GI Infections

Question 1

This is the term for alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools.

Answer 1

Diarrhea

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Most common cause of watery, non-inflammatory diarrhea

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Viral Infections

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Pathogenesis of Viral Infections

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Destruction of Mucosal Cells and Net Fluid Secretion, or Ionic Perturbations

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This is the most common viral cause in adults. Sometimes called the “Winter-vomiting disease” associated with outbreaks on cruise ships and shellfish and/or transient lactase deficiency

Answer 1

Norovirus

Question 1

Which of the following is true regarding viral diarrhea?
A. It is generally self-limited and supportive care with rehydration is sufficient
B. Rotavirus, Norwalk, Adenovirus and Astrovirus are common causes
C. Viral diarrheal illness may be associated with a transient lactase deficiency
D. It is the most common cause of infectious diarrhea
E. Going on a cruise is like buying a lottery ticket for viral diarrhea
F. All of the above

Answer 1

F. All of the above

Question 1

Treatment of Viral Pathogens Causing Non-inflammatory, watery diarrhea.

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Supportive

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Function of Normal Enteric Flora

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Acts as innate host defense by occupying a niche that pathogens might otherwise overtake

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Examples of Normal Enteric Flora

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• Bacteroides
• Clostridium
• Peptostreptococci

Facultative Anaerobes:

• E. Coli
• Klebsiella

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T/F: Listeria is a common cause of death if untreated infection in gut.

Answer 1

False, it’s a very rare infection, but it IS potentially lethal

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In Bacterial Gastroenteritis, what are the major signs/symptoms?

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• Nausea
• Vomiting
• Usually afebrile

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Incubation period of bacterial gastroenteritis 6 hours to 24 hours would make you think what pathogens?

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• C. perfringens

- B. cereus

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Non-typhoidal strains of Salmonella Gastroenteritis

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• Typhimurium
• Enteritidis
• Newport

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Duration of Diarrhea for > 14 days, < 30 days.

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Persistent

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Duration of Diarrhea for < 14 days

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Acute

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Duration of Diarrhea for > 30 days.

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Chronic

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If inflammation is present, then what will be present?

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White Fecal Count

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When should you consider a non-viral etiology of diarrhea?

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If the following is present for > 3 days:

• Systemic Illness
• Fever
• Tenesmus
• Blood Stools

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Common Viral Pathogens

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• Norovirus
• Rotavirus
• Enterociruses
• Adenoviruses
• Echoviruses
• Coronaviruses
• Astroviruses
• H1N1

Question 1

This is a common viral cause in infants, and there is a vaccine available

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Rotavirus

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Common pathogens causing foodborne illness/ Food Poisoning

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• Norovirus
• Salmonella
• Campylobacter

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Treatment of Foodborn illnesses

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• Norovirus: Supportive

- Salmonella, E. coli and Campylobacter: ??

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99% of normal enteric flora are __________.

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Anaerobes

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T/F: Disruption of normal enteric flora balance by abx or introduction of a different organism may lead to disease

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True

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T/F: The shorter the incubation period, the greater the chance the cause is a toxin such as S. aureus, B. cereus.

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True

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Incubation period of bacterial gastroenteritis less than 6 hours would make you think what pathogens?

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- S. aureus - B cereus And their toxins

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Incubation period of bacterial gastroenteritis 16 - 72 hours would make you think what pathogens?

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- S. aureus - B. cereus - Vibrio - Salmonella - Shigella - Campylobacter - Yersinia - Shiga toxin producing E. coli, ETEC - Giardia - Cyclospora - Cryptospordium

Question 1

Signs/Symptoms of Salmonella Gastroenteritis

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- Crampy abdominal pain - Nausea - Vomiting - Diarrhea begins 6-48 hours after ingestion of contaminated food - Water diarrhea, but may be dysenteric - Fever?

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Can bacteremia occur with a patient with Salmonella Gastroenteritis?

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Yes - 1-4% (transient) bacteremia in normal hosts - 50% bacteremia in immunocompromised

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Do you treat Salmonella Gastroenteritis with abx?

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Only if they are immunocompromised

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Pathogens causing Traveler's Diarrhea

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- Shigella - Salmonella - Campylobacter - E. coli -- probably ETEC - Vibrio cholerae