Mehl. HY Peds GI infections 04-02 (2) Flashcards
Most common cause of watery diarrhea in unvaccinated children < 5 years.?
rotavirus
Rotavirus vaccine when is given?
Vaccine normally given orally at 2, 4, and 6 months of age.
Vaccine normally given orally at 2, 4, and 6 months of age. FOR WHAT VIRUS?
rotavirus
rotavirus = Double-stranded, segmented RNA, Wheel-shaped (NBME asks it).
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Norwalk (aka norovirus) virus. CP?
Most common cause of watery diarrhea in adults and rotavirus-vaccinated children.
Rotavirus CP?
Watery diarrhea in unvaccinated children < 5 years
Norwalk (aka norovirus) virus. buzzy words?
Cruise ships and business conferences are buzzy places to acquire (fecal-oral); basically any place with high density of people.
Staph. aureus. what toxin?
pre-formed heat-stable toxin is acquired from two main sources on NBME.
Staph. aureus. 2 sources on NBME?
1) various meats sitting under a heat lamp / out for long periods of time, e.g., at a buffet;
2) dairy products like creams, custards, potato salad.
Staph. aureus. Notable CP?
Notably causes vomiting 1-6 hours after consumption. This is notable, as the symptoms occur rather quickly. Diarrhea, both watery and bloody, can occur, but is not mandatory. The main crux is the vomiting.
Yersinia enterocolitica. CP?
Causes bloody diarrhea + appendicitis-like (i.e., RLQ) pain in Peds.
Yersinia enterocolitica. pain what what quadrant?
appendicitis-like (i.e., RLQ) pain
Yersinia enterocolitica. what MSK can occur?
Arthritis can also occur, but this finding is more common in adults.
Yersinia enterocolitica. why RLQ pain?
The RLQ pain is from mesenteric adenitis or terminal ileitis.
EHEC/Shigella. Hemolytic uremic syndrome.
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EHEC/Shigella. mechanism of effect of toxin?
Toxin causes endothelial damage in renal afferent arterioles that leads to consumption of platelets + shearing of RBCs flying past the platelet plugs.
EHEC/Shigella. triad?
Presents as triad of 1) thrombocytopenia, 2) ̄ Hb with schistocytes, 3) renal issues (i.e., RFTs and/or hematuria).
EHEC/Shigella. 2CK Peds Q gives Q where “Shigellosis” is the answer and HUS is wrong in kid with bloody diarrhea, but it’s easy if you simply see that the classic HUS triad isn’t there. In other words, GI infection with blood in the stool isn’t automatically HUS.
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Enterobius vermicularis. How gained?
Ingested.
Enterobius vermicularis. CP?
Causes perianal itching / (+) tape test in children. (Enterobiasis)
Ascaris lumbricoides. How gained?
Ingested
Ascaris lumbricoides. CP?
Giant roundworm; causes intestinal obstruction. (Ascariasis)
Hookworms. How acquired?
Acquired through soil/one’s feet.
”Hookworms” refers to Ancylostoma duodenale and Necator americanus.
Hookworms. causes what anemia?
Microcytic anemia / ̄ hemoglobin due to sucking blood in GI tract.
Hookworms. Peds form will say a kid was running around barefoot in rural Louisiana + has high eosinophils + microcytic anemia -> asks how the causal organism was contractedàanswer = “through the skin.”
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