Gastroenteritis Flashcards
Q: What defines acute gastroenteritis?
A: A clinical syndrome with increased stool frequency and loose consistency, with or without vomiting, fever, or abdominal pain.
Q: What are the characteristics of diarrhea?
A: More than 3 loose stools in 24 hours or bowel movements that exceed the child’s usual number by two or more.
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Q: What is dysentery?
A: Frequent small bowel movements associated with tenesmus, pain on defecation, and visible blood or mucus in stools.
How is acute diarrhea classified by duration?
A: Less than 2 weeks is acute, 7-13 days is prolonged, and more than 14 days is persistent.
What is the most common cause of diarrhea-related deaths worldwide?
A: Rotavirus.
What are the risk factors for acute gastroenteritis?
A: Poverty, poor hygiene, young age, malnutrition, immunodeficiency, and contaminated water/food.
What is osmotic diarrhea?
A:
Diarrhea caused by ingestion of unabsorbable solutes or enzyme deficiencies, stopping with fasting.
What is secretory diarrhea?
A:
Diarrhea caused by stimulation of chloride secretion into the gut by bacterial toxins (e.g., cholera, E. coli).
What is exudative diarrhea?
A: Diarrhea caused by inflammation, often seen in bacterial infections like Shigella and parasitic infections like Amebic dysentery.
How is rotavirus diagnosed and treated?
A:
Diagnosis: Stool immunoassay or PCR (though not typically used). Treatment: Supportive care.
What is the leading cause of gastroenteritis in the USA?
A: Norovirus.
How is Campylobacter jejuni transmitted?
A: Feco-oral route or direct contact with infected animals or their products.
What is a major complication of Campylobacter jejuni infection?
A: Guillain-Barre Syndrome (GBS).
What is the typical presentation of Salmonella enterica?
A:
Self-limited watery or bloody diarrhea.
Q: When should antibiotics be used in non-typhoidal Salmonella?
A: In cases of age <3 months, immunodeficiency, ill appearance, or sickle cell anemia.
What is the treatment for Shigella infections?
A: Antibiotics like ceftriaxone, ampicillin, or TMP-SMX.
What are complications of Shigella infection?
A: Seizures, hemolytic uremic syndrome (HUS), rectal prolapse, and sepsis.
How is EHEC (enterohemorrhagic E. coli) treated?
A: Supportive care only, no antibiotics due to the risk of hemolytic uremic syndrome (HUS).
What are the symptoms of Vibrio cholerae infection?
A: “Rice water” stools, watery diarrhea, abdominal cramps, and fever.
How is Staphylococcus aureus gastroenteritis typically acquired?
A: Ingesting contaminated food, with a rapid onset of severe nausea and vomiting.
What is the treatment for severe Listeria infection?
A: Ampicillin.
How is Yersinia enterocolitica typically acquired?
A: Insufficiently cooked pork or contaminated water, meat, or milk.
What is Entamoeba histolytica’s incubation period?
A: 2-4 weeks.
What is the treatment for Entamoeba histolytica infection?
A: Metronidazole and a luminal agent like iodoquinol or paromomycin.
What is a complication of Entamoeba histolytica?
A: Liver and lung abscesses.
What are the symptoms of Cryptosporidium infection?
A: Watery diarrhea, severe in immunocompromised patients.
Q: What history questions are important in gastroenteritis?
A: Diarrhea duration, frequency, vomiting, abdominal pain, fever, urination, antibiotic use, and contact/travel history.
Q: What history questions are important in gastroenteritis?
A: Diarrhea duration, frequency, vomiting, abdominal pain, fever, urination, antibiotic use, and contact/travel history.
What are signs of dehydration?
A: Sunken fontanelles, dry mucus membranes, thirst, low urine output, hypotension, and prolonged capillary refill.
Q: What is the first-line treatment for mild-to-moderate dehydration in children?
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A: Oral rehydration solution (ORS
What are the indications for hospital admission in gastroenteritis?
A: Severe dehydration, intractable vomiting, decreased oral intake, young age (<6 months), and electrolyte disturbances.
What is a routine stool exam looking for?
A: Blood, mucus, fecal leukocytes, and cysts or trophozoites of parasites.
What stool tests are used to diagnose rotavirus and adenovirus?
A:
Stool immunoassay.
What lab tests are indicated in moderate to severe dehydration?
A: Electrolytes, glucose, KFT, ABG, CBC, and urine analysis.
What are contraindications for ORS?
A: Shock, ileus, intussusception, carbohydrate intolerance, severe emesis, and high stool output.
What types of fluids should not be used for rehydration?
A: Soda, fruit juices, and tea due to their inappropriate osmolality and sodium content.
What are the risks of using antidiarrheal medications like loperamide?
A: Severe abdominal distention and death.
What are probiotics used for in gastroenteritis?
A: To promote intestinal flora balance and decrease the duration of diarrhea.
When are zinc supplements recommended in gastroenteritis?
A: In cases of known zinc deficiency or areas with prevalent malnutrition.
Which antibiotics are indicated for gastroenteritis caused by Shigella and E. histolytica?
A: Metronidazole for E. histolytica, ceftriaxone or TMP-SMX for Shigella.
What is the role of ondansetron in gastroenteritis?
A: It reduces vomiting and the need for IV rehydration.
What are contraindications for the rotavirus vaccine?
A: Severe combined immunodeficiency, intussusception history, or age beyond the vaccine window.
How many doses are required for the Rotarix and RotaTeq vaccines?
A: Rotarix requires 2 doses, RotaTeq requires 3 doses.
What is the leading cause of diarrhea-related deaths in children under 5 years?
A: Rotavirus.
What diagnostic test is recommended for Cryptosporidium in severe cases?
A: Stool microscopy and possibly paromomycin treatment.
What is the management of severe dehydration in gastroenteritis?
A: Immediate IV fluids (20 mL/kg bolus of normal saline) followed by ORS as needed.
