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Clin Med II - Exam 3 > Schoenwald - GI Infections > Flashcards

Schoenwald - GI Infections Flashcards

1
Q

acute infectious diarrhea lasts <

A

2 weeks

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2
Q

community outbreaks of infectious diarrhea suggest what source (2)

A

viral

food

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3
Q

__ hx is important in infectious diarrhea

A

travel

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4
Q

2 characteristics of noninflammatory diarrhea

A

watery

non bloody

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5
Q

noninflammatory has no __ invasion

and no __ on smear

A

tissue

fecal leukocytes

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6
Q

anti motility agents are ok to use in which type of infectious diarrhea

A

noninflammatory

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7
Q

pathogens associated w. non inflammatory infectious diarrhea

A

staph

bacillus cereus

listeria

enterotoxigenic e.coli

vibrio cholera

norovirus

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8
Q

inflammatory infectious diarrhea is differentiated from non-inflammatory by

A

inflammatory diarrhea: colonic tissue invasion by organism or toxin

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9
Q

inflammatory infectious diarrhea mc affects

A

lower colon

LLQ

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10
Q

2 common sx in inflammatory infectious diarrhea

A

fever

bloody diarrhea

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11
Q

__ will be present on smear with infectious inflammatory diarrhea

A

fecal leukocytes

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12
Q

if diarrhea lasts > __ days,

you should consider __,

except in the case of __

A

14

non infectious cause

cdiff

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13
Q

do NOT use __ in the tx of inflammatory infectious diarrhea

A

anti motility agents

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14
Q

pathogens associated w. cytotoxin production in infectious inflammatory diarrhea (2)

A

E.coli 0157:H7

Cdiff

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15
Q

pathogens associated w. mucosal invasions in infectious inflammatory diarrhea (3)

A

campylobacter

shigella

salmonella

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16
Q

virus associated w. infectious inflammatory diarrhea

A

cytomegalovirus

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17
Q

parasite associated w. inflammatory infectious diarrhea

A

entamoeba histolytica

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18
Q

mc symptom associated w. c.diff infxn

A

copious watery diarrhea → ex 15-30 bm/day

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19
Q

possible other sx of cdiff infxn (besides watery diarrhea)

A

abd pain/cramps

low grade fever

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20
Q

2 intestinal complications of cdiff infxn

A

toxic megalocolon

colectomy

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21
Q

rf for cdiff infxn (4)

A

previous abx

advanced age

previous hospitalization

nursing home resident

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22
Q

what abx are associated w. cdiff infxn

A

clindamycin

penicilins

cephalosporins

fluoroquinolones

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23
Q

cdiff infxn definition

A

3 or more unformed stools over 24 hr x 2 consecutive days

in conjunction w. positive stools for pseudomembranes

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24
Q

incidence of cdiff has __ from 2000-2005

A

tripled

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25
Q

3 serology findings used in cdiff dx

A

leukocytosis → bandemia

hypoalbuminemia

(+) stool test

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26
Q

3 tests used for cdiff

A

PCR

antigen detection

toxin testing

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27
Q

__ test used for cdiff is highly sensitive and specific

and can be (+) in asymptomatic pt

A

PCR

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28
Q

__ test for cdiff is nonspecific

A

antigen detection

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29
Q

which cdiff test has high rates of false negatives

A

toxin testing (A and B)

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30
Q

cdiff tx

A

know dosing for this

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31
Q

tx for initial episode of mild/mod cdiff w. leukocytosis <15,000, creat < 1.5

A

vanco 125 mg po qid x 10 days

OR

fidaxamin 200 mg po qid x 10 days

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32
Q

tx for initial episode of severe cdiff w. leukocytosis >15000 and creat > 1.5

A

vancomycin 125 mg po qid x 10 days

OR

fidaxamin 200 mg po bid x 10 days

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33
Q

tx for initial episode of complicated cdiff

A

vanco 500 mg po qid OR via NG tube

AND/OR

metronidazole 500-750 mg IV q 8 hr

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34
Q

complicated cdiff clinical parameters (3)

A

hypotn or shock

perforation

megacolon

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35
Q

tx for 1st recurrence of cdiff

A

vanco oral taper

OR

fidaxamin

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36
Q

tx for 2nd recurrence of cdiff

A

vanco oral taper

OR

fidaximin

fecal microbiota transplant

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37
Q

oral vanco is only used for

A

cdiff

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38
Q

how do you oral taper vanco

A

125 mg qid x 1-2 weeks → then start tapering down to tid → then bid → then qd → then stop

