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Gastrointestinal > Infectious Diarrhea > Flashcards

Infectious Diarrhea Flashcards

1
Q

Causative agent of salmonellosis

A

Salmonella bongori
Salmonella enterica

GNR

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2
Q

Reservoir of salmonellosis (6)

A 
poultry is most common
pet reptiles
swine
cows
rodents
pets
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3
Q

General of Salmonellosis

A

An acute, febrile, bacterial diarrhea typically caused by consumption of raw or undercooked poultry products (meat, eggs)

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4
Q

Sequelae of Salmonellosis

A
  • Irritable bowel syndrome

- Reactive arthritis (Reiter syndrome - can’t see, can’t pee, can’t climb a tree)

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5
Q

Diagnostics of Salmonellosis

A

Stool culture is gold standard

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6
Q

Management of Salmonellosis

A
  • Usually supportive

- Antibiotics in severe cases (high risk groups) x 7-14 days

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7
Q

Causative organisms of Shigellosis (4)

A
  • Shigella dysenteriae – more aggressive
  • Shigella flexneri – less-developed nations
  • Shigella boydii
  • Shigella sonnei – developed nations, milder disease

GNR

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8
Q

Reservoirs of Shigellosis

A

contaminated water, food,

produce grown where sewage used as fertilizer

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9
Q

Salmonellosis clinical manifestations

A

Fever
Bloody diarrhea

Invasive disease: bacteremia, meningitis, septic arthritis, osteomyelitis, sickle cell patients are at particular risk of bone complications

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10
Q

Shigellosis rapidly spreads in…

A 
military campaigns 
day care centers
prisons
refugee camps
households
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11
Q

Shigellosis clinical manifestations

A

Anorexia
Tenesmus
Non-bloody diarrhea initially becoming mucoid and bloody

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12
Q

Complications of Shigellosis

A

hemolytic uremic syndrome (HUS) – rare (more common with E. coli)
bacteremia
seizures (in children)
reactive arthritis

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13
Q

AKA shigellosis name

A

bacillary dysentery

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14
Q

Diagnostics of Shigellosis

A
  • Index of suspicion: bloody diarrhea, abdominal pain, fever, and small, frequent stool volumes
  • Stool culturing or testing using PCR
  • Fecal leukocytes
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15
Q

Management of Shigellosis

A

Avoid antispasmodics

ABX

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16
Q

Name of the disease with the shiga toxin

A

shigellosis, EHEC

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17
Q

Causative organisms of campylobacter

A

Campylobacter jejuni

GNR

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18
Q

Reservoirs for campylobacter

A
  • GI tract of animals and livestock (MC is poultry – including undercooked and raw)
  • Raw or unpasteurized milk
  • Chicken pate
  • Food in contact with the above
  • Domestic dogs and cats can also be culprits
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19
Q

Clinical manifestations of Campylobacter

A

Prodrome of fever, malaise, abdominal pain and cramps

watery diarrhea that becomes bloody

self-limiting up to 7 days

Pseudoappendicitis with RUQ pain

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20
Q

Complications of Campylobacter

A

Guillain-Barre syndrome (ascending paralysis)

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21
Q

Enterohemorrhagic diarrhea causative agent

A

Enterohemorrhagic Escherichia coli (EHEC)

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22
Q

Transmission of EHEC occurs with ingestion of…

A

green leafy vegetables
undercooked meat
raw milk

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23
Q

Reservoirs of EHEC

A

ruminants

cattle MC

Can also be goats, sheep, deer, elk

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24
Q

Clinical manifestations of EHEC

A

bloody diarrhea
fever is ABSENT
abdominal pain

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25
Q

Diagnostics of EHEC

A

bloody diarrhea, abdominal pain, and lack of fever

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26
Q

EHEC complications

A

hemolytic uremic syndrome

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27
Q

Causative organisms of Yersiniosis

A

Yersinia enterocolitica

Yersinia pseudotuberculosis

GNR

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28
Q

Reservoirs of Yersiniosis

A 
Pigs (most important)
rodents
rabbits
sheep
horses
dogs, and cats
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29
Q

Transmission of Yersiniosis

A

handling or consuming undercooked pork – esp. chitterlings

raw or unpasteurized milk

contaminated water

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30
Q

Presentation of Yersinia enterocolitica

A

Presents like everything else

Acute, febrile, bacterial diarrhea

Nausea, vomiting, abdominal pain, and bloody diarrhea

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31
Q

Presentation of Yersinia pseudotuberculosis

A

Pseudoappendicitis, occasionally without diarrhea

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32
Q

Clinical manifestations of Yersiniosis

A

Infants and children usually present with more severe disease

may progress to necrotizing enterocolitis

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33
Q

Causative organism of Pseudomembranous colitis

A

Clostridium difficile

GPR

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34
Q

AKA of Pseudomembranous colitis

A

Antibiotic-associated colitis

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35
Q

Pseudomembranous colitis clinical manifestations

A

Wipe out all normally present intestinal flora and replaces it with C. difficile

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36
Q

unique feature of Pseudomembranous colitis

A

superinfection with toxin production

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37
Q

Most common ABX of Pseudomembranous colitis

A
  • Clindamycin
  • Ampicillin
  • Cephalosporins (second- and third-generation)
  • Fluoroquinolones
38
Q

Diarrhea characteristics of Pseudomembranous colitis

A

Mild to moderate greenish, foul-smelling watery diarrhea 5-15 times per day (usually no blood or mucus)

39
Q

Severe cases of Pseudomembranous colitis

A

Hemodynamic compromise secondary to volume depletion

toxic megacolon with risk of perforation

40
Q

Stool studies of Pseudomembranous colitis

A

Nucleic acid amplification tests (PCR assays) for TcdB toxin have higher sensitivity (97%)

