GI / GU Flashcards
Normal Flora of small intestine
- Lactobacillus
2. Enterococcus
Normal Flora of large intestine:
Aerobic/ facultative anaerobic:
Anaerobic:
Yeast:
- Enterococcus, Gram- bacilli, (E. coli)
- Clostridium, Bacteroides
- Candida
Inflammation/ infection of stomach
Gastritis
main etiology of gastritis
- Helicobacter pylori
- Viral
- v imbalance in protective factors
Upset stomach
dyspepsia
A disruption of the mucosal integrity of stomach/duodenum–most likely cause
- Peptic ulcer disease PUD (bloody feces)
- H. pylori–“urea breath test”
Gallbladder infections (3) and most common causes (3). _________ may cause diarrhea
- Acute cholecystitis, cholangitis, biliary sepsis
- Enterobacteriaceae (E. coli, Shigella, Salmonella)
- Enterotoxins
Gallbladder infection not caused by obstruction (sone, stricture, neoplasm) of bile duct–treatment
- analgesics
- IV antibiotics
- surgical consult
Viral hepatitis
A, B, C, D (D in presence of B), E, CMV, HSV, parvovirus B19, mono
CMV, HSV
cytomegaly virus
herpes simplex virus
hepatocellular damage and inflammation (video)
hepatitis (usually viral, but may be toxins i.e. alcohol)
- -fatigue, “TEA-COLORED URINE”, pale stools, malaise
- -jaundice, fever, hepatomegaly
- fecal-oral transmitted hepatitis
- parenterally or STI transmitted
- A&E
- B,C,D
Hepatitis treatments
- supportive
2. avoid alcohol
hepatic abscess may be caused by–Pus-filled cavity in liver (may present like hepatitis–later ^ fever, ^ jaundice, sepsis)
- Enterobacteriaceae (esp. Klebsiella),
- Bacteroides,
- enterococci
- amebic (tropics)
Treat hepatic abscess w/
- IV antibiotics
2. admission
LFT
liver function tests
Liver Function Test: (if hepatitis suspected)
- liver injury:
- livery function:
- Liver as a filter:
1-measure AST, ALT, alk phosph
2-Protein synth: albumin and INR,
Glucogeneogenesis: Serum glucose
3-Total BILIRUBIN
- Acute pancreatitis etiologies (2)
- gallbladder/ biliary tract disease
2. alcohol
Tests for pancreatitis
serum amylase and lipase, serum trypsin, ultrasound
Pancreatitis treatment
- IV analgesia (very painful)
- fluids
- antibiotics
- parenteral nutrition
For GI infection think
Enterobacteriaceae
classic appendicitis history (rebound tenderness at McBurney’s)
-treatment
- anorexia
- abdominal pain RLQ/flank –worse on palpation/bumping
- N&V some diarrhea/constipation
- surgery/antibiotics
Diverticulitis history
- LLQ pain / fever
- tenderness
- NVD
Diverticula that aren’t inflammed or bleeding
diverticulosis
Diverticulitis treatment–get CT if unsure
- rest / antibiotics (metronidazole)
increased frequency or volume of stool (3 or more liquid or semisolid stools daily for 2-3 consecutive days)
diarrhea
bloody diarrhea w/ fever indicates invasive organisms or
Inflammatory bowel disease ==> inflamatory diarrhea
large volume of diarrhea w/ out inflammation
Secratory diarrhea
diarrhea almost always caused by Clostridium difficile
antibiotic-associated diarrhea
Bacterial infectious diarrhea caused by
Gram - rods
virus causing NVD from food–watery diarrhea lasting 1-2 days
norovirus
virus causing NVD from PTP–watery diarrea lasting 5-8 days
rotavirus
treatment for Giardia lamblia–water, PTP -treatment
- Metronidazole
bloody diarrhea treatment
cipro
Infection of any/all of urethra, bladder, ureter, kidney
UTI
UTI treatment
- Nitrofurantoin 7 days
- Trimethoprim/Sulfamethoxazole 3 days
- Cipro if pyelonephritis suspected (infection ascended into kidney)
- main acute cystitis and female urinary tract infection etiology
