Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med 2 > GI Tract Infections > Flashcards

GI Tract Infections Flashcards

1
Q

Gastroenteritis

A

diarrhea or vomiting involving either non-inflammatory infection of the upper small intestine or inflammatory infection of the colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute diarrheal episode

A

increased frequency of defecation”
3+ times per day
<14 days duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Persistent diarrhea

A

> 14 day duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Chronic diarrhea

A

> 30 day duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the onset of food poisoning?

A

1-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What defenses do the host have against GI infections?

A 
gastric acidity (pH <4) 
intestinal motility 
normal enteric flora (mostly anaerobes) 
Intestinal immunity 
breast milk 
personal hygiene (wash your hands)

70% of your immune system lives in your gut

H. Pylori can get past the acidity of your stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most common bacterial pathogens of enteric infections?

A

gram negative rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What viruses are most common pathogens of enteric infections?

A

norovirus

rotovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What parasites are most common enteric infections?

A

protozoa (giardia, cryptoporidium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are non infectious causes of diarrhea?

A 
IBD 
IBS 
Malignancy 
Ischemic colitis 
Diverticulitis 
Malabsorption (celiac, lactose intolerance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which pathogens are more common in tropical climates?

A

Enterotoxigenic E. Coli (ETEC)

parasites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which pathogens are more common in temperate zones?

A

viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which pathogens are common in day care settings?

A

rotavirus

norovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do H2 blockers increase your risk of GI infections?

A

reduce gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which pathogen is commonly see with uncooked poultry?

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the major microbial virulence factors?

A

Toxins
attachment
invasiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Enterotoxins

A

direct effect on intestinal mucosa to elicit net fluid and electrolyte secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cytotoxins

A

mucosal destruction

C. diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Neurotoxins

A

pre-formed toxins

food poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes the watery diarrhea present during food poisoning?

A

Enterotoxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Staph Areus

A

good poisoning
more common during summer months
room temp incubation
high salt content foods

  • ham
  • poultry
  • baked goods
  • salads
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What sxs and time frame do you see with food poisoning from staph?

A 
4.4h for roughly 20h
vomiting 
diarrhea
abd pain 
\+/- fever, chills, HA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bacillus cereus

A

food poisoning

Emetic syndrome

  • Associated with fried rice
  • onset 1-6 hours
  • N/V

Diarrheal syndrome

  • associated with rice, powdered milk, macaroni
  • 10-12 hour incubation
  • cramps, N, watery diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Clostridium botulinum

A

an extremely potent neurotoxin produces lassitude, progressive weakness and vertigo

