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Ex3GI CM > Infections of the GI Tract- Schoenwald > Flashcards

Infections of the GI Tract- Schoenwald Flashcards

1
Q

Infectious diarrhea is ______ in onset and lasting

A

Acute in onset and lasting <2 weeks

So >2 weeks then unlikely infectious cause

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2
Q

Community outbreaks (nursing homes, schools, cruise ships) suggest ______ etiology or ______ _____ _____

A

Community outbreaks (nursing homes, schools, cruise ships) suggest viral etiology or common food source

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3
Q

Does tissue invasion occur in noninflammatory diarrhea?

A

No tissue invasion with non-inflamm so fecal leukocytes = negative

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4
Q

Give me some description of noninflammatory diarrhea

A

watery, nonbloody diarrhea that is associated with cramping, bloating, N/V

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5
Q

Which type of diarrhea (inflamm or noninflamm) has fever and bloody diarrhea?

A

Inflammatory diarrhea

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6
Q

This type of diarrhea involves primarily the lower colon quadrant cramping, urgency

A

Inflammatory diarrhea

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7
Q

Are fecal leukocytes present in Inflammatory diarrhea?

A

Yes, present because of invasion of mucosa

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8
Q

Diarrhea >______ days is most likely not due to infectious agent (except _______)

A

Diarrhea >14 days most likely not due to infectious agent (except C diff)

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9
Q

In inflammatory diarrhea, what should we NOT use for patients?

A

DO NOT USE promotility agents in inflammatory diarrhea

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10
Q

Why do we care about inflammatory or non-inflammatory diarrhea?

A

Major difference is colonic tissue invasion by the organism and/or toxin and so we know what to give promotility agents for (eg. Imodium)

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11
Q

name some typical stool pathogens

A
  • Salmonella
  • Shigella
  • Campylobacter
  • E. coli
  • C. diff
  • Entero and norovirus
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12
Q

Non inflammatory diarrhea is due to __________ production and does/does not invade colonic tissue?

A

Enterotoxin production, does not invade colonic tissue

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13
Q

Inflammatory diarrhea is due to __________ production and does/does not invade colonic tissue?

A

cytotoxin production and invades colonic tissue and MUCOSA

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14
Q

Name 4 enterotoxin producing noninflammatory pathogens

A

“SBEV”

Staph, bacillus, enterotoxigenic E. coli, vibrio

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15
Q

Name 2 cytotoxin producing inflammatory pathogens and then 3 muscosal invader pathogens

A

Enterohemorrhagic e coli & C. diff

Shigella, salmonella, campylobacter

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16
Q

If you have C. diff, the main symptom is _______

A

diarrhea

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17
Q

What medications are major risk factors for C. diff?

A

*Clindamycin, penicillins, cephalosporins

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18
Q

This is a sign of what?

Three or more unformed stool over 24 hours for 2 consecutive days in conjunction with positive stools for pseudomembranes

A

C. diff infection

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19
Q

What are some clinical findings of C. diff?

A
  • watery diarrhea with 15-30 bowel movements/day

- abd cramping, fever

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20
Q

C. diff lab findings show ________ often with bandemia, hypo_______- and positive ________

A
  • Leukocytosis with bandemia (left shift)
  • hypoalbuminemia
  • positive stool C. diff test
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21
Q

If patient has symptoms of C. diff, how should we test for this?

A
  1. Toxin testing (high rate of false negs though)
  2. Molecular PCR (sensitive and specific) but patients can be asymptomatic and + so hospitals would have to report and thats bad

*can be an asymptomatic carrier of C. diff

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22
Q

What is the treatment for a C. diff infection?

A

Vancomycin PO!!!

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23
Q

Labs for mild C. diff/initial episode show what?

A

Leukocytosis <15000

Creat <1.5

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24
Q

Labs for initial episode of severe C. diff show what?

