infectious diarrhea

Question 1

normal stool volume

Answer 1

3-7 BM/day

< 1 liter stool/day

Question 2

acute infectious diarrhea

Answer 2

20-30 BM/day

up to 20 liters stool per day

Question 3

what does diarrhea reflect?

Answer 3

increased water in the stool

• increased intestinal secretion of water or
• decreased intestinal reabsorption of water

Question 4

acute diarrhea

Answer 4

< 14 days

Question 5

persistent diarrhea

Answer 5

14-30 days

Question 6

chronic diarrhea

Answer 6

> 30 days

Question 7

pseudodiarrhea

Answer 7

increased frequency of bowel movements

Question 8

fecal incontinence

Answer 8

can’t hold it in, involuntary

Question 9

overflow incontinence

Answer 9

people who are constipated, fecal impaction and liquid stool leaks out thats backed up behind impaction

Question 10

chronic diarrhea causes

Answer 10

watery: no form
fatty: greasy, floating
inflammatory: bloody, pus

Question 11

when does secretory diarrhea usually occur?

Answer 11

at night

Question 12

what is osmotic diarrhea usually related to?

Answer 12

over eating

Question 13

who tends to have fatty diarrhea?

Answer 13

those with celiac disease or Giardiasis

Question 14

who tends to have inflammatory diarrhea

Answer 14

ulcerative colitis, cystic fibrosis

Question 15

causes of acute diarrhea

Answer 15

1. viral infections
2. more severe diarrhea more likely bacterial
3. protozoa least common

Question 16

C. perfringens

Answer 16

enterotoxin produced by bacteria in small intestine

-acute gastroenteritis symptoms

Question 17

C. botulinum

Answer 17

paralytic neurotoxin formed by bacteria present in anaerobic environment
-weakness diplopia, progresses to paralysis
botulism

Question 18

C. tetani

Answer 18

excitatory neurotoxin formed by bacteria presents in wounds

“lockjaw”

Question 19

C. difficile

Answer 19

toxin mediated colitis caused by overgrowth of C. difficile in colon
-pseudomembranous colitis

Question 20

staph A likely food source

Answer 20

salads, dairy

Question 21

B. cereus likely food sounce

Answer 21

rice, meat

Question 22

Norwalk likely food source

Answer 22

shellfish, salads, sandwiches, fruit

Question 23

non-typhoidal salmonella likely food source

Answer 23

eggs, poultry, meat, unpasterized milk, juice

Question 24

shiga toxin producing E. coli likely food source

Answer 24

ground beef, unpasterized milk, juice, raw vegetables,

water, spinach

Question 25

V. parahemolyticus likely food source

Answer 25

raw shellfish

Question 26

epidemiology of rotavirus

Answer 26

daycares centers

Question 27

epidemiology of noroviruses

Answer 27

cruise ships

Question 28

epidemiology of hepatitis A

Answer 28

MSM, shellfish, food workers, overcrowding, lack of clean water

Question 29

epidemiology of giardia lamblia

Answer 29

travel, surface water, daycare centers

Question 30

tests for acute diarrhea

Answer 30

1. routine stool culture
2. ova/parasites
3. endoscopy

Question 31

treatment of acute diarrhea

Answer 31

1. oral hydration
2. symptomatic therapy: anti-motility agents (loperamide, diphenoxylate), bismuth subsalicylate (pepto-bismol)
3. probiotics
4. dietary alterations
5. empiric antibiotics

Question 32

ETEC

Answer 32

traveler’s diarrhea

Question 33

some causes of inflammatory diarrhea

Answer 33

Camplobacter, shigella, salmonella, EHEC, C. difficile

Question 34

organisms that won’t cause inflammatory diarrhea

Answer 34

norwalk, rotavirus, C. perfringens, S. aureus, B. cereus, Giardia

Question 35

when would you not want to use anti-motility agents for treatment of acute diarrhea?

Answer 35

if they have an infection

-can get toxic megacolon.

Question 36

if take pepto-bismol, what should you warn them about their stools?

Answer 36

its going to appear black