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DEMS unit 1 > Infectious Diarrhea > Flashcards

Infectious Diarrhea Flashcards

1
Q

Leading 2 causes of death worldwide

A

pneumonia, diarrhea

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2
Q

leading cause of morbidity and death

A

Dehydration

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3
Q

important part of therapy for dehydration/diarrhea

A

Rehydration

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4
Q

Most common cause of infectious gastroenteritis in US

A

unknown!! (40%)

Viral (30-40%)
Bacterial/Parasitic (20-30%)

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5
Q

GI site implicated in non-inflammatory diarrhea

A

upper small bowel

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6
Q

GI site implicated in inflammatory diarrhea

A

colon

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7
Q

what might labs show in inflammatory diarrhea

A

increased T cells, WBC, RBC

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8
Q

pathogens causing Non-inflammatory diarrhea

A

vibrio cholerae, Norwalk, Rotavirus, ETEC, Giardia

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9
Q

Inflammatory diarrhea pathogens

A

C. JEJUNI, Shigella, Salmonella, E. coli O157:H7, C difficile, E. histolytica

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10
Q

What makes cholera infectious

A

Toxin (A:5B)

- similar to ETEC

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11
Q

symptoms of cholera

A
  • abrupt diarrhea, vomiting

- “rice water stool” up to 24 L per day (yellowish–probably mucin)

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12
Q

how does cholera affect mucosa

A

binds epithelial cells and causes secretion – not really harming epithelium

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13
Q

incubation period of cholera

A

18h - 5 days

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14
Q

Blood in cholera diarrhea?

A

NO

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15
Q

Oral rehydration solution

A

water, a little salt, carbohydrate (sugar)

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16
Q

what infectious agent similar to cholera toxin?

A

ENEC - enterotoxic E coli

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17
Q

What is the leading cause of prolonged diarrhea

A

Rotavirus

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18
Q

Leading cause of dehydration from diarrhea

A

Rotavirus

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19
Q

leading cause of hospitaliziation from diarrhea

A

Rotavirus

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20
Q

Leading cause of death from diarrhea (US and world)

A

Rotavirus (due to prolonged diarrhea and dehydration)

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21
Q

Rotavirus vaccine

A

live attenuated vaccine;

  • Efficacy in US >90%
  • Efficacy in developing countries 17-65%
22
Q

Incubation pd and duration of illness of rotavirus

A

1-3 days incubation; duration 5-8 days usually

23
Q

age mostly affected by rotavirus

A

infants, young children

24
Q

age mostly affected by norwalk virus

A

older children adults

25
Q

Norwalk transmission

A

fecal-oral, contaminated.

- shellfish and water

26
Q

Rotavirus transmission

A

fecal-oral

27
Q

Epidemiology of rotavirus

A

sporadic cases, usually winter, occasionally epidemic

28
Q

Norovirus epidemiology

A

family and community epidemics, often winter; comes on fast/goes away fast

29
Q

incubation pd and duraiton of norovirus

A

1-2 days incubation and 1-2 day duration

30
Q

therapy for norovirus/rotavirus

A

none really; vaccine work on rotavirus

31
Q

giardia

A

eukaryote –protozoan

32
Q

Giardia symptoms

A

diarrhea, fatigue, abdominal cramps, gas, fatty stool, stomach makes noises

33
Q

cause of most hemorrhagic colitis in US

A

E coli O157:H7

34
Q

E coli O157:H7 population affected/duration

A

lasts 2-4 days (

35
Q

source of E coli O157:H7

A

mostly meat

36
Q

symptoms of E coli O157:H7

A
  • large spectrum of illness
  • asymptomatic
  • nonbloody diarrhea
  • hemorrhageic colitis
  • Hemolytic uremic syndrome (HUS)
  • thrombocytic thrombocytopenic purpura (TTP)
37
Q

what makes E coli O157:H7 so bad

A

toxin!

38
Q

what happens when you give antibiotics to someone with E coli O157:H7

A

lyse cells so that toxin released…more toxin production?

39
Q

Nosocomial diarrhea definition

A

-hospital-acquired; >3 days in hospital

40
Q

leading cause of nosocomial diarrhea

A

C. difficile

41
Q

reason for C difficile infection

A

disruption of normal microbiota– most commonly associated with antibiotic use

42
Q

C difficile symptoms

A

mild diarrhea, watery or bloody, may have fever, leukocytosis with severe colitis

43
Q

Therapy for C difficile

A

antibiotics, recurrence (15-26%)– bug can persist and you have knocked out all other bugs in GI–hard to get balance back

  • Fecal transplant if a few rounds
  • working on pills of fecal microbiota
44
Q

1 cause of traveler’s diarrhea

A

Enterotoxic E coli

45
Q

No fever suggests what kind of diarrhea?

A

non-inflammatory diarrhea

46
Q

when diarrhea doesn’t respond to antibiotics consider what org?

A

Giardia

47
Q

grossly bloody diarrhea without fever suggests what org

A

E coli O157:H7

48
Q

E. coli O157H7 toxin

A

Verotoxin; shiga-like toxin (SLT-I/II)

  • binds especially to human renal endothelial cells
  • inhibits protein synthesis
49
Q

Therapy of E. coli 0157H7

A

TMP/SMX- all sensitive

  • IV Ig?
  • Prevention (food, cooking)
50
Q

Enteric Fever

A

Site: Nodes, blood, gallbladder

- Pathogens: Salmonella typhi, paratyphi, +/- Yersinia

51
Q

Typhoid fever

A
  • caused by Salmonella enteric serotype typhi
  • Gram (-) rod; human only
  • risks: fecal contamination, food/water (poor handling), contact with carrier

DEMS unit 1 (15 decks)

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