Infections of the GI System Flashcards
What is gastroenteritis?
It is the inflammatory process of the stomach or intestinal mucosal surface
Which type of gastroenteritis infection is caused by the pathogen entering the GI tract and multiplying, delay in appearance of symptoms and is accompanied by a fever?
Type 1 infection
What is a Type 2 gastroenteritis infection?
food poisoning, sudden appearance of symptoms because of the ingestion of the exotoxin, NO fever
Gastroenteritis infections and intoxications cause _ diarrhea
acute
What are the characteristics of gastroenteritis?
abdominal pain/ cramping, N&V, dehydration, weight loss, fever
What are the 3 clinical syndromes of acute diarrhea?
non-inflammatory, inflammatory, and invasive (subset of inflammatory)
Which type of acute diarrhea is most common in north america and is often referred to as “traveler’s diarrhea”?
non-inflammatory (secretory)
Which type of diarrhea is caused by viruses such as norovirus, rotavirus and bacteria such as enterotoxigenic E. coli, vibrio cholerae?
non-inflammatory (secretory)
Which type of diarrhea is characterized by infection of the small intestine leading to large volumes of watery diarrhea and ABSENCE of fecal leukocytes?
secretory
Which type of diarrhea is characterized by an infection in the colon, causing frequent small volume loose stools, with the PRESENCE of fecal leukocytes?
inflammatory
Which type of diarrhea has dysentery?
inflammatory
What bacteria often causes inflammatory diarrhea?
salmonella, shigella and campylobacter jejuni
When vomiting is a dominant symptom what should we consider?
viral infection or food poisoning
During the physical exam what 4 things are we looking for that will tell us the severity of the disease?
- orthostatic hypotension
- tachycardia
- decreased skin turgor
- dry mucous membranes
When is it not recommended to do a bacterial culture?
if patient has been in the hospital for > 72 hours and has a new onset of symptoms, likely due to C. diff
When are studies for ova and parasites indicated?
- persistent diarrhea (even tho treated with antibiotics)
- international or wilderness travel
- day care centers
- immunosuppression (HIV/AIDS)
Which bacteria can molecule assays identify?
- salmonella spp
- shigella spp
- campylobacter spp
- verocytotoxigenic E. coli
What medications can also cause diarrhea and must be on the look for?
- metformin
- colchicine
- diuretics
- ACE inhibitors
- PPIs magnesium containing antacids
- antibiotics
What is the initial focus for management of gastroenteritis?
rehydration
What are some agents to control diarrhea?
- bulking agents
- bismuth compounds (prevents water going into stool)
- antimotility drugs (only in non-inflammatory)
What agent that is used to control diarrhea is NOT to be used if person has inflammatory diarrhea?
antimotility drugs
Which type of therapy is recommended only in severe cases of infectious bacterial gastroenteritis when we do not expect a person to get better on their own?
empiric antibiotic therapy
what is the prefered method of treatment once positive stool culture or parasite is identified?
specific antimicrobial therapy