infant: honey, dust, water
Foodborne: meat, canned vegtables, seafood
Wound
Iatrogenic: too much BoTox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Secretory diarrhea
acute, non-inflammatory enterotoxin mediated proximal small bowel watery diarrhea
26
Vibrio Cholerae
secretory diarrhea curved gram negative rod food/waterborne reservoir: aquatic environments and humans incubation: 14h - 5d hallmark: abrupt onset of profuse watery diarrhea with flecks of mucus ("rice water stool")
27
What is the hallmark of vibrio cholerae?
rice water stool | abrupt onset of profuse watery diarrhea with flecks of mucus
28
What is the treatment for vibrio cholerae?
rehydration: fluid/electrolyte ABX -shorten duration of illness and shedding of organism -doxycycline (300mg single dose) -azithromycin if pregnant (1gm single dose)
29
Vibrio parahemolyticus
secretory diarrhea acquired from raw/undercooked shellfish - Gulf Coast mild, self-limited water diarrhea
30
What is the most common cause of travelers diarrhea?
ETEC
31
Travelers diarrhea
secretory diarrhea ETEC incubation 1-3 days watery diarrhea, abdominal cramps, low-grade fever self-limited 2-4 days Contaminated food or water
32
What is the treatment for traveler's diarrhea?
ABX and antimotility agents antimotility - loperamide ABX - Fluoroquinolones (cipro 500mg twice a day for 1-3 days_ Azithromycin (500mg daily x 1-3 days) Instructions: don’t take the meds unless you have had sxs >24 h Self-limited (sxs resolve in 2-4 d)
33
Loperamide
antimotility agent used for traveler's diarrhea
34
Which type of virus is more likely to occur on a cruise ship?
Norovirus
35
Who is more likely to get astrovirus?
children <3 | immunocompromised
36
Giardia
secretory diarrhea ``` 1-4 week incubation acute vs chronic acute: loose, FOUL SMELLING stools steatorrhea anorexia no blood in stools ``` chronic: steatorrhea, growth impairment
37
How do you dx giardia?
fecal examination fecal antigen test (EIA) enterotest --pt swallows gelatin capsule on end of string --removed after 4-6 hours
38
Enterotest
"used" to help dx giardia
39
What is the treatment for giardia?
Metronidazole 250 mg PO three times daily fo 7-10 days Tinidazole Nitazoxanide
40
Inflammatory diarrhea
``` cytotoxin mediated colon invasive blood diarrhea fever ```
41
What are the major differences between inflammatory and secretory diarrhea?
secretory is in the proximal small intestine, mediated by enterotoxin inflammatory is in the colon and is cytotoxin mediated
42
Shigellosis
``` inflammatory diarrhea gram negative rod reservoir: asymptomatic human carriers transmission: fecal-oral, food-borne, or water-borne 4 species ```
43
What are the sxs of shigellosis?
``` FEVER abdominal cramps watery diarrhea progressing to blood mucoid stools tenesmus ```
44
Tenesmus
cramping rectal pain
45
Shiga toxin
only in Shigellosis dysenteriae enters cell via receptor mediated endocytosis binds 60S ribosome --inhibits protein synthesis cytotoxin
46
What is the treatment for shigellosis?
rehydration | fluoroquinolones - cipro 500mg twice daily for 305 days or 2gm single dose
47
Campylobacter
``` inflammatory diarrhea comma-shaped gram negative rod C. Jejuni = poultry -self limited C. fetus = cattle, sheep -BAD - bacteremia, meningitis, may be fatal in immunocompromised ```
48
What is the treatment for Camylobacter enterocolitis?
azithromycin or ciprofloxacin resistance to fluoroquinolones in SE asia
49
"Hamburger disease"
inflammatory diarrhea STEC - shiga toxin producing E. coli ground beef, salami, spinach, apple cider, yogurt
50
What are the sxs for STEC?
prodrome: abdominal cramps and mild fever non-blood diarrhea within hours that progresses to blood diarrhea within 1-2 days
51
What are the possible complications of STEC?
HUS - hemolytic uremic syndrome commonly < 5 years of age NO TX --just supportive
52
How do you dx STEC?
stool antigen test
53
Salmonella enteroclolitis
inflammatory diarrhea foodborne - eggs, PB, pistachios, fruit, cantaloupe exotic pets incubation 6-48 hours self-limited to 3-7 days
54
Amoebiasis
inflammatory diarrhea common in tropical areas with crowded living conditions sxs include liver abscess
55
What are the sxs of ameobic colitis?
``` location GRADUAL onset diarrhea dysentery (blood and mucus in diarrhea) abdominal pain weight loss fever ```
56
When do you see amoebic liver abscess?
``` Amoebiasis sxs > 4 weeks M > F fever hepatomegaly jaundice weight loss ```
57
How do you dx ameobiasis?
stool microscopy stool antigen detection stool PCR serology
58
What is the treatment for ameobiasis?
Metronidazole | followed by luminal agent (acts on cysts)
59
Clostridium difficile sxs
inflammatory diarrhea ``` watery diarrhea fever loss of appetite nausea abdominal pain/tenderness ``` hx: ABX, PPI