A

Leukocytosis >15000

Creat >1.5

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25
What is the tx for initial episode of severe C. diff?
Vancomycin PO!!!
26
For complicated C. diff infection with hypotension, shock or perforation, what is the tx?
Vancomycin PO and/or metronidazole
27
Salmonella is a problem in people with ________
sickle cell
28
Salmonella is a gram _____ _____
negative rod
29
This bug is associated with handling reptiles and also from eating contaminated meat or eggs from infected food handlers
Salmonella
30
Patients with salmonella can remain culture + for __ _______ after treatments and can be ________
can be culture + for one month and can be long term carriers
31
What is the incubation period of salmonella
6-48 hrs
32
What are the two most common symptoms of salmonella?
Fever & diarrhea
33
Are bloody stools in salmonella common?
No
34
What is the tx for uncomplicated salmonella?
Most cases are self limiting if uncomplicated and no antibiotic treatment is necesscary
35
What is the tx for complicated salmonella?
Cipro is the tx of choice
36
If a patient has a joint in place, other surgeries, graft in place, or a patient has sickle cell, what is the TOC for salmonella?
Bactrim
37
What is a main symptoms of typhoid fever?
- constipation - skin rash on torso and back - diarrhea
38
"rose colored skin rash" should make you think of what?
Typhoid fever
39
What is the tx for typhoid fever?
Fluroquinolone (Fluoroquinolone= F fever)
40
What is the current recommendation for mild typhoid cases?
azithromycin
41
What is the current recommendation for severe typhoid cases, especially in cases with history of travel to SE asia?
carbapenems "penems"
42
This bug is typically linked with daycare and diarrhea
Shigella
43
Shigella is a gram ______ ____
Shigella is a gram negative rod
44
What is the incubation time for shigella?
Incubation 12 hours to 4 days
45
Symptoms of this disease are diarrhea (bloody, watery, pus and mucus)- secretory
Shigella
46
What is the treatment for shigella?
-Rehydration and Cipro
47
Campylobacter is a gram ______ ___ that comes from sausages, hard meats and undercooked chicken
gram negative rod
48
This bug has symptoms of low grade fever- often a prodrome of fever, HA, myalgia and malaise
Campylobacter
49
What is the treatment for campylobacter?
Cipro (Campylobacter = C Cipro)
50
Guillain Barre causes _______ paralysis
ascending paralysis
51
Campylobacter infections can also be associated/cause what three things?
- bacteremia <1% - guillain barre - reactive arthritis
52
This E. coli pathogen is in 80% of traveler's diarrhea?
Enterotoxigenic-shiga toxin
53
This E. coli pathogen can be very bad and cause HUS?
Enterohemmorhagic-shiga toxin E.Coli 0157-H7
54
A major pathogen involved in bloody diarrhea is what? Can also cause HUS?
Enterohemmorhagic-shiga toxin E.Coli 0157-H7
55
What is the triad of HUS?
- Acute renal insufficiency - Hemolytic anemia - Thrombocytopenia
56
If ADAM13 is negative, you have _____
HUS
57
If ADAM13 is negative, you have ____
TTP
58
You will have a + or - Coombs test in Ecoli 0157:H7?
Negative coombs
59
What is the treatment for Ecoli 0157:H7 (enterohemorrhagic shiga toxin)?
supportive care
60
Staph food poisioning is from a ______, not bacteria
toxin
61
What foods is staph food poisioning common in?
Foods high in salt or sugar content (cream sauces, custard, hams, canned meat)
62
This bug has a rapid onset of 4-8 hours and is like when all the people eat at a party and rush to the bathroom at the same time
Staph food poisioning
63
Treatment for Staph food poisioning?
Supportive care
64
Listeria is typically caused by ________
foodborne
65
What people are more susceptible to listeria infection?
pregnancy and immunosuppressed
66
Symptoms of _______: fever, hypotension, tachycardia
listeria
67
Previous _________ use is a predisposing RF for listeria
corticosteroid use
68
What is the tx of choice for Listeria?
Ampicillin (crosses the blood brain barrier to treat meningitis) *ampicillin has a lot of L and listeria starts with L
69
Treatment for Enterotoxigenic E coli?
- Cipro - Trimeth/sulfa - Azithro
70
This is a waterborne pathogen resulting in massive secretion from small bowel
cholera
71
What is the incubation of vibrio cholera?
12-72 hours after ingestion
72
Symptoms of vibrio cholera?
"Rice water stools" | -rapid dehydration
73
"Rice water stools" should make you think of what?
vibrio cholera
74
What is the treatment for cholera?
HYDRATION HYDRATION HYDRATION & Doxy or Cipro
75
This disease is known as the cruise ship virus and is inflammation of the stomach and intestinal tract
Viral gastroenteritis (norovirus)
76
What is the mc cause for Viral gastroenteritis?
norovirus
77
What is the transmission of norovirus?
Person to person contact, contaminated food and water, airborne
78
What are the symptoms of norovirus?
- sudden onset vomiting or diarrhea - nausea - fever - abd cramping - 1 to 3 days
79
Tx for norovirus?
Its self limiting
80
Food handlers should stay away from work for ___to ____ ____ after symptoms of norovirus resolve
Food handlers should stay away from work for 48-72 hours after symptoms of norovirus resolve
81
What is the GOLD STANDARD test for GI pathogens?
stool culture

Ex3GI CM (15 decks)

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