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Infectious Diarrhea Flashcards

1
Q

How long does acute diarrhea typically last?

A

Less than 2 weeks (except for C. diff)

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2
Q

Community outbreaks of acute diarrhea typically suggests which of the following:
Viral etiology
Bacterial pathogen
Common food source

A

Viral etiology or common food source

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3
Q

Describe stool in noninflammatory diarrhea.

A

Watery diarrhea without blood

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4
Q

Fecal smear of noninflammatory diarrhea does NOT have _______

A

Fecal leukocytes

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5
Q

Describe stool in inflammatory diarrhea.

A

Bloody diarrhea

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6
Q

Typical symptoms associated with noninflammatory diarrhea?

A

Cramping, bloating, nausea, vomiting

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7
Q

Typical symptoms associated with inflammatory diarrhea?

A

Fever, LLQ pain, urgency

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8
Q

Inflammatory diarrhea causes blood and fecal leukocytes to be present. Why?

A

Bacteria or toxin invades colonic tissue causing tissue damage

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9
Q

In what type of diarrhea is it okay to use promotility agents or antimotility agents?

A

Non-inflammatory diarrhea

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10
Q

Why shouldn’t you use promotility or antimotility agents in inflammatory diarrhea?

A

Promotility: risk of dehydration
Antimotility: allows bacteria and toxin to stay in place for a longer amount of time

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11
Q

Bacteria that produce enterotoxin cause noninflammatory diarrhea. What bacteria produce enterotoxin?

A

Staph aureus, Bacillus cereus, Enterotoxigenic E. coli, Vibrio cholerae

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12
Q

What are the other causes of noninflammatory diarrhea?

A

Norovirus, Rotavirus, Giardia, Cryptosporidium, Listeria monocytogenes

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13
Q

What cytotoxin producing bacteria cause inflammatory diarrhea?

A

Enterohemorrhagic E coli. 0157:H7, C. Diff

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14
Q

What are the mucosal invading pathogens of inflammatory diarrhea?

A

Camylobacter, Shigella, Salmonella

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15
Q

What two other pathogens of inflammatory diarrhea?

A

Cytomegalovirus, Entamoeba histolytica

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16
Q

Risk factors for C. diff infections?

A

Antibiotics use, typically clindamycin, penicillin, and cephalosporins

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17
Q

What symptoms must be present for C. diff infection?

A

Three or more unformed stool over 24 hours for 2 consecutive days in conjunction with positive stools for pseudo membranes

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18
Q

Lab findings in C. diff?

A

Leukocytosis with left shift
Hypoalbuminemia
Positive stool C. diff test

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19
Q

What is the correct sequence of C. diff tests to order?

A

Toxin testing, if negative, consider PCR

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20
Q

Downside of C. diff PCR test?

A

It is so good it can pick up asymptomatic carriers.

We don’t really know what to do for them, so try not to go there

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21
Q

First line treatment for C. Diff?

A

Vancomycin 125mg PO QID

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22
Q

Treatment for C. diff accompanied by hypotension or shock or toxic megacolon?

A

Vanco 500 PO QID+/- metronidazole

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23
Q

Treatment for 2nd recurrence of C. diff?

A

Vanco oral taper

Fecal microbiota transplant

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24
Q

What new medication works as well as vanco for C. diff?

A

Fidaximin

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25
Salmonella most commonly from acquired from?
Contaminated meat or eggs | Infected food handlers
26
Incubation period for salmonella?
6-48 hours
27
Common symptoms of salmonella?
Fever and diarrhea
28
Treatment for uncomplicated salmonella?
Supportive care - it is self limiting
29
Treatment for complicated salmonella?
Cipro
30
Typhoid fever is caused by what bacteria?
Salmonella typhi
31
T/F? Typhoid fever is endemic in US
False
32
Symptoms of typhoid fever?
Diarrhea or constipation, maculopapular rose color skin rash, fever, abd pain, weakness
33
Diagnosis of typhoid fever is?
Clinical diagnosis + travel history
34
Treatment for typhoid fever?
Azithromycin for mild cases. | Carbapenems for severe cases
35
Most common ways to spread shigella?
Inanimate objects*** - think day care Fecal oral Flies
36
Symptoms of shigella?
``` Diarrhea (bloody, watery, purulent, and mucous) Fever Stomach cramps Nausea Emesis Dehydration ```
37
Treatment for shigella?
Cipro
38
Most common cause of bacterial GI symptoms?
Campylobacter
39
One symptom of campylobacter that differentiates it from other causes of infectious diarrhea is what?
A prodrome of fever, headache, myalgia, and malaise
40
Treatment for campylobacter?
Cipro
41
Complication of campylobacter?
Guillain Barre syndrome
42
Most common cause of "traveler's diarrhea"?
Enterotoxigenic E coli shiga toxin + or -
43
Main cause of HUS in US?
E Coli 0157:H7
44
Sources of E oli 0157
Undercooked ground beef, unpasteurized juices and milk
45
Triad of HUS symptoms?
Renal insufficiency Hemolytic anemia Thrombocytopenia
46
Treatment for E coli 0157?
Supportive
47
Most common cause of staph food poisoning?
Foods with high salt or sugar - think cream sauces, custard, hams, canned meat
48
Onset of staph food poisoning?
Rapid 4-8 hours
49
Treatment for staph food poisoning?
Supportive care
50
Staph food poisoning typically lasts no longer than _____
24 hours
51
What noninflammatory diarrhea can cause spontaneous abortion, sepsis, bacteremia, and meningitis?
Listeria monocytogenes
52
Treatment for listeria?
Ampicillin
53
Diagnosis of this noninflammatory diarrhea is done by stool culture or PCR.
Enterotoxigenic E coli non 0157 strains
54
Treatment options for enterotoxigenic e coli?
Cipro
55
Common sources of Vibrio cholera infections?
Poor water sanitation, shellfish
56
Incubation period of Vibrio cholera?
12-72 hours
57
Description of stools in cholera?
"rice water stools"
58
Treatment for Vibrio cholera?
HYDRATION!!!! | and doxycycline or cipro
59
Most common cause of nonbacterial gastroenteritis?
Norovirus
60
Gold standard test for norovirus?
Stool culture
61
``` Does the following pathogen cause infectious or non infectious diarrhea? Staph aureus Vibrio cholerae Shigella Giardia Cytomegalovirus Campylobacter C. diff Rotavirus Giardia Salmonella E coli 1057:H7 Bacillus cereus Enterotoxigenic E coli Listeria ```
``` Staph aureus - noninflammatory Vibrio cholerae - noninflammatory Shigella - inflammatory Giardia - noninflammatory Cytomegalovirus - inflammatory Campylobacter - inflammatory C. diff - inflammatory Rotavirus - noninflammatory Entamoeba histolytica - inflammatory Salmonella - inflammatory E coli 1057:H7 - inflammatory Bacillus cereus - noninflammatory Enterotoxigenic E coli - noninflammatory Listeria - noninflammatory ```

Cam's Cards (103 decks)

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