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AII 4 > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

Viral GI- Eti

A

Rotovirus- young children- vaccine available, fecal- oral route w/in 72 hrs of exposure
Norovirus- adults, w/in 48 hrs- resistant to chlorination
Astrovirus- kids in developing
Enteric Adenovirus- resp infection followed by diarrhea

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2
Q

Viral GI- Sx

A

Roto- Damage to sm. bowel epithelium, damage brush border-.prolong sx
Noro- acute explosive vomiting and diarrhea- small bowel- fever, HA & malaise
Astro- N/v less common
Enteric Adeno- Resp sx proceed GI

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3
Q

Viral GI- Dx

A

PCR if needed, self-limiting

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4
Q

Viral GI- Tx

A

Self limiting- rehydration & oral nutrition

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5
Q

Typhoid fever- Eti

A

Salmonella Typhi & parathyphi. Small intestine. colonizes epi cells-> tissue damage-> inflame. diarrhea. Person to person only! 1-2 wk incubation

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6
Q

Typhoid fever- Sx

A

Pea soup diarrhea, rose spots, fever- rises in stepladder, bradycardia, HSM, LAD, delirium, HA

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7
Q

Typhoid fever- Dx

A

Blood culture- stool unreliable. Presence of rose spots

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8
Q

Typhoid fever- Tx

A

Quinalones or 3rd g cephalosporins
Corticosteroids
Cholecystectomy if not cleared

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9
Q

Cholera- Eti

A

Vibrio cholerae. Coastal salt water and estuaries- Asia, Africa & Gulf coast. Contaminated seafood, fecal/oral and travel to endemic areas. 70% mortality if untreated.

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10
Q

Cholera- Sx

A

Rice water stools, profuse, watery diarrhea-> vomiting-> rapid dehydration and hypovolemic shock + death. Sm bowel.

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11
Q

Cholera- Dx

A

Dark field microscopy on wet mount

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12
Q

Cholera- Tx

A

Oral rehydration salts- Na, K, Cl, Citrate, Glucose. Tetracycline

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13
Q

Giardia- Eti

A

Most common parasite in US. Fecal-oral- camping, well water. Cysts & trophozoites. Sm bowel-> trophozoites attach to duodenum and jejunum.

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14
Q

Giardia- Sx

A

Foul, fatty diarrhea, bloating, flatus. Upper GI sx- fever uncommon, sulfurous belching

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15
Q

Giardia- Dx

A

cysts or trophozoites in stool

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16
Q

Giardia- Tx

A

Metronidazole, avoid lactose, treating carriers can prevent outbreaks

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17
Q

Giardia- Prevention

A

Boil water, iodine based tx effective

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18
Q

Shigella- Eti

A

S. Sonni (common) S. dysenteria (shiva toxin- severe & rare) Food, water, person transmission. Resistant to stomach acid.

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19
Q

Shigella- Sx

A

Fever, malaise, abd pain, watery stool, respiratory symptoms, seizures. May turn bloody, mucus/ pus

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20
Q

Shigella- Complications

A

Toxic megacolon- toxic paralysis of colon, trapping flatus. Hemolytic-uremic syndrome, Reactive arthritis. Most common in <5.

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21
Q

Shigella- Tx

A

Self limiting- hydration & avoid anti motility agents. Cipro if needed.

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22
Q

Shigella- Dx

A

Fecal leukocytosis, culture

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23
Q

Salmonella- Eti

A

Highest food borne pathogen in US. Raw poultry, petting zoos, reptiles, produce treated with feces. Small intestine

24
Q

Salmonella- Sx

A

N/V-> D/cramps. May be bloody. Fever, RLQ tenderness, self limiting

25
Q

Salmonella- complications

A

bacteremia-> meningitis, pulmonary infections, osteomyelitis or reactive arthritis

26
Q

Salmonella- Dx

A

Stool culture

27
Q

Salmonella- Tx

A

Hydration- avoid anti motility agents. Quinolones recommended if severe

28
Q

Amebiasis- Eti

A

Intestinal protozoa- ingestion of cysts through fecal oral route. Human only. Encystation in sm bowel causing tissue distruction -> bloody diarrhea.