41
Q

Labs of Pseudomembranous colitis suggesting negative outcomes

A
  • Leukocytosis (> 30,000/mcL)
  • Hypoalbuminemia (< 2.5 g/dl)
  • Elevated serum lactate
  • Azotemia
42
Q

Treatment of Pseudomembranous colitis

A

Metronidazole (Preferred first-line agent for mild-moderate disease) CHEAP

Vancomycin (IV vancomycin does not penetrate bowel, hence oral administration) ORAL ONLY, use if have bad prognostics

43
Q

Treatment of refractory Pseudomembranous colitis

A

Fecal transplantation

44
Q

Causative agent of Amebiasis

A

Entamoeba histolytica

45
Q

Transmission of Amebiasis

A

fecal-oral (contaminated water/food, anal-oral sexual contact)

46
Q

Morphology of Amebiasis

A

Amebia!
Trophozoite:
- Motile
- Bull’s eye shaped nucleus, with red blood cells in the cytoplasm

47
Q

Clinical manifestations of Amebiasis

A

Liver abscesses and RUQ pain

Possible toxic megacolon and intestinal rupture

48
Q

Treatment of Amebiasis

A

Metronidazone - esp. if liver abscess present

49
Q

Causative organism of Norovirus

A

Norovirus

50
Q

AKA of Norovirus

A

“Norwalk virus”

“Winter Vomiting Bug”

“Stomach flu”

51
Q

Norovirus unique features

A

Extremely contagious virus - viral gastroenteritis

outbreaks: cruise ships, daycare, nursing homes, school

52
Q

Causative organism of Rotavirus

A

Rotavirus

53
Q

Viral properties of Rotavirus

A

Double-stranded RNA virus

54
Q

MCC of childhood diarrhea

A

rotavirus

55
Q

Staphylococcal food poisoning transmission

A

meats, dairy, mayonnaise, and bakery products (cream pastries)

56
Q

Prevention of rotavirus

A

2 different vaccines available

57
Q

Staphylococcal food poisoning commonly seen in…

A

summer months

58
Q

Enterotoxigenic E. coli (ETEC) aka

A

Traveler’s Diarrhea, Montezuma’s Revenge, Delhi Belly, Turista

59
Q

Transmission of ETEC

A

consumption of contaminated foodstuffs

drinking contaminated water or ice

60
Q

MCC of traveler’s diarrhea

A

ETEC: enterotoxigenic E. coli

61
Q

Toxins of ETEC

A

1: heat stable enterotoxin (ST)
2: heat labile enterotoxin (LT)

62
Q

ETEC clinical manifestations

A

NO BLOOD
NO MUCOUS
see profuse watery diarrhea

63
Q

Bacillus cereus bacterial characteristics

A
  • Motile
  • Non-encapsulated
  • Resistant to PCN
64
Q

2 types of Bacillus cereus

A

Heat-stable form

Heat-labile form

65
Q

ETEC management drug

A

pepto-bismol and has mild antimicrobial activity

66
Q

Preferred ABX for Rx for a patient prior to travel for ETEC prevention

A

Azithromycin

67
Q

Third most common cause of foodborne illness in United States

A

Clostridium perfringens

68
Q

Clostridium perfringens transmission

A

consumption of cooked meat or poultry that is allowed to cool without proper refrigeration

69
Q

Clostridium perfringens bacterial characteristics

A

releases 12 various destructive enzymes

70
Q

One subtype of C. perfringes that leads to…

A

jejunal hemorrhagic necrosis

71
Q

AKA of cholera

A

blue death

72
Q

Causative organism of cholera

A

Vibrio cholerae

73
Q

Transmission of cholera

A

naturally contaminated shellfish

74
Q

Voluminous “gray” fluid diarrhea (“rice water stools”) with flecks of mucus

A

cholera

75
Q

Severe cases of cholera results in…

A

Hypovolemic shock with electrolyte abnormalities

Patients may lose 10-20 liters per day

Renal failure

Sunken eyes, loss of skin turgor, sunken fontanelles

76
Q

ABX Tx of Cholera

A

Azithromycin (1st choice in pregnancy and children)

doxycycline

77
Q

Management of cholera

A

Vaccine! for high risk exposure

78
Q

Vibriosis causative organism

A

Vibrio parahaemolyticus

Vibrio vulnificus

GNR

79
Q

Vibriosis infections are worse in…

A

immunocompromised, chornic hepatic dysfunction, and alcoholics

80
Q

Suspect ____ in watery diarrhea that begins shortly after eating raw or undercooked shellfish

A

Vibriosis - GI disease

Vibrio parahemolyticus

81
Q

Vibriosis is found in…

A

brackish water with undercooked/raw shellfish

82
Q

Wound infections after swimmin in marine/brackish waters

A

Vibrio vulnificus

83
Q

Vibrio vulnificus results in…

A

cellulitis that spreads rapidly causing hemorrhagic bullae

84
Q

Septicemia, high fevers/chills, rapid onset of shock, high mortality

A

Vibrio vulnificus

85
Q

Management of Virbiosis

A

Doxycycline

OR

Minocycline and ceftriaxone

86
Q

Causative agent of giardiasis

A

Giardia lamblia

aka Beaver fever

87
Q

MC intestinal parasite disease in the United States

A

Giardia lamblia

88
Q

Foul-smelling, greasy diarrhea (with high fat content) and abdominal gassy distention

A

Giardia lamblia

89
Q

Drinking questionable water

A

Giardia lamblia

90
Q

First line of giardiasis

A

metronidazole

tinidazole (second line/on way to first)

Gastrointestinal (12 decks)

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