Gastrointestinal Infections & Diarrhea

Question 1

Define diarrhea

Answer 1

3 or more loose or watery stools within 24 hours

Question 2

Define the 4 different types of diarrhea

Answer 2

Question 3

Define gastroenteritis

Answer 3

infection related to the stomach and small intestine

Question 4

Define infectious colitis

Answer 4

infection located in the colon

Question 5

Describe the etiology of infectious diarrhea

Answer 5

Question 6

Describe the presentation of small bowel infectious diarrhea

Answer 6

Question 7

Describe the presentation of large bowel infectious diarrhea

Answer 7

Question 8

Describe the diagnosis of acute infectious diarrhea

Answer 8

Question 9

Which organisms are difficult to grow on culture for stool samples/diarrhea testing

Answer 9

Vibrio & listeria - do GI panel instead

Question 10

Describe the etiology & presentation of norovirus diarrhea

Answer 10

Question 11

Describe the etiology & presentation of clostridium perfringens diarrhea

Answer 11

Question 12

Describe the etiology & presentation of enterotoxigenic coli (E. Coli) diarrhea

Answer 12

Question 13

Describe the etiology & presentation of vibrio cholerae diarrhea

Answer 13

Question 14

Describe the etiology & presentation of listeria monocytogenes

Answer 14

Question 15

Describe the etiology & presentation of aeromonas & plesiomonas diarhea

Answer 15

Question 16

Describe the etiology & presentation of staph aureus diarrhea

Answer 16

Question 17

Describe the etiology & presentation of salmonella diarrhea

Answer 17

Question 18

Describe the etiology & presentation of campylobacter diarrhea

Answer 18

Question 19

Describe the etiology & presentation of shigella

Answer 19

Question 20

Describe the etiology & presentation of enterohemmorrhagic E coli

Answer 20

Question 21

Describe the etiology & presentation of yersinia enterocolitica

Answer 21

Question 22

Describe the etiology & presentation of c. diff

Answer 22

Question 23

Describe the etiology & presentation of CMV/HSV diarrhea

Answer 23

Question 24

Describe the etiology & presentation of botulism

Answer 24

Question 25

Describe the etiology & presentation of ciguatera fish poisoning

Answer 25

Question 26

Describe the etiology & presentation of scombroid

Answer 26

Question 27

Describe the etiology & presentation of typhoid

Answer 27

Question 28

Describe the etiology of intestinal parasites

Answer 28

Question 29

Describe the etiology & presentation of brucella

Answer 29

Question 30

Describe the etiology & presentation of ascaris

Answer 30

Question 31

Describe the etiology & presentation of whipworm

Answer 31

Question 32

Describe the etiology & presentation of pinworm

Answer 32

Question 33

Describe the etiology & presentation of schistosomiasis

Answer 33

Question 34

Describe the etiology & presentation of strongyloides

Answer 34

Question 35

Describe the etiology & presentation of entamoeba histolytica

Answer 35

Question 36

Describe the etiology & presentation of giardia

Answer 36

Question 37

Describe the etiology & presentation of cryptosporidium

Answer 37

Question 38

Describe the etiology of Rotavirus

Answer 38

Question 39

Describe the presentation of rotavirus

Answer 39

Question 40

Describe the treatment for rotavirus

Answer 40

Question 41

What abx are implicated with C. diff

Answer 41

Question 42

Describe the etiology of acute diarrhea

Answer 42

- <14 days - mostly caused by infectious bug - fever, vomiting, abd pain

Question 43

Describe the etiology of chronic diarrhea

Answer 43

- >30 days - usually non-infectious - warrants further eval to exclude malabsorptive disease

Question 44

Describe the characteristics of small bowel diarrhea

Answer 44

- watery - large volume - associated with abd craming, bloating, gas, weight loss - fever not likely - occult blood not likely - less inflammatory cells - enteric viruses MC

Question 45

Describe the characteristics of large bowel diarrhea

Answer 45

- inflammatory - frequent, regular, small volume, often painful - fever - bloody/mucoid - inflammatory cells present - bacterial pathogens MC

Question 46

What are the most common viral pathogens causing acute diarrhea

Answer 46

Norovirus, rotavirus, adenovirus, astrovirus, etc.

Question 47

What bacteria commonly cause acute diarrhea

Answer 47

salmonella, campylobacter, shigella, enterotoxigenic E coli, C diff, etc.

Question 48

What protozoa commonly cause acute diarrhea

Answer 48

cryptosporidium, giardia, cyclospora, entamoeba, etc.

Question 49

Describe food poisoning

Answer 49

Diarrhea within 6hrs of eating - generally staph aureus or bacillus cereus - vomiting is a major symptom Within 8-16 hrs = clostridium perfringens Greater than 16 hrs = viral or other bacterial etiologies that require time for toxin to develop (ETAC)

Question 50

When to do stool testing

Answer 50

- severe illness: hosp, hypovolemic, 6+ days of severe symptoms - concern for inflammatory diarrhea: bloody, fever - high risk host features: 70+ years old, immunocompromised, IBD, pregnant - public health concern: food worker, healthcare worker, day care - symptoms +1 week

Question 51

Describe fecal leuk testing

Answer 51

- looking for WBC in stool - WBC not normally there - indicate infection with microorganisms that invade tissue or produce toxins that damage tissue - can also be seen in IBD - not accurate for inflammatory diarrhea

Question 52

What is the danger zone for bacterial multiplication in food

Answer 52

40 degrees to 140 degrees F

Question 53

List some infection control & prevention measures relevant to diarrhea

Answer 53

- avoid daycares, schools, water activities until no symptoms for at least 48 hrs - avoid anal receptive and oral-anal sex until no symptoms for at least 48 hrs - hand hygiene - water purification tools

Question 54

What diarrheal illness commonly causes guillain-barre syndrome

Answer 54

campylobacter (30-40% of GBS cases attributed)

Question 55

90% of hemolytic uremic syndrome in kids is caused by which two diarrheal illnesses

Answer 55

E coli most common, then shigella