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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
Q

What is the tx for initial episode of severe C. diff?

A

Vancomycin PO!!!

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26
Q

For complicated C. diff infection with hypotension, shock or perforation, what is the tx?

A

Vancomycin PO and/or metronidazole

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27
Q

Salmonella is a problem in people with ________

A

sickle cell

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28
Q

Salmonella is a gram _____ _____

A

negative rod

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29
Q

This bug is associated with handling reptiles and also from eating contaminated meat or eggs from infected food handlers

A

Salmonella

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30
Q

Patients with salmonella can remain culture + for __ _______ after treatments and can be ________

A

can be culture + for one month and can be long term carriers

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31
Q

What is the incubation period of salmonella

A

6-48 hrs

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32
Q

What are the two most common symptoms of salmonella?

A

Fever & diarrhea

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33
Q

Are bloody stools in salmonella common?

A

No

34
Q

What is the tx for uncomplicated salmonella?

A

Most cases are self limiting if uncomplicated and no antibiotic treatment is necesscary

35
Q

What is the tx for complicated salmonella?

A

Cipro is the tx of choice

36
Q

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?

A

Bactrim

37
Q

What is a main symptoms of typhoid fever?

A
  • constipation
  • skin rash on torso and back
  • diarrhea
38
Q

“rose colored skin rash” should make you think of what?

A

Typhoid fever

39
Q

What is the tx for typhoid fever?

A

Fluroquinolone (Fluoroquinolone= F fever)

40
Q

What is the current recommendation for mild typhoid cases?

A

azithromycin

41
Q

What is the current recommendation for severe typhoid cases, especially in cases with history of travel to SE asia?

A

carbapenems “penems”

42
Q

This bug is typically linked with daycare and diarrhea

A

Shigella

43
Q

Shigella is a gram ______ ____

A

Shigella is a gram negative rod

44
Q

What is the incubation time for shigella?

A

Incubation 12 hours to 4 days

45
Q

Symptoms of this disease are diarrhea (bloody, watery, pus and mucus)- secretory

A

Shigella

46
Q

What is the treatment for shigella?

A

-Rehydration and Cipro

47
Q

Campylobacter is a gram ______ ___ that comes from sausages, hard meats and undercooked chicken

A

gram negative rod

48
Q

This bug has symptoms of low grade fever- often a prodrome of fever, HA, myalgia and malaise

A

Campylobacter

49
Q

What is the treatment for campylobacter?

A

Cipro (Campylobacter = C Cipro)

50
Q

Guillain Barre causes _______ paralysis

A

ascending paralysis

51
Q

Campylobacter infections can also be associated/cause what three things?

A
  • bacteremia <1%
  • guillain barre
  • reactive arthritis
52
Q

This E. coli pathogen is in 80% of traveler’s diarrhea?

A

Enterotoxigenic-shiga toxin

53
Q

This E. coli pathogen can be very bad and cause HUS?

A

Enterohemmorhagic-shiga toxin

E.Coli 0157-H7

54
Q

A major pathogen involved in bloody diarrhea is what? Can also cause HUS?

A

Enterohemmorhagic-shiga toxin

E.Coli 0157-H7

55
Q

What is the triad of HUS?

A
  • Acute renal insufficiency
  • Hemolytic anemia
  • Thrombocytopenia
56
Q

If ADAM13 is negative, you have _____

A

HUS

57
Q

If ADAM13 is negative, you have ____

A

TTP

58
Q

You will have a + or - Coombs test in Ecoli 0157:H7?

A

Negative coombs

59
Q

What is the treatment for Ecoli 0157:H7 (enterohemorrhagic shiga toxin)?

A

supportive care

60
Q

Staph food poisioning is from a ______, not bacteria

A

toxin

61
Q

What foods is staph food poisioning common in?

A

Foods high in salt or sugar content (cream sauces, custard, hams, canned meat)

62
Q

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

A

Staph food poisioning

63
Q

Treatment for Staph food poisioning?

A

Supportive care

64
Q

Listeria is typically caused by ________

A

foodborne

65
Q

What people are more susceptible to listeria infection?

A

pregnancy and immunosuppressed

66
Q

Symptoms of _______: fever, hypotension, tachycardia

A

listeria

67
Q

Previous _________ use is a predisposing RF for listeria

A

corticosteroid use

68
Q

What is the tx of choice for Listeria?

A

Ampicillin (crosses the blood brain barrier to treat meningitis)

*ampicillin has a lot of L and listeria starts with L

69
Q

Treatment for Enterotoxigenic E coli?

A
  • Cipro
  • Trimeth/sulfa
  • Azithro
70
Q

This is a waterborne pathogen resulting in massive secretion from small bowel

A

cholera

71
Q

What is the incubation of vibrio cholera?

A

12-72 hours after ingestion

72
Q

Symptoms of vibrio cholera?

A

“Rice water stools”

-rapid dehydration

73
Q

“Rice water stools” should make you think of what?

A

vibrio cholera

74
Q

What is the treatment for cholera?

A

HYDRATION HYDRATION HYDRATION

& Doxy or Cipro

75
Q

This disease is known as the cruise ship virus and is inflammation of the stomach and intestinal tract

A

Viral gastroenteritis (norovirus)

76
Q

What is the mc cause for Viral gastroenteritis?

A

norovirus

77
Q

What is the transmission of norovirus?

A

Person to person contact, contaminated food and water, airborne

78
Q

What are the symptoms of norovirus?

A
  • sudden onset vomiting or diarrhea
  • nausea
  • fever
  • abd cramping
  • 1 to 3 days
79
Q

Tx for norovirus?

A

Its self limiting

80
Q

Food handlers should stay away from work for ___to ____ ____ after symptoms of norovirus resolve

A

Food handlers should stay away from work for 48-72 hours after symptoms of norovirus resolve

81
Q

What is the GOLD STANDARD test for GI pathogens?

A

stool culture

Ex3GI CM (15 decks)

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