E. coli
main pyelonephritis pathogen
E. coli
For GU infection think
E. coli
Pyelonephritis findings
fever, dysuria (frequency/ urgency)
CVA tenderness, palpable and tender kidney
Pyelonephritis treatment
Cipro outpatient usually
Pt under 35 prostatitis likely from
- N. gonorrheae
2. Klebsiella spp
narrowing of foreskin that may predispose man to infection
Phimosis
Prostatitis history
malaise, fever, chills, Pain (low back, abdominal, DEEP rectal, or pelvic) dysuria
prostatitis tests
- urine pre and post massage
2. culture
prostatitis treatment
Quinolone 4-6 wks
epididymitis prepubertal boys cause
Escherichia coli
men younger than 35 years epididymitis cause
- Chlamydia trachmatis
2. neisseria gonorrheae
men older than 35 yo epididymitis cause
- E. coli
2. Pseudomonas species
Balantitis likely causes–pain and tenderness–treatment after culture
- Candida (antifungal)
2. Group B strep (bacitracin)
Urethritis causes–inflammation usually caused by STD
Neisseria gonorrheae
most common cause of orchitis–labs–history comes into play
- Mumps or other viruses/bac
- viral study for mumps
Genital Lesions (5)
- Herpes simplex virus (grouped vesicles)
- Treponema pallidum (syphilis–painless)
- haemophilus ducreyi (chancroid)
- Chlamydia trachomatis
- Klebsiella granulomatis
Normal flora reproductive system:
Male:
Female:
-sterile
-Lactobacilli, Group B strep, E. coli, Staph epidermidis
(thus women may get yeast infection w/ antibiotics)
A clinical syndrom arising from infection that may involve any or all of the following: uterus, fallopian tuves, ovaries, peritoneal surfaces, and contiguous structures.
Pelvic inflammatory disease
PID history
lower abdominal and pelvic pain, vaginal discharge, dysuria
PID treatment
antibiotics
opportunistic infection of mucous membranes and skin caused by yeast–name and cause
- Candidiasis
- Candida albicans
PID uterus cuases
- N gonorrhoeae
- Chlamydia
- Bacteroides
PID cervix causes
- N gonorhoeae
- Chlamydia
- HSV
- Trichomonas
Vaginitis causes
- Trichomonas vaginalis
- Chlamydia
- Gardnerella vaginalis
- Gonorrhoeae
Diaper rash and culcovaginal skin rash (yeast infection)? / history
- candidiasis
- ODDORLESS vaginal discharge resembling CURD/ COTTAGE CHEESE, redness, edema
Local painful inflammation of the breast, which may or may not be accompanied by infeciton, flulike symptoms, and abscess formation
Abscess and Mastitis (breast ABSCESS and CELLULITIS)
Likely cause of mastitis
Staph aureus or Strep
For skin infection think
Staph aureus or Strep species or Candida
Classic Neisseria gonorrhoeae Symptoms:
Males:
Females:
- dysuria and “PURULENT discharge”
- Vaginal discharge, dysuria, 50-80% asymptmatic
2nd most common STI, Oblicage intracellular bacterial parasite
Chlamydia trachomatis
Classic Chlamydia trachomatis Symptoms:
male:
female:
- “WHITISH/CLEAR discharge”, dysuria (gonorrhea purulent),
- Most asymptomatic, mild discharge, pain
Chancroid think
Haemophilus ducreyi (gram - coccobacilli)
Haemophilus ducreyi Symptoms/Dx (Asia/Africa)
male:
- painful vesiculopusular lesion, nodules, on inguinal canal
- Gram stain bubo aspirate
“Beefy red ulcers” and “purulent discharge
Kelbsiella (Granuloma Inguinale)
“DONOVAN BODIES” think
Klebsiella
HSV type I in
mouth
HSV type 2 in–PE–Tx
- Genitals
- vesicles present
- Acyclovir
“Copious FOUL-SMELLING vaginal discharge”–“motile organisms”
Trichomonas vaginalis–urethritis in men
Tx for Trichomonas vaginalis
Metronidazole
