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Infectious Disease > EXAM #1: DIAGNOSING GI INFECTIONS > Flashcards

EXAM #1: DIAGNOSING GI INFECTIONS Flashcards

1
Q

What is a the major host defense against esophagitis?

A

Motility

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2
Q

What are the typical pathogens that cause esophagitis?

A

1) Candida
2) HSV
3) CMV

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3
Q

What is the major host defense against gastritis?

A

Acidity

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4
Q

What is the typical pathogen that causes gastritis?

A

H. pylori

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5
Q

What are the typical pathogens that causes infectious diarrhea?

A

1) C. diff
2) E. coli
3) Salmonella
4) Shigella

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6
Q

What are the sx. of esophagitis?

A

1) Dysphagia
2) Retrosternal pain
3) Fever

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7
Q

Why is it important to determine if a patient has Candida cruzi?

A

This is resistant to the normal first line therapy (fluconazole)

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8
Q

What causes ulcerative esophagtitis?

A

1) HSV

2) CMV

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9
Q

You suspect a patient has infectious esophagitis; however, diagnostic work-up is negative. What should be next on your differential diagnosis?

A

GERD

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10
Q

What inclusion is associated with HSV?

A

asdf

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11
Q

How is candida esophagitis treated?

A

1) Oral fluconazole
2) IV echinocandin

or

Amphoterocin B

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12
Q

How is HSV esophagitis treated?

A

Acyclovir

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13
Q

How is CMV treated?

A

Valganciclovir or Ganciclovir

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14
Q

How is H. pylori non-invasively diagnosed?

A

1) Urea breath test*

2) Stool antigen test

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15
Q

If you have to do an endoscopy for H. pylori infection, what is the first choice test?

A

Biopsy urease test

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16
Q

How is H. pylori treated?

A

1) PPI + amoxicillin, then

2) PPI + clarithromycin + tinidazole

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17
Q

For patients that are allergic to clarithromycin, what should you do for H. pylori?

A

Quad therapy:

1) Bismuth subsalicylate
2) TCN
3) Metronidazole
4) Omeprazole

18
Q

How long to you have to wait to re-test urea breath test and stool antigen s/p H. pylori treatment?

A

6-8 weeks

19
Q

In taking a patient history, what is the most important feature to ask about when a patient has diarrhea?

A

Duration

  • Less than 2 weeks= infectious
  • More than 4 weeks= non-infectious
20
Q

What is unique about the morphologic appearance of v. cholerae?

A

Curved* gram negative rod

21
Q

What is C. perfringens highly associated with?

A

Home canned foods

22
Q

What is Bacillus cereus highly associated with?

A

Rice

23
Q

What is enterotoxigenic E. coli highly assocaited with?

A

Traveling to foreign countries

24
Q

What is Salmonella highly associated with?

A

Caesar salad

25
Q

What are the epidemiological clues that differentiate between Rotavirus and Norovirus?

A 
Rotavirus= daycare 
Norovirus= nursing home/ cruise ship
26
Q

What is Hepatitis A highly associated with?

A

Overcrowding

27
Q

What organism is highly associated with swimming pools?

A

Cryptosporidium

28
Q

How long does it take to get ill from a preformed toxin?

A

6-8 hours

29
Q

How long does it take to get ill from an enterotoxin toxin?

A

8-72 hours

30
Q

How long does it take to get ill from a cytotoxin?

A

Days

31
Q

List the non-inflammatory diarrheas.

A
  • V. cholerae

- Enterotoxigenic E. coli

32
Q

List the inflammatory diarrheas.

A
  • Shigella
  • Salmonella
  • Campylobacter jejuni
33
Q

What is the difference between inflammatory and non-inflammatory diarrhea?

A

Non-inflammatory= watery (voluminous)

Inflammatory=

  • Bloody/mucus
  • Fever
  • Positive fecal leukocytes
34
Q

What is unique about E. coli O157:H7

A
  • Inflammatory diarrhea (bloody) but no fever

- NO abx, may give patient HUS

35
Q

Is it recommended to test stools of an asymptomatic patient for C. diff? What about for cure s/p treatment?

A

No- neither

36
Q

What is emerging as the diagnostic of choice for C. diff?

A

PCR Toxin Gene Detection

37
Q

If a patient has a positive endoscopy for PMC, do you need to do further testing?

A

No

38
Q

How is C.diff treated?

A

1) Metronidazole

2) Vancomycin (more severe)

39
Q

What route does Vancoymin need to be given for C. diff?

A

Oral, NOT IV

*Can be given as an enema if ileus with PMC

40
Q

If a patient has chronic c. diff, what should you do?

A
  • Normal regimen for first recurrence
  • AFTER FIRST RECURRENCE, NO METRONIDAZOLE
  • Vancomycin with second or later recurrence
41
Q

Should probiotics be given to patients with recurrent C. diff?

A

No

42
Q

When should you AVOID antiperistaltic agents in lower GI infections?

A

1) Fever

2) Bloody stool

Infectious Disease (21 decks)

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