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Cam's Cards COPY > Infectious Diarrhea > Flashcards

Infectious Diarrhea Flashcards

1
Q

How long does acute diarrhea typically last?

A

Less than 2 weeks (except for C. diff)

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2
Q

Community outbreaks of acute diarrhea typically suggests which of the following:
Viral etiology
Bacterial pathogen
Common food source

A

Viral etiology or common food source

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3
Q

Describe stool in noninflammatory diarrhea.

A

Watery diarrhea without blood

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4
Q

Fecal smear of noninflammatory diarrhea does NOT have _______

A

Fecal leukocytes

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5
Q

Describe stool in inflammatory diarrhea.

A

Bloody diarrhea

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6
Q

Typical symptoms associated with noninflammatory diarrhea?

A

Cramping, bloating, nausea, vomiting

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7
Q

Typical symptoms associated with inflammatory diarrhea?

A

Fever, LLQ pain, urgency

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8
Q

Inflammatory diarrhea causes blood and fecal leukocytes to be present. Why?

A

Bacteria or toxin invades colonic tissue causing tissue damage

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9
Q

In what type of diarrhea is it okay to use promotility agents or antimotility agents?

A

Non-inflammatory diarrhea

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10
Q

Why shouldn’t you use promotility or antimotility agents in inflammatory diarrhea?

A

Promotility: risk of dehydration
Antimotility: allows bacteria and toxin to stay in place for a longer amount of time

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11
Q

Bacteria that produce enterotoxin cause noninflammatory diarrhea. What bacteria produce enterotoxin?

A

Staph aureus, Bacillus cereus, Enterotoxigenic E. coli, Vibrio cholerae

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12
Q

What are the other causes of noninflammatory diarrhea?

A

Norovirus, Rotavirus, Giardia, Cryptosporidium, Listeria monocytogenes

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13
Q

What cytotoxin producing bacteria cause inflammatory diarrhea?

A

Enterohemorrhagic E coli. 0157:H7, C. Diff

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14
Q

What are the mucosal invading pathogens of inflammatory diarrhea?

A

Camylobacter, Shigella, Salmonella

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15
Q

What two other pathogens of inflammatory diarrhea?

A

Cytomegalovirus, Entamoeba histolytica

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16
Q

Risk factors for C. diff infections?

A

Antibiotics use, typically clindamycin, penicillin, and cephalosporins

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17
Q

What symptoms must be present for C. diff infection?

A

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

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18
Q

Lab findings in C. diff?

A

Leukocytosis with left shift
Hypoalbuminemia
Positive stool C. diff test

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19
Q

What is the correct sequence of C. diff tests to order?

A

Toxin testing, if negative, consider PCR

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20
Q

Downside of C. diff PCR test?

A

It is so good it can pick up asymptomatic carriers.

We don’t really know what to do for them, so try not to go there

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21
Q

First line treatment for C. Diff?

A

Vancomycin 125mg PO QID

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22
Q

Treatment for C. diff accompanied by hypotension or shock or toxic megacolon?

A

Vanco 500 PO QID+/- metronidazole

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23
Q

Treatment for 2nd recurrence of C. diff?

A

Vanco oral taper

Fecal microbiota transplant

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24
Q

What new medication works as well as vanco for C. diff?

A

Fidaximin

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25
Q

Salmonella most commonly from acquired from?

A

Contaminated meat or eggs

Infected food handlers

26
Q

Incubation period for salmonella?

A

6-48 hours

27
Q

Common symptoms of salmonella?

A

Fever and diarrhea

28
Q

Treatment for uncomplicated salmonella?

A

Supportive care - it is self limiting

29
Q

Treatment for complicated salmonella?

A

Cipro

30
Q

Typhoid fever is caused by what bacteria?

A

Salmonella typhi

31
Q

T/F? Typhoid fever is endemic in US

A

False

32
Q

Symptoms of typhoid fever?

A

Diarrhea or constipation, maculopapular rose color skin rash, fever, abd pain, weakness

33
Q

Diagnosis of typhoid fever is?

A

Clinical diagnosis + travel history

34
Q

Treatment for typhoid fever?

A

Azithromycin for mild cases.

Carbapenems for severe cases

35
Q

Most common ways to spread shigella?

A

Inanimate objects*** - think day care
Fecal oral
Flies

36
Q

Symptoms of shigella?

A 
Diarrhea (bloody, watery, purulent, and mucous)
Fever
Stomach cramps
Nausea
Emesis
Dehydration
37
Q

Treatment for shigella?

A

Cipro

38
Q

Most common cause of bacterial GI symptoms?

A

Campylobacter

39
Q

One symptom of campylobacter that differentiates it from other causes of infectious diarrhea is what?

A

A prodrome of fever, headache, myalgia, and malaise

40
Q

Treatment for campylobacter?

A

Cipro

41
Q

Complication of campylobacter?

A

Guillain Barre syndrome

42
Q

Most common cause of “traveler’s diarrhea”?

A

Enterotoxigenic E coli shiga toxin + or -

43
Q

Main cause of HUS in US?

A

E Coli 0157:H7

44
Q

Sources of E oli 0157

A

Undercooked ground beef, unpasteurized juices and milk

45
Q

Triad of HUS symptoms?

A

Renal insufficiency
Hemolytic anemia
Thrombocytopenia

46
Q

Treatment for E coli 0157?

A

Supportive

47
Q

Most common cause of staph food poisoning?

A

Foods with high salt or sugar - think cream sauces, custard, hams, canned meat

48
Q

Onset of staph food poisoning?

A

Rapid 4-8 hours

49
Q

Treatment for staph food poisoning?

A

Supportive care

50
Q

Staph food poisoning typically lasts no longer than _____

A

24 hours

51
Q

What noninflammatory diarrhea can cause spontaneous abortion, sepsis, bacteremia, and meningitis?

A

Listeria monocytogenes

52
Q

Treatment for listeria?

A

Ampicillin

53
Q

Diagnosis of this noninflammatory diarrhea is done by stool culture or PCR.

A

Enterotoxigenic E coli non 0157 strains

54
Q

Treatment options for enterotoxigenic e coli?

A

Cipro

55
Q

Common sources of Vibrio cholera infections?

A

Poor water sanitation, shellfish

56
Q

Incubation period of Vibrio cholera?

A

12-72 hours

57
Q

Description of stools in cholera?

A

“rice water stools”

58
Q

Treatment for Vibrio cholera?

A

HYDRATION!!!!

and doxycycline or cipro

59
Q

Most common cause of nonbacterial gastroenteritis?

A

Norovirus

60
Q

Gold standard test for norovirus?

A

Stool culture

61
Q 
Does the following pathogen cause infectious or non infectious diarrhea?
Staph aureus
Vibrio cholerae
Shigella
Giardia
Cytomegalovirus
Campylobacter
C. diff
Rotavirus
Giardia
Salmonella
E coli 1057:H7
Bacillus cereus
Enterotoxigenic E coli
Listeria
A 
Staph aureus - noninflammatory
Vibrio cholerae - noninflammatory
Shigella - inflammatory
Giardia - noninflammatory
Cytomegalovirus - inflammatory
Campylobacter - inflammatory
C. diff - inflammatory
Rotavirus - noninflammatory
Entamoeba histolytica - inflammatory
Salmonella - inflammatory
E coli 1057:H7 - inflammatory
Bacillus cereus - noninflammatory Enterotoxigenic E coli - noninflammatory
Listeria - noninflammatory

Cam's Cards COPY (93 decks)

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