Mehl. UW bullet 6 bacterial/viral GI 04-02 (2) Flashcards
Mehl. 4M + watery diarrhea two weeks ago + now has heavier diarrhea and bloating and flatulence with meals; Dx?
Secondary lactose intolerance caused by sloughing of brush border following gastroenteritis (rotavirus).
Mehl. Child <5 years + watery diarrhea, Dx?
rotavirus; classically seen < age 5.
Mehl. Child <5 years + watery diarrhea + 12-year-old brother and parents have similar Sx; Dx?
Norwalk (same as norovirus) virus, not rotavirus, because rest of family wouldn’t get rotavirus.
UW. A 16-year-old girl is brought to the clinic due to vomiting and abdominal pain. Since this morning, the patient has had multiple episodes of nonbilious, nonbloody emesis as well as intermittent nausea and abdominal pain. She has also had 3 episodes of watery diarrhea. The patient attended a school cookout approximately 36 hours prior to her first bout of emesis, and several of her friends who also attended have similar symptoms. Temp. 37.4 C, BP115/75, pulse 95/min. She appears uncomfortable but is alert and interactive. Mucous membranes are slightly dry. There is diffuse tenderness to deep palpation on abdominal examination but no masses or hepatosplenomegaly. The skin is well perfused, and no rashes are evident. Which of the following is the most likely etiology of this patient’s illness?
NOROVIRUS
Rotavirus causes severe vomiting and watery diarrhea in unvaccinated children age ≤2. Infection in adolescents and adults is typically mild or asymptomatic due to the presence of antibodies from prior exposure or vaccination. Rotavirus is less likely than norovirus in this symptomatic, teenage patient.
Peds form will say a kid was running around barefoot in rural Louisiana + has high eosinophils + microcytic anemia -> asks how the causal organism was contracted?
answer = “through the skin.”
it’s HOOKWORM
UW. 5y/o boy + sudden-onset nausea, abdominal cramps, and several episodes of vomiting over the last 2 hours. He has not had diarrhea. The patient ate barbecue chicken with potato salad at a community lunch 4 hours before the symptoms began. His mother says that 2 other children who ate at the lunch have similar symptoms. The patient lives with his 3-year-old sister. vitals normal, no temp. The abdomen is soft and nontender. Next step in management of this patient?
NO ADDITIONAL TESTING OR CONTACT PRECAUTIONS NEEDED
S.aureus
UW. A 5-year-old boy is brought to the clinic for follow-up for abdominal pain and diarrhea. Four days prior, he was evaluated at the onset of low-grade fever and mucus-filled diarrhea. A stool culture was obtained, and the parents were instructed to increase the patient’s fluid intake. Since that visit, the fever has resolved, but he continues to have 5 or 6 episodes of watery, mucus-filled diarrhea daily. The patient has no chronic medical conditions. Temperature is 37.2 C (99 F), and other vital signs are normal for age. Mucous membranes are moist. Heart and lung examinations are normal. The abdomen is mildly distended and diffusely tender to deep palpation without hepatosplenomegaly or masses. Hemoccult testing is negative. Stool culture shows a large growth of Campylobacter coli with the following susceptibilities: Ciprofloxacin – resistant; Ampicillin – sensitive; Erythromycin – intermediate; Tetracycline – sensitive. Which of the following is the most appropriate treatment for this patient’s condition?
SYMPTOMATIC CARE ONLY
(zymejau amoxicillin)
UW. A 5-year-old girl is brought to the clinic due to abdominal cramping and diarrhea. The diarrhea started 3 days ago and was initially watery but now contains visible mucus. The patient attends a small day care, where several other children have recently developed similar diarrhea. Temp. 38 C (100.4 F), BP 100/62, pulse 98/min. On examination, the patient appears uncomfortable but appropriately answers questions and is interactive. The mouth is slightly dry. Heart and lung examinations are normal.The abdomen is diffusely tender to palpation without hepatosplenomegaly. A stool sample is positive for occult blood, and a stool culture is also obtained. The patient tolerates fluids that she receives in the office. In addition to encouraging increased fluid intake, what best Mx?
close follow up only
zymejau abdominal UG - daryt jeigu suspected intussusception
