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F3 E3 Shea > IBS-2 > Flashcards

IBS-2 Flashcards

1
Q

Most cases of diarrhea are what?

A

self-limited

(esp. when associated with N/V)

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2
Q

Diarrhea:

  • Acute= < ___days
  • Persistent= > ____ days but < ____
  • Chronic= >____ days
A
  • Acute= < 14days
  • Persistent= > 14 days but < 30
  • Chronic= >30days
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3
Q

Most cases of acute diarrhea are _____

A

viral

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4
Q

What 3 viruses are common causes of acute diarrhea

A
  1. Rotavirus
  2. Adenovirus
  3. Norwalk-like virus

“RAN”

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5
Q

Bacterial causes of diarrhea tend to be _______ than viral causes

A

more severe- cause inflammatory diarrhea

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6
Q

What are the 6 common bacterial causes of acute diarrhea

A
  1. Campylobacter
  2. Salmonella
  3. Shigella
  4. Enterohemorrhagic E coli (E. coli 0157-H7)
  5. Vibrio (seafood)
  6. Listeria
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7
Q

What are the 2 protozoa to cause acute diarrhea?

A
  1. Giardia- MC
  2. Crytosporidium (HIV)
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8
Q

Presentation of inflammatory or non-inflammatory diarrhea?

  • Diffuse, watery diarrhea
  • abdominal cramping
  • N/V
  • Fever
A

Non-inflammatory

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9
Q

What are the 3 causes of non-inflammatory diarrhea

(“NAG”)

A
  1. Norwalk-like virus
  2. Adenovirus
  3. Giardia
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10
Q

Presentation of inflammatory or non-inflammatory diarrhea?

  • Bloody diarrhea
  • Fever
  • LLQ pain and tenesmus
A

Inflammatory

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11
Q

What are the 5 causes of inflammatory diarrhea

A
  1. Shigella
  2. Salmonella
  3. Campylobacter
  4. Enterohemorrhagic E coli
  5. C- diff
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12
Q

Which cause of noninflammatory diarrhea?

  • < 2y/o
  • sxs < 1wk
  • Present with V/D and F
A

Rotavirus

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13
Q

How do you treat noninflammatory diarrhea caused by Rotavirus?

A

Supportive

(can progress to dehydration or be fatal)

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14
Q

Bloody diarrhea is MCly associated w/ what

A

Enterohemorrhagic E coli

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15
Q

Noninflammatory diarrhea with vomiting suggests what

A

Viral enteritis or food poisoning

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16
Q

Recent antibiotic ingestion or hospitalization suggests what

A

C. difficile

17
Q

Acute Diarrhea clues:

  • Proctitis and rectal discharge suggest what 2 causes
A

Gonorrhea, LGV (lymphogranuloma venereum)

18
Q

The following are classic sxs of what cause of acute diarrhea?

  • NO FEVER
  • Bloody stool
  • abdominal tenderness
A

Enterohemorrhagic E. coli (EHEC)

(E coli 0157:H7 MC serotype in US)

19
Q

Acute diarrhea caused by Enterohemorrhagic E. coli (EHEC) is associated with what syndrome?

A

Hemolytic Uremic Syndrome

20
Q

What are the 3 components of Hemolytic Uremic Syndrome associated with acute diarrhea caused by EHEC?

A
  1. Hemolytic anemia
  2. Renal failure
  3. Thrombocytopenia
21
Q

What cause of acute diarrhea is associated with contaminated water (camping)

22
Q

Classic sxs of what cause of acute bacteria:

  • Persistent Diarrhea >7days
  • fatty stools
23
Q

A routine stool culture tests for what 4 causative agents

A
  1. shigella
  2. salmonella
  3. Campylobacter
  4. Enterotoxigenic E. coli
24
Q

What 3 causative agents of acute diarrhea must you order a separate test for?

A
  1. EHEC (culture of E coli 0157:H7 and stool test for shiga toxin)
  2. Stool for C. diff toxin
  3. Stool for Giardia Antigen
25
Enterohemorrhagic E. coli (EHEC) produces which toxin
Shiga toxin
26
What test should be ordered when evaluating acute diarrhea
**stool culture** with separate tests ordered for each specific cause (C.diff toxin, Giardia Ag, Shiga toxin & Ecoli 0157:H7)
27
If inflammatory diarrhea is suspected consider ordering what 3 tests
1. Stool for occult blood and for wbc's (or lactoferrin) 2. Routine stool culture 3. Stool culture for E. coli 157:H7 & stool test of shiga toxin
28
What is the main priority of managing Acute diarrhea
rehydration
29
What are the 4 components of management for acute diarrhea?
1**_. Rehydration_** 2. +/- **Loperamide** (immodium)- NOT for pts w/ suspected inflam. diarrhea- blood, etc 3. +/- **Bismuth subsalicylate** (NOT for kids) 4. Empiric abx w/ **Cipro** (if benefits \> risks; stool culture before)
30
When should you avoid use of antidiarrheal agents?
* **CHILDREN** * Pts with suspected **inflammatory diarrhea** (fever, tenesmus, blood/pus in stool)
31
What are the 2 ADEs of Bismuth Subsalicylate
turn tongue/stools black
32
Acute Diarrhea: * Use caution in patients with what 4 sxs?
1. Fever- NO Immodium 2. Significant abd. tenderness 3. bloody diarrhea- NO Immodium or abx
33
What medication should NOT be given if there is acute diarrhea with **fever**
Immodium
34
What 2 medications should not be given if there is bloody diarrhea
No immodium or antibiotics

F3 E3 Shea (24 decks)

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