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Infectious Disease > GI Diseases > Flashcards

GI Diseases Flashcards

1
Q

What is the major host defense in the esophagus? Small/large intestines?

A

Motility/acidity

Motility/normal flora

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2
Q

What are the three major pathogens that infect the esophagus?

A

Candida
HSV
CMV

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3
Q

What is the major pathogen that infects the stomach?

A

H. Pylori

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4
Q

What are the four major pathogens of the Small/large intestines?

A

C. diff
E. coli
Salmonella
Shigella

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5
Q

What are the common ssx of esophagitis?

A
  • Dysphagia wwo odynophagia
  • Retrosternal pain
  • Fever (sometimes)
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6
Q

What are the gross findings of candida infection of the esophagus?

A

White, non-ulcerative plaques

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7
Q

What are the gross findings of HSVI (II) infection of the esophagus?

A

Ulcerations

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8
Q

What is the most common viral infection of the esophagus?

A

HSV I

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9
Q

What are the gross characteristics of CMV infections of the esophagus?

A

Ulcerations

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10
Q

What species of candida is resistant to fluconazole?

A

Candida krusei

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11
Q

What are the findings of an esophagram with esophagitis?

A

Loss of the smooth appearance

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12
Q

What is the advantage of a culture over PCR?

A

PCR just tells you if it is there, not if it’s the causative agent

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13
Q

What is the treatment for candida esophagitis?

A

Oral fluconazole fro 2-3 weeks

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14
Q

What is the alternative to oral antifungals for candida esophagitis?

A

IV echinocandin or amp B

inhibit the synthesis of glucan in the cell wall, via noncompetitive inhibition of the enzyme 1,3-β glucan synthase

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15
Q

What is the treatment for herpes esophagitis? MOA?

A

Acyclovir

Converted by thymidine kinases to inhibit DNA polymerases

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16
Q

What is the treatment for CMV esophagitis? MOA?

A

IV ganciclovir or oral valganciclovir

Synthetic analogue of guanosine, that is converted into dGTP to inhibit DNA polymerases

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17
Q

What is the enzyme H. Pylori has that allows it to survive in the low pH of the stomach?

A

Urease

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18
Q

What is the effect of altered stomach lining/pH in the rest of the GI tract?

A

Alters flora in mouth and intestines

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19
Q

What are the three non-invasive ways to diagnose H. Pylori infection?

A
  • Urea breath test
  • Stool antigen
  • Serology
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20
Q

What is the method of choice for diagnosing H. Pylori infection if an endoscopy is indicated? What may interfere with this?

A

Biopsy urease test

PPIs will alter this result

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21
Q

What is the major disadvantage of stool antigen testing for H. Pylori?

A

May have false positives if treated

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22
Q

What is the major downside of serology testing for H. Pylori infection?

A

Doesn’t distinguish between active and past infection

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23
Q

What is the treatment for H. Pylori infection? (3)

A

PPI
Clarithromycin
amox

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24
Q

How long should treatment last for H. Pylori before checking again?

A

6-8 weeks

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25
Q

When do IgG antibodies fall with H. Pylori infections?

A

6 months

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26
Q

When are false negative results seen with H. Pylori treatment?

A

Less than 4 weeks after treatment

Within 2 weeks of a PPI

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27
Q

When is an endoscopy indicated for GI tract infections?

A

If gastric ulcer and to exclude cancer

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28
Q

What is the clinical definition of diarrhea?

A

3 or more watery stools within a 24 hour period

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29
Q

When is a further diagnostic evaluation warranted for GI tract symptoms? (non-obvious)

A
  • Temp of more than 101.3 F

- More than 6 unformed stools /24 hours of illness

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30
Q

What are the characteristics of diarrhea that can aid you in diagnosing the infection or assessing the severity?

A
  • Frequency
  • Volume
  • Duration
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31
Q

What is the clinical definition of acute, persistent, and chronic diarrhea?

A

Acute = less than 2 weeks

2-4 weeks = persistent

More than 4 weeks = chronic

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32
Q

True or false: the vast majority of diarrhea cases in the US are caused by infectious agents

A

True

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33
Q

What are the things that can be elucidated from diarrhea samples?

A
  • Parasitic infection
  • Mal digested food
  • Lipid droplets
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34
Q

Curved gram negative rod that causes diarrhea= ?

A

Vibrio cholerae

35
Q

Reheated rice syndrome = ?

A

Bacillus cereus

36
Q

Raw milk diarrhea?

A

Salmonella

37
Q

Poultry or raw milk/cheese diarrhea = ?

A

Campylobacter

38
Q

What is the common infectious cause of diarrhea that occurs in daycare centers?

A

Shigella

39
Q

What are the foods associated with shellfish or coconut milk?

