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GI 2015 > Infectious Diarrhea > Flashcards

Infectious Diarrhea Flashcards

1
Q

Definition of diarrhea

A

More than 3 bms per day
Acute = less than 14 days
Chronic = more than 30 days

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2
Q

4 most common viruses

A

Norovirus
Rotavirus
Adenovirus
Astrovirus

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3
Q

6 Associated with beef poultry pork

A 
Staph
Clostridium
Salmonella
Campylobacter
Yersinia
Bacillus cereus
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4
Q

2 if hospitalized

A

C diff

Bacteroides fragilis

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5
Q

6 with fever

A 
Salmonella
Shigella
Campylobacter
C diff
Listeria
Entamoeba histolytica
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6
Q

Reheated rice

A

Bacillus cereus

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7
Q

4 Unpasteurized cheese, milk

A

Listeria
Ehec
Eiec
Campylobacter

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8
Q

5 with bleeding

A 
E. coli 0567:h7
Shigella
Campylobacter
Salmonella
Vibio parahemoliticus
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9
Q

Jaundice and increased lfts

A

Hep A

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10
Q

Pregnancy

A

Listeria

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11
Q

Pet lizard, turtle

A

Salmonella

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12
Q

3 with vomiting

A

Norovirus
Bacillus cereus
Staph

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13
Q

3 with veggies/salad

A

Ehec
Shigella
Bacillus cereus

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14
Q

2 seafood

A

Vibrio cholera

Vibrio parahemoliticus

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15
Q

Norovirus recent locations

A

Nursing homes, day area, cruise ships, hospitals

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16
Q

Norovirus long term consequences

A

Post viral gastroparesis

Irritable bowel

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17
Q

Norovirus rx

A

Supportive - self limited viruses, 48-72 hrs

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18
Q

2 types of salmonella

A

1) typhoid, outside of US, esp Asia and Southern Africa

2) non typhoid, inside US. Most common cause of bacterial food borne illness. Pet transmission.

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19
Q

Typhoid fever progression

A

Week 1 - stepwise fever, relative bradycardia (pulse-temperature dissociation)
Week 2 - abdominal pain and rose spots on trunk and abdomen
Week 3- heptosplenomegaly, GI bleeding, perforation, sepsis (15%)

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20
Q

Where does typhoid fever reside in chronic carriers?

A

Gallstones

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21
Q

Typhoid fever: presents with diarrhea or constipation?

A

Either is equally likely

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22
Q

Non typhoid all disease usually preceded by…?

A

Antibiotics

23
Q

Campylobacter 3 acute and 3 chronic complications

A

Acute: pseudo appendicitis, cholecystitis, pericarditis, myocarditis, septic pseudo aneurysm

Chronic: lymphoma, reactive arthritis, Guillian barre polyneuropathy

24
Q

Shigella is most similar to…?

A

EIEC

25
Q

Campylobacter animal association

A

Commensal in poultry

26
Q

Shigella course of disease

A

Intense inflammation, ulceration, entry into enterocytes via micropinocytosus, escape from vacuole, lateral spread to neighboring cells

27
Q

Shigella virulence factors

A

shet2 shet1 Shiga toxin(HUS)

28
Q

EHEC

A

Bloody diarrhea and deadly systemic illness in U.S.

29
Q

ETEC AND EPEC

A

Watery diarrhea in young children in developing countries

30
Q

EIEC

A

Uncommon, similar to shigella (dysentery)

31
Q

HUS triad

A

Acute renal failure
Microangiopathic hemolytic anemia
Thrombocytopenia

32
Q

EHEC and abx?

A

Don’t use them - higher risk of HUS

33
Q

ETEC: Heat labile vs heat stable

A

Labile - related to cholera toxin

Stable - increased chloride secretion and decreased sodium resorption, leading to loss of water and diarrhea

34
Q

EPEC effect

A

Attaching and effacing, tight junction disruption

35
Q

Cholera toxin

A

A subunit: cleaved into A1 and A2 in enterocyte. A1 irreversibly activates G protein, increasing cAMP and activating kinases, inhibiting NaCl transport and increasing Cl secretion.

B subunit: binds to ganglioside receptor on apical surface of enterocyte a

36
Q

Cholera, clinical

A

Painless rice water stool with fishy smell, up to 1 L per hour
Vomiting
Large losses of Na, K bicarbonate

37
Q

C Diff associated with which abx

A

Clindamycin, fluoroquinolone

38
Q

Two exotoxins in C diff? Which is more potent?

A

Toxin A - enterotoxin

Toxin B - cytotoxin, more potent

39
Q

C diff clinical findings

A

Watery diarrhea, cramping, fever, high leukocytosis, pseudomembranes

40
Q

C diff complications

A

Recurrent disease, toxic megacolon, complicating IBD

41
Q

C diff treatment

A

Metronidazole, vanco, fecal microbial transplant

42
Q

Clostridium perfringens risk factors and pathogenesis

A

Consumption of pig guts, sweet potatoes, psychiatric drugs. Produces enterotoxin and cause enteritis necroticans (pig bel)

43
Q

Bacteroides fragilis

A

Normal component of microbiome
Produces enterotoxin (fragilysin)
Similar to c diff presentation

44
Q

Yersinia enterocolitica

A 
Contaminated pork (chitterlings)
Ferrophilic
In children, fever, dysentery, pharyngitis, no abdominal pain, pseudo appendicitis
45
Q

Listeria monocytogenes

A

Pregnant women, immunosuppressed. Facultative intracellular
Joint pains and headache associated
Unpasteurized cheese
can lead to bacteremia and meningitis

46
Q

Staph

A

Heat stable enterotoxin

Vomiting abdominal cramping

47
Q

Bacillus cereus

A

Spore forming
Reheated fried rice
Direct ingestion of cereulide toxin

48
Q

Giardia

A

Most common parasite
Lots of people have it
Contaminated water
Fatty poop, weight loss, lactose intolerance, malabsorption

49
Q

Cryptosporidium

A

Intracellular protazoa
Children and HIV patients
Water outbreaks from contaminated reservoirs
Profuse watery diarrhea, nausea, abdominal pain, malaise, fever
Complication: cholangitis

50
Q

Entamoeba histolytica

A

90% asymptomatic
Invasive disease can cause dysentery and fulminant colitis
Rx is metronidazole and paromomomycin

51
Q

HIV extras

A

Cmb, cyclospora, isospora, microsporidium

52
Q

Scromboid

A

Histamine poisoning
Tuna, Swiss cheese
Anaphylaxis

53
Q

Ciguatera

A

Reef fish
Dinoflagellate
Weird symptoms

54
Q

Three broad categories of infectious diarrhea

A

Norovirus

Foodborne illness

C diff

GI 2015 (1 decks)

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