Gastroenteritis Flashcards
What is the best test to confirm a Dx of Giardiasis?
stool Ag
Wat is the best Tx for Giardia?
metronidazole
What is the Tx for Cryptosporidium?
paromomycin
What is the Tx for Isospora?
TMP-SMX
What is the Tx for B.cereus or staphylococcal gastroeneteritis? Why?
no Tx; mediated by toxins and resolve spontaneously
Which organisms cause gastroenteritis w/ RBCs and WBCs in the stool?
Salm, Shig, Campylobacter, Yersinia, E. coli, Vibrio parahemolyticus
What is the Tx for mild gastroenteritis caused by Salmonella, Shigella, Campylobacter, E. coli, Vibrio parahemolyticus, or Yersinia?
nothing!
What is the Tx for gastroenteritis caused by salm, Shig, Yersinia, Campylobacter, E. coli, or Vibrio parahemolytica that is severe (accompanied by pain, fever, blood, abd. tenderness)?
ciprofloxacin
What don’t you give in the case of HUS?
Don’t give Abx and plts!!
Why don’t you give Abx in HUS?
cell lysis –> release of Shiga-like toxin
Why don’t you give plts in HUS?
worsens clotting
Which people are more prone to infection w/ Vibrio vulnificus?
w/ liver disease
What can be seen on PE in liver disease pts w/ V. vulnificus infection?
bullous skin lesions
What are the most likely causes (3) for bloody diarrhea and a fever 1 hour after eating contaminated food?
Salm, Shig, Camp
What are 3 ways in which IBS differs from other forms of chronic diarrhea?
- alternates w/ constipation
- predominantly PAIN
- no Sx @ night
What drug is used to treat Diarrhea-predominant IBS?
Alosetron
What is the mech of alosetron?
5-HT (serotoin) antagonist
What drug is used to treat constipatrion predominant IBS?
Tegaserod
What is the mech of action of Tegaserod?
5-HT agonist
What should be used to treat all IBS pts?
fiber and bulking agents
What kind of drugs are hyosayamine and dicyclomine, also used to tx IBS?
anti-spasmodics
What kind of anti-depressants are used to tx IBS?
TCAs
Intermittent diarrhea, flushing, wheezing, and/or cardiac problems (tricuspid insufficiency, pulmonic stenosis).
Carcinoid
What do the neurotransmitters do to the right heart that causes tricuspid regurg and pulm stenosis?
fibrosis
What is the test for carcinoid syndrome?
5-HIAA level in urine
What is the Tx for carcinoid syndrome?
octreotide