29
Q

Amebiasis- Sx

A

90% asymptomatic. Subacute onset- diarrhea, abd pain, fever, tenesmus- stool has little fecal matter- mostly blood/ mucus. Flask shaped amebic ulcers. Liver abscesses.

30
Q

Amebiasis- Dx

A

ID org. in stool or antigen assay

31
Q

Amebiasis- Tx

A

Metronidazole, dont drain abscess, Diloxanide for cysts

32
Q

Clostridium difficile- Eti

A

Abx associated colitis via fecal oral route. Exotoxins lead to inflammation and bacteria.
1) Alteration in gut flora
2) Acqusition and germination of spores
3) C. diff overgrowth
4) toxin production.
Toxin A- damage mucosa
Toxin B- hemorrhage, inflammation & cellular necrosis.

33
Q

C. diff Sx

A

Watery to mucoid diarrhea, abd. pain, low grade fever, sm. amounts of blood, toxic megacolon & perforation.

34
Q

C. diff- Dx

A

Enzyme immunoassay with PCR. Caused by fluoroquinolones and many other abx.

35
Q

C. diff Tx

A

Metronidazole for mild, vanco for severe

36
Q

Campylobacter- Eti

A

Contaminated poultry- common in kids & teens. 2nd most prevalent food bourne disease.

37
Q

Campylobacter- Sx

A

Fever, myalgia, malaise, abd pain, HA followed by profuse watery to bloody diarrhea.

38
Q

Campylobacter- Dx

A

Blood or stool culture

39
Q

Campylobacter- Complications

A

Hemolytic uremic syndrome, reactive arthritis, Gullian-Barre syndrome

40
Q

Campylobacter-Tx

A

Erythromycin- wihtin 3 days. Qunialones later in illness.

Only if >1 wk, pregnant, immunocompromised, dysentery, fever

41
Q

Hemolytic Uremic Syndrome

A

Simultaneous occurrence of hemolytic anemia, thrombocytopenia & acute kidney injury caused by abx

42
Q

Reactive arthritis

A

arthritis, urethritis & conjunctivitis

43
Q

Guillain Barre Syndrome

A

Inflammatory auto immune condition- causes body not to recognize self

44
Q

E. coli EHEC- Eti

A

Produces shiga toxin- adhering to small and large bowel. Reservoir of ruminant animals- undercooked near, milk, petting zoos. Low innoculum.

45
Q

EHEC- Sx

A

3-5 day incubation. Colonizes colon-> colitis. Grossly bloody diarrhea >90% cases, abd pain, myalgia, NO fever

46
Q

EHEC- Complications

A

Hemolytic uremic syndrome- young & elderly. 2-8% of cases

47
Q

EHEC- Dx

A

Not part of routine culture screening- specify with lab

48
Q

EHEC- Tx

A

No abx! Self limiting. Avoid narcotics, anti-motility agents. Replace h20 and lytes

49
Q

Enteroinvasive E.coli- EIEC- Sx

A

identical to shigellosis- profuse diarrhea, vomiting, malaise, abd cramsp, high fever & chills, within 12-72 hrs of ingestion

50
Q

Enterotoxigenic Ecoli- ETEC

A

Common cause of travelers diarrhea. Watery diarrhea, bloating, fatigue, cramps- 3-5 days. Bloody & fever uncommon.

51
Q

ETEC- Tx

A

Only immunocomp- cipro and bismuth. Others bismuth, rehydration, no antidiarrheals

52
Q

B. Cereus- Epi

A

Abundant in marine environs, soil dwelling- food contaminant- heat resistant spores

53
Q

B. Cereus- sx

A

Food poisoning- 8-16 hrs following ingestion- copious diarrhea

54
Q

B. Cereus- Dx

A

Stool culture

55
Q

B. Cereus- Tx

A

Hydration therapy

AII 4 (10 decks)

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