A

Vibrio cholerae

40
Q

Processed meats bacteria = ?

A

Listeria monocytogenes

41
Q

Home canned foods bacteria = ?

A

Clostridium spp

42
Q

What are the four major viral causes of GI illnesses?

A

Rotavirus
Norovirus
Hep A
CMV

43
Q

What parasite is characterized by daycare centers and ingestions of stream water?

A

Giardia

44
Q

What are the endemic areas for entamoeba histolytica?

A

Mexico

45
Q

What diarrhea causing parasite is found in daycare centers, swimming pools, and animal exposure?

A

Crytosporidium

46
Q

What parasite is found in raspberries that causes diarrhea?

A

Cyclospora

47
Q

Microsporidium diarrhea is usually found in whom?

A

AIDS pts

48
Q

What is the incubation period for: bacillus cereus?

A

1-8 hours

49
Q

What is the incubation period for: s. aureus

A

8-24 hours

50
Q

What are the three major bacteria that have preformed toxins that cause GI illness

A
  • Bacillus cereus
  • S. Aureus
  • C. Perfringens
51
Q

What are the four major enterotoxic bacteria?

A
  • V. Cholerae
  • ETEC
  • Klebsiella pneumoniae
  • Aeromonas
52
Q

What are the two major cytotoxic bacteria?

A
  • C diff

- EHEC

53
Q

What is the incubation period for enterotoxic bacteria?

A

8-72 hours

54
Q

What is the incubation period for: cytotoxic bacteria?

A

Day(s)

55
Q

Inflammatory or noninflammatory symptom: voluminous stool?

A

Non-inflammatory

56
Q

Inflammatory or noninflammatory symptom: fecal leukocytes present

A

Inflammatory

57
Q

What are the typical pathogens of inflammatory diarrhea? (3)

A

Shigella
Campy
Salmonella

58
Q

What are the typical pathogens for noninflammatory diarrhea? (2)

A

VIbrio cholerae

ETEC

59
Q

What is the therapy for inflammatory vs noninflammatory diarrhea?

A

Inflammatory = rehydrate and abx

Non = abx if severely ill

60
Q

What is the bacteria that causes HUS?

A

E.coli O157:H7

61
Q

What is the metabolic disturbance that can occur with HUS?

A

Azotemia

62
Q

What is the approach to therapy for hemorrhagic diarrhea?

A

Supportive; abx may increase risk of HUS

63
Q

What are the two major toxins that C.diff has?

A

Toxin A and toxin B

64
Q

What is the best test for C. Diff?

A

Culture

65
Q

Testing for C. Diff should be performed on what type of stool?

A

Diarrheal stool

66
Q

True or false: testing for C.diff in stool in asymptomatic pts can prove useful

A

False–don’t do it

67
Q

Is PCR widely available for C. Diff?

A

Not widely

68
Q

What is the sensitivity/specificity of endoscopy for diagnosing C. Diff?

A

51 and 100%

69
Q

What is the sensitivity/specificity of culture for diagnosing C. Diff?

A

90%ish for both

70
Q

What is the sensitivity/specificity of cell culture cytotoxin test for diagnosing C. Diff?

A

70-100% for both

71
Q

What is the sensitivity/specificity of EIA toxin test for diagnosing C. Diff?

A

65-95 sensitive

75-100 specific

72
Q

What is the sensitivity/specificity of PCR for diagnosing C. Diff?

A

90s for both

73
Q

What is the treatment for C. diff?

A

Vanco or metronidazole

74
Q

What indicated a mild-moderate C. Diff infx? (2) What drug is indicated?

A
  • WBC less than 15
  • Cr less than 1.5x premorbid levels

Metronidazole

75
Q

What indicated a severe C. Diff infx? (2) What drug is indicated?

A
  • WBC greater than 15
  • Cr more than 1.5x premorbid levels

Vanco

76
Q

What is the dosage for vanco?

A

125mg

77
Q

What is the abx of choice for a second bout of c.diff?

A

use the same regimen

78
Q

True or false: metronidazole is the preferred abx of choice for recurrence /long term chronic C.diff therapy

A

False– do not use more than once

79
Q

Are probiotics recommended to prevent primary CDI?

A

No–Limited data to support

80
Q

What is the major side effect of long term metronidazole use?

A

Peripheral neuropathy

81
Q

Who should never receive probiotics during/after C. DIff infx?

A

Immunosuppressed

82
Q

Why are antiperistaltic agents not indicated for infectious diarrhea?

A

May cause toxic megacolon

83
Q

What is the MOA of loperamide?

A

Loperamide is an opioid-receptor agonist and acts on the μ-opioid receptors in the myenteric plexus of the large intestine

Infectious Disease (18 decks)

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