GI Infections- OBrien Flashcards
What are the most common symptoms of GI infections?
Vomiting and diarrhea
T/F?
Vomiting and diarrhea are responsible for morbidity and mortality.
False
-dehydration which results from vomiting and diarrhea
What is diarrhea?
Increase in frequency of stools to ≥ 3 per day
Acute diarrhea
What is diarrhea?
Inflammation of the lining of the GI tract
Infectious diarrhea
What is diarrhea?
Diarrhea lasting between 14 and 30 days
Persistent diarrhea
T/F?
Younger patients are at higher risk for mortality.
False
-elderly
What groups are at risk for GI infections?
- Travelers and campers
- Patients in chronic care facilities
- Military personnel overseas
- Immunocompromised patients
What agents cause secretory diarrhea?
- Norovirus (adults)
- Rotavirus (children)
- ETEC
- Vibrio cholerae
What agents cause inflammatory diarrhea?
- Shigella
- Salmonella
- Campylobacter
- EHEC
- C. difficile
What is the most common cause of Traveler’s diarrhea?
- ETEC
- transmitted through food and water
What 2 pathogens produce toxins and shouldn’t be used w/ motility agents?
- EHEC
- Shigella
In what type of diarrhea is associated Organisms cause altered movement of ions and water.
Secretory Diarrhea
How do organisms cause inflammatory diarrhea?
They adhere to the intestinal mucosa can cause cytokine release and inflammatory mediator release
Which type of diarrhea is associated with systemic toxicity (fever)?
Inflammation Diarrhea
Secretory Diarrhea
number of stools:?volume:?
- less than 10 stools per day
- increased
T/F?
Secretory Diarrhea is more common than Inflammatory Diarrhea.
True
Inflammatory Diarrhea
number of stools:?volume
- > 10 stools
- smaller in volume
Which type of diarrhea is associated with Shock, severe dehydration, electrolyte imbalance?
Secretory Diarrhea
Which type of diarrhea is associated with MILD dehydration, seizures, sepsis, and toxic megacolon.
Inflammatory Diarrhea
Which type of diarrhea is associated with MANY fecal PMNs?
Inflammatory
When is a stool culture indicated?
- dysenteric diarrhea
- diarrhea lasting for greater than 7 days
- diarrhea where an outbreak is suspected
What pathogens do the stool culture detect?
(CSS)
- Camphylobacter
- Salmonella
- Shigella
Cornerstone management of diarrhea?
Fluids- rehydration therapy
What are the 2 types of rehydration therapy?
- Oral rehydration therapy (ORT)- mild to moderate
- IV fluid therapy- severe
Why are lactated ringer’s solution preferred for IV fluid therapy?
-it corrects acidosis and hypokalemia
What rehydration therapy prevents dehydration and over-hydration?
- ORT
When is antimicrobial tx NOT recommended?
- mild to moderate (viral infections)
- EHEC diarrhea
When is antimicrobial tx recommended?
- dysenteric (Shigella, Campylobacter, Salmonella)
- Traveler’s diarrhea
Severity of Diarrhea
MILD
- 3 or less stools/day
- no fever
Severity of Diarrhea
MODERATE
- 4 to 5 stools/day
- +/- fever
Severity of Diarrhea
SEVERE
- 6 or more stools/day
- Fever (greater than 101 F)
- blood or leukocytes present
Ciprofloxacin is recommended for the tx of what pathogens? Duration?
- ETEC (1 - 3 days)
- Shigella (1- 3 days)
- Salmonella (7-10 days)
Azithromycin is used to treat what pathogen? duration?
Campylobacter
Why are Atx NOT recommended for EHEC?
- worsened outcomes
- Antibiotics may increase the risk of hemolytic uremic syndrome [HUS] by increasing the production of Shiga-like toxin
T/F?
EHEC culture must be requested.
true
What are the 2 anti-motility agents used to treat diarrhea?
- Loperamide
- bismuth subsalicylate (Pepto Bismol)
Which motility agent can’t be used in children why?
- reye’s syndrome w/ salicylates
Which GI infection agent has a vaccine for prevention?
-Rotavirus vaccine for infants beginning at age 2 months
