NBME and Diarrhea

Question 1

Watery Diarrhea right after returning from a trip:
for days =
for weeks =

Answer 1

for days = ETEC (Travelers Diarrhea)
for weeks = Giardia (tx: Metronidazole)

Question 2

Watery Diarrhea with massive fluid losses

Answer 2

Vibrio Cholerae

Question 3

Watery Diarrhea in a hiker/camper:
Watery Diarrhea on a Group/Military Outbreak:

Answer 3

hiker/camper: → Giardia
Group/Military Outbreak: → Noro

Question 4

Watery diarrhea in ICU outbreak &
treatment (2)?

Answer 4

Clostridium Dificil
Oral Vancomycin or Oral Fidaxomycin

Question 5

Watery Diarrhea in an infant:
Watery Diarrhea in an AIDS patient:

Answer 5

Infant→ Rota Virus
AIDS→ Cryptosporidum Parvum
tx: Nitazoxanide or paromomycin
(+ Acid-fast)

Question 6

Bloody diarrhea after consuming poultry/eggs
(+ no other clues of etiology given):

Answer 6

Salmonella
(if not much other clues)

Question 7

MCC of bloody diarrhea in the US:

Answer 7

Campylobacter Jejunai

Question 8

Any Diarrhea + loss of DTRs in BLE + Leg weakness a few weeks laters

Answer 8

Campylobacter Junai

(guillain-barré)

Question 9

Diarrhea after ANY antibiotic exposure:

Answer 9

C-diff
(especially Clindamycin)

Question 10

ANY Diarrhea + RLQ pain:

Answer 10

Yersenia Enterocolitica
(bloody or watery)

Question 11

Protozoal cause of bloody diarrhea
± Liver Abscess
and treatment

Answer 11

Entomeba Histolytica
Metronidazole

(Amibiasis)

Question 12

Bloody Diarrhea requiring a small # of organisms:

Answer 12

Shigella

Question 13

Diarrhea after consuming Oysters/Seafood:
─
Diarrhea after consuming Oysters/Seafood + ↑ LFTs
or
hx of liver problems

Answer 13

Vibrio Parahemolyticus
─
Vibrio VuLnificuns → ↑ LFTs
can even cause necrotic skin lesion if inoculated on beach

Question 14

Diarrhea after consuming reheated rice:

Answer 14

Bascillus Cereus

Question 15

Vomiting 2 hours after consuming potato salad ± diarrhea:

Answer 15

Staph Aureus
(super fast onset → Gastroenetritis)