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GI Final > DSA slides from McGowan > Flashcards

DSA slides from McGowan Flashcards

1
Q

bacteria from chicken

A

salmonella
campylobacter
shifella

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2
Q

Undercooked hamburger

A

EHEC (O157:H7 E coli)

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3
Q

Fried rice

A

Bacillus Cereus

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4
Q

Potato salad, mayo, or cream pastries

A

Staph Aureus

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5
Q

Eggs

A

Salmonella

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6
Q

Lunch meat and soft cheeses

A

Listeria

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7
Q

Raw seafood

A

Vibrio!

-or norwalk, campylobacter

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8
Q

Staph aureus

A

water diarrhea

  • rapid onset
  • preformed enterotoxins
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9
Q

Bacillus Cereus

A
  • preformed enterotoxins
  • comiting
  • rapid onset
  • rapid resolution
  • fried rice
  • watery diarrhea
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10
Q

Clostridium perfringens

A
  • preformed enterotoxins
  • watery diarrhea
  • crampy abd pain
  • rapid onset
  • rapid res
  • beef, ham, poultry, legumes, gravy: heat resistant spores inadequately cooked
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11
Q

Shigella

A
  • shiga toxin
  • usually children (daycare)
  • BLOODY diarrhea
  • Fecal leukocytes
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12
Q

Tx Shigella

A

BIsmuth, ampicillin, fluoroquinolone, or trimethoprim/sulfamethoxazole

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13
Q

Complications of Shigella

A
  • respiratory compliants and seizures (children)

- post infectious complications: REACTIVE ARTHRITIS AND HUS

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14
Q

Which Shigella is the most common species in the united states?

A

Shigella sonnei

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15
Q

Salmonella Typhimurium

A
  • fram negative, non-lactose fermenting, motile, rod-shaped, bacteria
  • Watery->bloody diarrhea
  • fever
  • Ingests contaminated food (eggs, poultry)
  • animal exposure: reptiles
  • Increased risk with sickle cell pts
  • Stool culture is lactose (-) motile
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16
Q

Are Abx indicated for Salmonella Typhimurium?

A

no!

-course of illness may be prolonged by it

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17
Q

What are complications of Salmonella typhimurium?

A

reactive arthritis, endocarditis, septic arthritis, osteomyelitis

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18
Q

Salmonella Typhi

A
  • travel
  • lives only in humans
  • Typhoid fever: 103-104
  • *rose spots rash
  • Dx: samples of stool or blood
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19
Q

Tx of salmonella typhi

A

Fluoroquinolones (becoming resistant), ceftriaxone, and azithromycin

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20
Q

Campylobacter Jejuni

A
  • Bloody diarrhea
  • Guillian Barre syndrome
  • Gram negative curved rod
  • Spiral shaped, oxidase +, motile with flagellum
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21
Q

Tx of campylobacter

A

supportive

-NO ABX NEEDED

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22
Q

Vibrio cholerae

A
  • O1 and O139 variants
  • Toxin production
  • watery rice water diarrhea (profuse)
  • Curved/comma shaped, anaerobic gram- bacilli with flagellum
  • waterborne illness (saltwater)
  • Raw oysters (seafood)
  • underdeveloped nations
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23
Q

Tx of vibrio cholerae?

A
  • rehydration/electrolyte replacement

- in africa and India

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24
Q

Vibrio Parahemolyticus

A

Cytotoxin production

  • Non-O1 and non O139 variants
  • cause seafood associated diarrhea
  • bloody diarrhea*
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25
Q

Vibrio Vulnificus

A

Gram negative bacillus

  • warm shallow, coastal salt water*
  • seafood
  • open wound in water
  • Bullous skin lesions
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26
Q

What kinds of patients are really in trouble if they have Vibrio Vulnificus?

