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AII Week 4 > GI Infections > Flashcards

GI Infections Flashcards

1
Q

Viral Gastroenteritis

A

US most cases viral, brief, self-limited; vaccine avail (roto)

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2
Q

Viral Gastroenteritis Signs/Sx

A

Diarrhea (w/N/V); absence of fever, severe abd pn, bloody stool

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3
Q

Viral Gastroenteritis Etiology

A

Diff causes (roto; noro - explosive sx; astro; adeno - illness first, then GI sx); fecal-oral route

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4
Q

Viral Gastroenteritis Diag workup

A

Stool cultures after sev days to R/O bact gastroenteritis (high costs)

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5
Q

Viral Gastroenteritis Management

A

Antiemetics, antipyretics, hydration; antidiarrheal (not for bact)

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6
Q

Viral Gastroenteritis Prog/Comp/Prevent

A

Hand washing

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7
Q

Typhoid Fever

A

Common in travel

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8
Q

Typhoid Fever Signs/Sx

A

Fever, malaise, arthralgia, myalgia, HA, delirium; GI symptoms delayed (abd pn and constipation > “pea soup” diarrhea)

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9
Q

Typhoid Fever Etiology

A

Caused by salmonella typhi and paratyphi; systemic infection following 1-2 weeks incubation

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10
Q

Typhoid Fever Diag workup

A

Bradycardia, HSM, LAD, macular rash (rose spots); stool cx

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11
Q

Typhoid Fever Management

A

Quinolones, 3rd gen cephalosporins; corticosteroids; cholecystectomy considered if not cleared

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12
Q

Typhoid Fever Prog/Comp/Prevent

A

Recurrent bacteremia is common

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13
Q

Cholera Signs/Sx

A

“Rice water” stools; rapid/severe dehydration (mortality high)

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14
Q

Cholera Etiology

A

Contam seafood (shellfish); water, food contam w/human feces

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15
Q

Cholera Diag workup

A

Look for vibrio cholerae w/dark field microscopy w/wet mount

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16
Q

Cholera Management

A

Rehydration salts; abx can decrease duration: tetra/doxycycline

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17
Q

Cholera Prog/Comp/Prevent

A

Death from profound hypovolemia; vaccine available but not cost effective; 20-50% fatality if untreated

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18
Q

Giardiasis

A

Camping, wells (for drinking water); most common parasite in US

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19
Q

Giardiasis Signs/Sx

A

Asxatic, steatorrhea, bloating, flatus, fever uncommon, sulf belch

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20
Q

Giardiasis Etiology

A

Drinking water, contact cysts, attach to duodenum and jejunum

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21
Q

Giardiasis Diag workup

A

O&P, antigen testing

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22
Q

Giardiasis Management

A

Metronidazole (don’t take with EtOH)

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23
Q

Giardiasis Prog/Comp/Prevent

A

Causes lactose intolerance (avoid x 1 month); boil water while camping/iodine treatment for water

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24
Q

Shigella Signs/Sx

A

Fever, malaise, abd pn, watery/bloody diarrhea, resp sx common

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25
Q

Shigella Etiology

A

S sonnei or s dysenteriae; person-to-person; diarrhea may decrease and become bloody with mucus/pus

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26
Q

Shigella Diag workup

A

Stool culture

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27
Q

Shigella Management

A

Self-limiting; hydration and do not give anti-motility agents; high risk: Cipro

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28
Q

Shigella Prog/Comp/Prevent

A

Toxic megacolon, HUS, reactive arthritis (abx inc risk)

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29
Q

Salmonella

A

Cause gastroenteritis to typhoid fever

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30
Q

Salmonella Signs/Sx

A

N/V followed by inflammatory/bloody diarrhea, cramps; fever, RLQ tender

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31
Q

Salmonella Etiology

A

Summer or fall; undercooked/raw poultry, pets, person-person

32
Q

Salmonella Diag workup

A

Test for S typhi in blood, bone marrow, rose spots, stool

33
Q

Salmonella Management

A

Fluids, rest; avoid anti-motility agents; old/young/immunocompromised: abx

34
Q

Salmonella Prog/Comp/Prevent

A

5-10% develop bacteremia, leads to: meningitis, pulm infs, osteomyelitis, reactive arthritis

35
Q

Amebiasis

A

Entamoeba histolytica, most common parasite worldwide

36
Q

Amebiasis Signs/Sx

A

Bloody diarrhea, abn pn, tenesmus (90% asxmatic)

