w/ which sxs?

A

freq, small volume stools

fevers, blood/wbc in stool, fecal leukocytes (+)

=Campylobacter, Salmonella, Shigella, Yersinia, EIEC, EHEC, C. diff, Vibrio parahaemolyticus, E. histolytica, CMV, Adenovirus, Herpes simplex

76
Q

What pathogens are common in AIDs (< 200 CD4)

A

Opp infxns: Mycobacterium species

Certain viruses: CMV, adenovirus, and herpes simplex

Protozoa: Cryptosporidium, Cystoisospora belli, Microsporida, and Blastocystis hominis)

Agents transmitted venereally per rectum – >(e.g., Neisseria gonorrhea, Treponema pallidum, Chlamydia) ==> proctocoltis

GI/GU II Exam 1 (16 decks)

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