A

Immunocompromised patients and

-especially cirrhosis patients

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27
Q

Aeromonas Hydrophila

A
  • Gram (-), non- spore forming rod, facultative anaerobic bacteria, motile with flagellum
  • FRESHWATER environments or bracksih water
  • Eating fish or shellfish
  • necrotizing fasciitis
  • 2 types: Cholera like (non bloody), and Bloody mucoid stools
  • scuba divers that swallow small amounts of fresh water and then have gastroenteritis
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28
Q

Tx of Aeromona Hydrophila

A

Ampicillin

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29
Q

Most common cause of Travelers diarrhea

A

ETEC

-affects small intestine

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30
Q

Ppl who go to russia and people who go camping a lot will get….

A

Giardia-associated diarrhea

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31
Q

Where is cyclospora found?

A

visitors to Nepal

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32
Q

What patients will have travelers diarrhea due to a Norwalk virus?

A

ppl who just went on a cruise ship

33
Q

What kind of Diarrhea does ETEC give you?

A

the watery kind

34
Q

What complication is much more likely to happen in EHEC than in shigella?

A

HUS

-tx with abx

35
Q

Yersinia Enterocolitica

A
  • Higher risk in Iron-overload syndromes*, diabetes, and preexisting GI disorders
  • bloody diarrhea
  • Clinically indistinguishable form salmonella or shigella
  • can mimic appendicitis*
36
Q

Complications of Y. enterocolitica?

A

rash, reactive arthritis, and hemochromatosis*

37
Q

Tx of yersinia

A

supportive

38
Q

Listeria Monocytogenes

A
  • preggos
  • non-bloody diarrhea
  • confirm Dx by blood culture
  • deli meaths
  • can multiply at refrigerator temps
  • meningoencephalitis
39
Q

Clostridium dicifile

A
  • Anaerobic, gram +, spore forming bacillus
  • cytotoxin production
  • watery diarrhea
  • Pseudomembranes on colonic mucosa
  • PCR for toxin (A and B)
  • wash hands with soap and water**
40
Q

Tx of Clostridium dificile?

A

PO/IV metronidazole, ORAL vancomycin

41
Q

Main complication with C. diff

A

Toxic Megacolon

-treat aggressively and surgery consult for colectomy

42
Q

What is the most common cause of acute diarrhea in children <2 yo?

A

rotavirus

43
Q

Rotavirus

A
  • children <2yo
  • watery diarrhea
  • wagon-wheel appearance on electron microscopy
  • Death can occur from dehydration
44
Q

Tx rotavirus

A

supportive care

-vaccine available

45
Q

Norwalk virus

A
  • older children and young adults
  • Watery diarrhea
  • symptoms within 24-48 hours
  • cruise ships*
46
Q

Tx of rotavirus

A

supportive care

47
Q

Adenovirus (40 and 41)

A
  • children (2nd to rotavirus as most common)
  • Fever
  • Watery diarrhea and vomiting
  • conjunctivitis
  • Pharyngitis
  • lasts about 10 days
  • Virus can shed for months after symptom resolution
48
Q

Tx of Adenovirus

A

Supportive care

49
Q

Cytomegalovirus (CMV)

A
  • rare cause
  • immunosuppressed patients
  • reactivation of previous infection
  • fever, abdominal pain, bloody diarrhea
  • dx by doing endoscopy with bx of ulcerated lesions using CMV specific stains
50
Q

Entamoeba histolytica

A

-Most common cause of dysentery in the world***
-Flask shaped ulcer
-Can penetrate bowel and into portal circulation….. LIVER ABSCESSES
-Toxic megacolon or pneumatosis coli
-needs treatment even if asymptomatic
(most are asymptomatic carriers)
-Stool antigen (PCR for DNA)
-crowded living conditions

51
Q

Tx of Entamoeba histolytica

A

metronidazole and paromomycin

52
Q

Giardia Lamblia

A
  • pear shaped, 4 flagella, 2 nuclei protozoan
  • Fecal-oral
  • Watery (malodorous) diarrhea
  • Stool antigen detection
  • get it from water or daycare or Russia
53
Q

Tx of Giardia Lamblia

A

Metronidazole

54
Q

Which one was associated with and overcrowded swimming pool?

