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HDID Block 2 > L53 > Flashcards

L53 Flashcards

1
Q

What is one physical exam technique you want to be sure to take when evaluating a patient with diarrhea?

A

Orthostatic pulse & BP

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2
Q

Which 3 bacteria are the most likely causes of acute gastroenteritis?

A

SA
Clostridium perfringens
Bacillus

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3
Q

Symptoms of acute gastroenteritis

A

Sudden onset + short duration

Vomiting may also be seen

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4
Q

Treat acute gastroenteritis

A

Rehydration

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5
Q

Major causes of acute watery diarrhea

A
  1. ETEC, EAEC, EPEC
  2. Vibrio cholerae - cholera
  3. Campy, salmonella, shigella, EIEC
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6
Q

Treat acute watery diarrhea

A

Rehydration w/ glucose & Na - osmotic balance shift via Na/glucose transporter

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7
Q

Major bacteria agents cause acute inflammatory diarrhea

A

C.diff

Campy, salmonella, shigella, EHEC. EIEC, yersinia

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8
Q

Complication of acute inflammatory diarrhea

A

Dysentery

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9
Q

Which patients are you going to get a diarrhea culture for?

A

Immune compromised
Present w/ dysentery
Suspect cholera

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10
Q

What is the first test you might order on a patient with diarrhea?

A

Fecal leukocytes/lactoferrin

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11
Q

Why do you treat shigella patients with anti-microbials?

A

Decrease shedding - decrease spreading to close contacts

B/c low infectious dose

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12
Q

Treat shigella

A 
Beware anti-microbial resistance 
Cipro
Azithro
TMP+SMX
Ceftriaxone
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13
Q

What is your first line of therapy for cholera? Second?

A 
1st = oral rehydration 
2nd = drugs to shorten duration
- Doxy
- Azithro
- Cipro
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14
Q

Do you treat salmonella and EHEC w/ antimicrobials?

A

NO
Salmonella = gets WORSE w/ antibiotics
EHEC = linked to HUS

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15
Q

What is your first choice for traveler’s diarrhea? 2nd?

A
  1. Oral rehydration
    Loperamide
  2. Cipro or rifaximin
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16
Q

Do you treat campylobacter with antimicrobials?

A

NO if been over 3 days infected - no benefit, only work if started early

17
Q

What cases SHOULD you use anti-microbials for diarrhea?

A 
C.diff
Shigellosis - unclear choice but should
Traveler's diarrhea when unresponsibe to anti-motility agents
Severe cholera
Early campylobacter

HDID Block 2 (39 decks)

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