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

Question 1

Most common cause of watery, non-inflammatory diarrhea

Answer 1

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

Question 1

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.

Answer 1

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

Question 1

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

Question 1

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

Question 1

Non-typhoidal strains of Salmonella Gastroenteritis

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• Typhimurium
• Enteritidis
• Newport

Question 1

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?

Answer 1

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

Question 1

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

Answer 1

Rotavirus

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Common pathogens causing foodborne illness/ Food Poisoning

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• Norovirus
• Salmonella
• Campylobacter

Question 1

Treatment of Foodborn illnesses

Answer 1

• Norovirus: Supportive

- Salmonella, E. coli and Campylobacter: ??

Question 1

99% of normal enteric flora are __________.

Answer 1

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

Answer 1

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.

Answer 1

True

Question 1

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

Answer 1

• 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?

Answer 1

• 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

Answer 1

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

Question 1

Can bacteremia occur with a patient with Salmonella Gastroenteritis?

Answer 1

Yes

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

Question 1

Do you treat Salmonella Gastroenteritis with abx?

Answer 1

Only if they are immunocompromised

Question 1

Pathogens causing Traveler’s Diarrhea

Answer 1

• Shigella
• Salmonella
• Campylobacter
• E. coli – probably ETEC
• Vibrio cholerae