A

Cryptosporidium

  • you’re fine as long as you’re not immunocompromised
  • resistant to chlorine treatment
  • watery diarrhea (large volume >20L a day)
55
Q

Strongyloides Stercoralis

A

nematode: roundworm
- bare feet on contaminated soil
- enters body through exposed skin
- Rhabditiform larvae in stool, eosinophils in stool

56
Q

Tx of Strongyloides Stercoralis

A

Ivermectin

57
Q

Cyclospora cayetanensis

A
  • Produce (like veggies) from endemic areas
  • Travel to endemic areas (tropics)
  • Watery diarrhea
  • oocysts are hard to kill
  • detect oocysts in stool sample
58
Q

Tx of cyclospora cayetanensis

A

Trimethoprim/sulfamethoxazole (TMP/SMX)

59
Q

Cystoisospora belli (used to be Isospora belli)

A
  • watery diarrhea
  • tropics
  • repeated stool exams and concentration procedures are recommended
  • if stool examinations are negative, do an examination of duodenal specimens by bx
  • oocysts can be visualized by modified acid fast stain
60
Q

Tx of Cysoisopora belli

A

Bactrim DS (TMP/SMX)

61
Q

Ascaris Lumbricoides

A
  • hook worm

- Bowel obstruction

62
Q

Diphyllobothrium latum

A

-fish tapeworm… from fish

63
Q

Schistosoma mansoni

A
  • most common cause of esophageal varices behind alcohol in africa
  • fresh water snails
  • blood stools, bladder cancer, liver cysts
64
Q

Taenia solium

A
  • pork tape worm, mostly asymptomatic

- rare serious cases of seizures and muscle or eye disease

65
Q

Echinococcus granulosus

A
  • dog tapeworm
  • cysts in liver or lungs
  • looks like free-flowing “hydatid sand” on CT
66
Q

What does an increase in fecal lactoferrin mean?

A

there is an inflammatory process behind the diarrhea

67
Q

What are the only 2 organisms that will give us fecal leukocytes but not necessarily bloody diarrhea?

A

Listeria and clostridium

68
Q

What are the only 2 penetrating things that cause diarrhea?

A

Salmonella typhi, Y. enterocolitica

69
Q

What 2 things gave us rapid onset diarrhea?

A

Staph aureus or b. cereus

70
Q

if there is diarrhea >16 hours after eating potato or egg salad and there’s dysentery, what organism?

A

Shigella!

71
Q

What do you not use in C diff or EHEC?

A

anti motility agents

-you just need to shit them out

72
Q

What kind of sanitation does NOT work for norovirus and C. diff?

A

alcohol gels…. they are Irishmen, they can handle their alcohol

73
Q

For travelers, is prophylaxis with abx recommended?

A

no

74
Q

What are some characteristics about pathogens that typically affect the small bowel?

A

Presents with: large volume, watery, abd cramps, weight loss

  • WBC’s absent in stools
  • pain is mid abdomen or diffuse
  • Dehydration/malabsorption
75
Q

What pathogens typcally affect the small bowel?

A 
Salmonella
Vibrio cholerae
ETEC
EPEC
Yersinia
Rotavirus
Norovirus
CMV
Adenovirus
Giardia
Cryptosporidium
Cyclospora
Clostridium perfringens
Staph aureus
Bacillus Cereus
76
Q

What are some characteristics about pathogens that typically affect the large bowel?

A

Present with: frequency, small colume stools

  • May be associated with: fever, blood or WBC’s in stool (inflammatory), Fecal leukocytes common*
  • Location: lower abd or rectum (tenesmus)
77
Q

What organsims typically affeect large bowel?

A 
Campylobacter, 
salmonella
shigella 
yersinia 
EIEC 
EHEC 
C diff 
Vibrio parahaemolyticus 
E. histolytica 
CMV 
Adenovirus 
Herpes simplex
78
Q

What are people with hemochromatosis prone to?

A

invasive, even fatal enteric infection

  • Vibrio and Yersinia infection
  • should avoid raw fish
79
Q

What are some common enteric pathogens in AIDS patients?

A 
Mycobacterium
CMV
Adenovirus
HSV
Cryptosporidium
Cystoisospora belli
Microsporida
Blastocystis hominis

GI Final (13 decks)

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