60
What are the possible complications of C. diff?
``` pseudomembranous colitis toxic megacolon colonic perforation (sepsis) ```
61
How do you dx C. diff?
NAAT -nucleic acid amplification | on stool for sxs pts
62
What is the treatment for C. diff?
D/C ABX mild to moderate: metronidazole 500mg 3 times daily for 10 -14 days Severe: PO Vanco 125-500 mg 4 times daily for 10 -14 days
63
Enteric fever
penetration of distal small bowel with intracellular replication of organisms in reticuloendothelial system and subsequent systemic dissemination
64
What is the mainstay of therapy for infectious gastroenteritis?
rehydration
65
Which deficiencies put you at a greater risk for gastroenteritis?
Vitamin A and Zinc deficiency
66
Beaver fever
Giardia duodenalis Protazoan from water (fresh water stream)
67
What is the onset for giardia?
Gradual onset — 1-4 week incubation Incubation is occurring in the duodenum (that is why it has fat in the poo)
68
What do you tell your pts you are prescribing Metronidazole?
Don’t drink EtOH —it will cause bad GI upset | Tx for giardia duodenalis Most azoles are antifungals but not this one
69
HUS is a complication of ______
Hemolytic-uremic syndrome STEC and Shigellosis
70
Comma-shaped gram negative rod
Campylobacter
71
What is the treatment for STEC?
NOTHING You want the pt to get rid of this asap by giving them fluids This means they will continue to have diarrhea but that will get the bug out faster
72
Which pathogens do we NOT treat with ABX?
Salmonella | STEC
73
When do you treat salmonella?
For pts at risk of invasive disease Treat with Ceftriaxone IM
74
What are the different types of amoebiasis syndromes?
Asymptomatic colonization Dysentery Colitis Liver abscess
75
How do you treat the asymptomatic colonization of amoebiasis?
Luminal agent alone | Paromomycin, lodoquinol
76
Rose spots
Faint salmon colored maculopapular rash on the trunk of pts with TYPHOID FEVER
77
How do you dx Typhoid fever?
Blood culture
78
How do you treat typhoid fever?
Fluoroquinolone (cipro), 3rd gen ceph (ceftriaxone)
79
BRAT diet
Bananas Rice Apple sauce Toast This is one of the first symptomatic therapies you do
80
When do you advance to a stool culture?
If the pt has had diarrhea > 1 day, especially if they have a fever, bloody stool, or systemic sxs
81
We have vaccines for some of these GI infections, which ones?
Rotavirus - Rotarix - RotaTeq - expensive - live, oral Typhus - Live-attenuated (PO) - heat killed shot (IV) - for long-term travel to rural areas
82
90% of enteric infection deaths are in pts ____y/o
<5 years old
83
What toxins cause food poisoning?
Pre-formed neurotoxins and enterotoxins
84
Fried Rice
B cerus
85
Clinical presentation of Giardia?
Loose, foul smelling stools Steatorrhea -fat malabsorption Anorexia No blood in stools
86
What is the treatment for Shigellosis?
Rehydrate | Flouroquinolones - ciprofloxacin
87
What is the clinical presentation of campylobacter enterocloitis?
Loose stools to massive watery or grossly blood diarrhea Severe abdominal cramping relieved by defecation Usually self limited but 10-20% have sxs >7 days
88
How do you treat STEC?
Supportive only | NO ABX or antimotility agents
89
NTS
Nontyphoidal salmonella entercolitis Foodborne/ contact with exotic pets Incubation period: 6-48 hours
90
Signs of NTS
``` Fever Abdominal cramping N/V Chills Watery diarrhea ``` Self limited to 3-7 days
91
What are complications of NST?
Bacteremia
92
What is the treatment for NTS?
Typically you dont treatment because the ABX could prolong carriage Diarrhea might resolve but the bacteria is excreted in feces for 4-5 weeks Only treat those at high risk of invasive disease Ceftriaxone
93
What are the signs and sxs of amoebic liver abscess?
``` History of sxs >4 weeks M > F Immigrant/traveler from endemic area Fever Abdominal pain Hepatomegaly Jaundice Diarrhea Weight loss Cough (diaphragm irritation) ```
94
For which enteric infections would a blood culture be positive?
Enteric fever Or Invasive NTS
95
Antigen detection (EIA0
Rotavirus | Giardia
96
When should you get a stool culture?
If pt has had diarrhea >1 day, especially if fever, bloody, or systemic sxs If the pt is a food handler Get NAAT if pt was on ABX in the last 2 weeks
97
When do you get ova and parasites (O and P)?
If persistent diarrhea > 7 days
98
Dukoral
Vaccine for ETEC + cholera Not licensed in US
99
Rotarix
One of the 2 vaccines for rotavirus RotaTeq CDC/ACIP recommends for all infants
100
What vaccines do they have for Salmonella Typhi?
Oral (Ty21a) -live attenuated Injectable (Vi) - heat killed Recommended for long term travel to rural areas of endemic countries

Clin Med 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions