GI Infections Part 1

Question 1

The GI microbiota is mostly what kind of bacteria?

Answer 1

Anaerobes

Question 2

Secretory diarrhea

Answer 2

Watery
No or minimal fever
Continues despite decreasing intake of food and water
Not invasive
Small bowel location
Mid-abdomen pain

Question 3

Inflammatory diarrhea

Answer 3

Fever
Bloody stool
WBC in stool
Some sort of invasion into the gut causes a systemic rxn
Large bowel locaion
Lower abdomen and rectum pain

Question 4

3 risk factors for C diff infection

Answer 4

Broad spectrum antibiotics
Proton pump inhibitors
Institutionalized elderly, multiple co-morbidities

Question 5

Characteristics of C diff diarrhea

Answer 5

Watery, foul smelling (like a barn)
Elevated WBC (20+)
Mild abdo discomfort/pain

Question 6

Treatment for C diff

Answer 6

Stop unnecessary antibiotics
Metronidazole 
Vancomycin
Stool transplant to replenish microbiota
Surgical for toxic megacolon

Question 7

Enterotoxigenic E coli

Answer 7

Mild watery diarrhea and nausea but no vomiting for 1-4 days
Diarrhea in children < 2
Traveller’s diarrhea
Need quite a few bacteria to get disease
Heat labile toxin is similar to cholera toxin

Question 8

Enterohemorrhagic E coli

Answer 8

Shiga toxin producing E coli/ O157:H7
Only need 10-100 organisms to get infected
Get bloody diarrhea and renal failure (HUS)
Do not give antibiotics!

Question 9

HUS

Answer 9

Hemolytic Uremic Syndrome
Low Hb (peripheral smear shows schistocytes, helmet cells)
Not producing urine

Question 10

Non-typhoidal salmonella

Answer 10

Usually non invasive disease
Self resolving gastroenteritis
Generally no abx required

Question 11

Typhoidal salmonella

Answer 11

Typically invasive
Fever, systemic symptoms, bacteremia
Requires abx treatment
Can be fatal if not treated