37
Q

Amebiasis Etiology

A

Transmission occurs thru ingestion of cysts from fecally contam food/water; can be person-to-person; flies/arthropods as vectors

38
Q

Amebiasis Diag workup

A

Stool sample (3 samples because not sensitive); stool antigen test avail and more sensitive; exam of fresh ucer

39
Q

Amebiasis Management

A

Metronidazole

40
Q

Amebiasis Prog/Comp/Prevent

A

Can cause abscess (sp liver) -> tissue destruction; safe water supplies

41
Q

C diff

A

Causes: abx-assoc colitis

42
Q

C diff Signs/Sx

A

Watery diarrhea, abd pn/tenderness; (severe) loss of appetite, fever, blood in stool, weight loss

43
Q

C diff Etiology

A

Gen iatrogenic (abx use - quinolone, clinda, PCN, cephs); fecal-oral route; disruption of normal intestinal flora

44
Q

C diff Diag workup

A

Enzyme immunoassay available; colonoscopy

45
Q

C diff Management

A

Vancomycin or flagyl (metronidazole)

46
Q

C diff Prog/Comp/Prevent

A

Relapse common (add probiotic in tx); sx flare up in IBD

47
Q

Campylobacter

A

2nd most common foodborne illness in US

48
Q

Campylobacter Signs/Sx

A

Fevers, myalgias, malaise, abd pn, HA x up to 1 week

49
Q

Campylobacter Etiology

A

Diarrhea begins later (profuse watery - bloody)

50
Q

Campylobacter Diag workup

A

Stool culture

51
Q

Campylobacter Management

A

Risk categories: <3 days erythromycin or quinolones (later)

52
Q

Campylobacter Prog/Comp/Prevent

A

Hemolytic uremic syndrome, reactive arthritis, Guillain-Barre syndrome; thoroughly cook chicken

53
Q

Bacillus cereus

A

Foodborne illness

54
Q

Bacillus cereus Signs/Sx

A

N/V/D

55
Q

Bacillus cereus Etiology

A

Toxins produced by Bacillus cereus causing sx

56
Q

Bacillus cereus Diag workup

A

Culture from implicated food

57
Q

Bacillus cereus Management

A

Self-limiting; symptomatic tx

58
Q

Bacillus cereus Prog/Comp/Prevent

A

Avoid undercooked foods; prognosis good

59
Q

E coli (Enterohemorrhagic -EHEC)

A

Many types

60
Q

EHEC Signs/Sx

A

Abd pn, myalgia, HA, N/V, no fever, grossly bloody diarrhea (event)

61
Q

EHEC Etiology

A

E. coli O157:H7 (an EHEC): produces Shiga toxin; incubation of 3-5 days

62
Q

EHEC Diag workup

A

Does not show up on normal stool culture (let lab know)

63
Q

EHEC Management

A

AVOID abx; avoid anti-motility/narcotics; replace water/electrolytes

64
Q

EHEC Prog/Comp/Prevent

A

Caused by undercooked meat, unpasteurized milk (cattle feces); HUS, EHEC can appear like ischemic colitis (esp in elderly)

65
Q

E coli (Enteroinvasive - EIEC)

A

Enteroinvasive E coli

66
Q

EIEC Signs/Sx

A

Profuse diarrhea, vomiting, malaise, abd cramps, high fever/chills

67
Q

EIEC Etiology

A

Occurs within 12-72 hours of eating contam food

68
Q

EIEC Diag workup

A

Culture from infected food, but not usually needed

69
Q

EIEC Management

A

Usually self-limiting

70
Q

EIEC Prog/Comp/Prevent

A

Avoid undercooked food

71
Q

E coli (Enterotoxigenic - ETEC)

A

“Traveler’s diarrhea”

72
Q

ETEC Signs/Sx

A

Watery diarrhea, bloating, fatigue, cramps, fever uncommon

73
Q

ETEC Etiology

A

Affects 40-60% of travelers to high-risk areas; bact 80-90%

74
Q

ETEC Diag workup

A

Hx: where traveled

75
Q

ETEC Management

A

Usually self-limiting; abx prophylaxis not rec; cipro or bismuth, rehyd

76
Q

ETEC Prog/Comp/Prevent

A

Avoid undercooked foods, local water (ice), unpasteurized drinks

AII Week 4 (7 decks)

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