Infectious Diarrhea

Question 1

describe type 7 diarrhea

Answer 1

entirely liquid stool

Question 2

describe type 6 diarrhea

Answer 2

mushy stool

Question 3

Diarrhea is defined as _______ or more loose or liquid stools in 24 hours

Answer 3

3

Question 4

prolonged diarrhea is how many days?
persistent diarrhea?
chronic diarrhea?

Answer 4

7-13
14-29
30 or more

Question 5

dysentery diarrhea describes?

Answer 5

inflammatory diarrhea associated with blood and pus

Question 6

watery diarrhea is typically caused by a ______ infection, commonly due to __________

Answer 6

viral, norovirus

Question 7

bloody diarrhea is typically caused by a ______ infection, commonly due to __________

Answer 7

bacterial, c. diff, entamoeba, Yersinia, or E. coli

Question 8

what are rare rxns from bloody diarrhea?

Answer 8

Guillain-barre syndrome
hemolytic uremic syndrome
toxic megacolon
reactive arthritis

Question 9

when do we perform lab tests for infectious diarrhea?

Answer 9

bloody diarrhea
fever/signs of sepsis
diarrhea longer than 7 days
pt is immunocompromised

Question 10

viruses are the most common cause of ____ diarrhea

Answer 10

acute

Question 11

when is empiric antibiotic therapy indicates for diarrhea?

Answer 11

traveler’s diarrhea
bloody with fever and abdominal pain
infant under 3 months
immunocompromised patient

Question 12

in the absence of signs and symptoms of inflammatory infection, you should suspect _____ infection and avoid _____

Answer 12

viral, antibiotics

Question 13

do NOT use antibiotics in _____________ due to increased risk of hemolytic uremic syndrome

Answer 13

shiga-toxin producing E. coli

Question 14

do NOT use antibiotics in shiga-toxin producing E. coli due to increased risk of _______________

Answer 14

hemolytic uremic syndrome

Question 15

studies have shown that antibiotics may reduce symptom duration in adults with severe diarrhea by _____

Answer 15

1 day

Question 16

what antimotility agents can be used and what type of diarrhea are they indicated for?

Answer 16

diphenoxylate, atropine and loperamide for watery diarrhea

Question 17

antimotility agents should be avoided with _______________ and bloody diarrhea

Answer 17

shiga-toxin producing e. coli

Question 18

norovirus is treated with? avoid?

Answer 18

rehydration, avoid antimotility agents

Question 19

T/F there is a vaccine to prevent norovirus

Answer 19

false

Question 20

T/F there is a vaccine to prevent rotavirus

Answer 20

true

Question 21

what vaccines help prevent traveler’s diarrhea?

Answer 21

live cholera vaccine
hep A
salmonella (typhoid) vaccine

Question 22

what OTC med can prevent traveler’s diarrhea, but is not commonly recommended?

Answer 22

bismuth subsalicylate

Question 23

when do we consider prophylactic antibiotics to prevent traveler’s diarrhea?

Answer 23

immunocompromised patients on short-term travel
critical travel (military)

Question 24

what is first-line tx for traveler’s diarrhea?
what about other options?

Answer 24

azithromycin

levo/ciprofloxacin
rifamycin
rifaximin

Question 25

what should be in a travel kit to prepare for traveler's diarrhea?

Answer 25

loperamide thermometer oral rehydration solution water purification method

Question 26

what is a good resource for travel medicine?

Answer 26

yellow book

Question 27

what is the most common cause of foodborne illness in the US?

Answer 27

norovirus

Question 28

a patient is diagnosed with foodborne illness after going to a new restaurant last week. The patient reported eating a salad with oysters. What is the most likely organism causing the symptoms? a. Rotavirus b. Clostridium perfringens c. Norovirus d. Clostridium botulinum

Answer 28

c

Question 29

a patient is diagnosed with foodborne illness after going to a new restaurant last week. The patient reported eating clams for dinner and has bloody diarrhea. what is the most likely organism causing the symptoms? a. Campylobacter b. Norovirus c. E. coli d. Clostridium difficile

Answer 29

a

Question 30

clostridium perfringens can cause foodborne illness from eating what? a. unpasteurized dairy, clams, or dirty water b. leafy greens, fruit, shellfish, or dirty water c. Improperly canned or fermented foods d. Beef, poultry, gravy, dried or precooked foods

Answer 30

d

Question 31

clostridium botulinum can cause foodborne illness and is found in ______. A main symptoms is descending ______

Answer 31

honey, paralysis

Question 32

_________ increases the risk of being exposed to salmonella

Answer 32

handling animals

Question 33

unpasteurized milk, soft cheeses, raw sprouts, melons, hot dogs, deli meats, and smoked seafood have the risk of causing what foodborne illness?

Answer 33

listeria

Question 34

what foodborne infection can lead to miscarriage, stillbirth and premature delivery?

Answer 34

listeriosis

Question 35

which antibiotics have the highest risk of c. diff?

Answer 35

clindamycin carbapenems fluoroquinolones cephalosporins broad spectrum penicillins

Question 36

what is the enzyme test for c. diff?

Answer 36

glutamate dehydrogenase

Question 37

what is the PCR test for c. diff?

Answer 37

NAAT

Question 38

Non-severe c. diff infection is a WBC ________ and SCr ________. what are the antibiotics used?

Answer 38

< 15,000, < 1.5 First line: fidaxomicin alt.: vanco third line: metronidazole

Question 39

Severe c. diff infection is a WBC ________ and SCr ________. what are the antibiotics used?

Answer 39

> 15,000, > 1.5 first line: fidaxomicin alt: vancomycin

Question 40

Fulminant c. diff infection presents as hypotension or shock or megacolon and is treated with what antibiotics?

Answer 40

oral vanco AND IV metronidazole

Question 41

when is a fecal microbiota transplant considered for a c. diff infection?

Answer 41

after 3 recurrent cases of C. diff

Question 42

when is bezlotoxumab contraindicated for treating c. diff?

Answer 42

pt with CHF