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39
Q

prevention for cdiff (3)

A

abx stewardship

environmental control/hand washing

chlorine based disinfectants

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40
Q

cdiff spores can live up to __ months on surfaces

and __ are an important vector

A

5

health care workers

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41
Q

__ are ineffective for cdiff prevention

A

etoh hand preps → must be soap and water

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42
Q

most effective surface disinfectant for cdiff

A

chlorine based

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43
Q

salmonella enteriditis bacteria classification

A

gram neg rod

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44
Q

source of salmonella enteriditis infxn (2)

A

meat/eggs

food handlers

45
Q

what is a long term carrier of salmonella

A

pt can be culture (+) for 1 month post tx

46
Q

mc symptoms in salmonella infxn

A

fever

diarrhea

47
Q

what sx is uncommon w. salmonella infxn

A

bloody stools

48
Q

salmonella commonly spreads to __ in bacteremic pt’s (4)

A

vascular grafts

joints

kidneys

liver

49
Q

salmonella is usually self limiting

if not, tx for complicated cases (2)

A
  1. cipro
  2. bactrim
50
Q

typhoid is a __ type of fever

A

salmonella

51
Q

typhoid fever may be asymptomatic, if not sx may include (6)

A

diarrhea

constipation

skin rash on torso/back

fever

abd pain

weakness

52
Q

high risk countries for typhoid fever (4)

A

india

pakistan

caribbean

mexico

53
Q

how is typhoid fever spread (3)

A

contaminated foods

sewage

food handlers

54
Q

t/f typhoid fever is resistant to abx

A

T!

55
Q

abx tx for mild typhoid fever

A

azithromycin

56
Q

tx for severe typhoid fever

A

carbapebems → esp w. travel hx

57
Q

in the US, what GI infxn is associated w. daycares

A

shigella

58
Q

shigella has __ spread

and the mc symptom is __

A

fecal/oral

secretory diarrhea

59
Q

shigella infxn is also called

A

dysentery

60
Q

4 characteristics of secretory diarrhea associated w. shigella

A

bloody

watery

pus

mucus

61
Q

bacteria classification of shigella

A

gram negative rod

62
Q

tx for shigella

A
  1. cipro
  2. bactrim or azithromycin → high resistance
63
Q

what GI infxn has associations w. guillain barre and reactive arthritis

A

campylobacter

64
Q

campylobacter is the #1 cause of __ in the US

A

food borne illness

65
Q

bacteria classification of campylobacter

A

gram negative rod

66
Q

campylobacter infxn is associated with what foods

A

sausages/hard meats

undercooked chicken

67
Q

prodrome sx of campylobacter (7)

A

low grade sx:

HA

fever

myalgia

malaise

abd pain

diarrhea

fever

68
Q

tx for campylobacter

A
  1. cipro
  2. azithromycin
69
Q

main cause of HUS in US

A

Enterohemorrhagic shiga toxin 0157 (e.coli 0157)

70
Q

80% of travelers diarrhea is caused by

A

enterotoxigenic e.coli (not the same as 0157)

71
Q

sources of e.coli 0157 (4)

A

undercooked ground beef

unpasteurized juice

milk

working w. cattle

72
Q

sx of e.coli infxn (3)

A

bloody diarrhea

severe cramping

n/v

73
Q

__ is uncommon in ecoli infxn

A

fever

74
Q

HUS is severe and can be fatal in (2)

A

kids

elderly

75
Q

hemolytic anemia leads to (2)

A

thrombocytopenia

acute renal insufficiency

76
Q

what factor differentiates TTP from HUS

A

ADAMTS 13 will be (+) in TTP

77
Q

common lab findings in HUS

A

anemia

decreased haptoglobin

increased creatinine

thrombocytopenia

hematuria, proteinuria

negative coombs

78
Q

tx for HUS is __

and __ are not very effective

A

supportive

abx

79
Q

protozoa related to non inflammatory diarrheas

A

giardia

amoeba

80
Q

why is this card here?

A

brainscape wouldn’t let me delete it?

81
Q

why is this card here??

A

brainscape wouldn’t let me delete it :(

82
Q

staph food poisoning is from __, not the bacteria

A

toxin

83
Q

cardinal sign of staph food poisoning

A

rapid onset → 4-6 hr

other: cramping, diarrhea, n/v

84
Q

foods associated w. staph food poisoning

A

high salt

high sugar

ex potato salad at cook out

85
Q

tx for staph food poisoning

A

self limiting

no abx

86
Q

what foodborne infection is associated w. unpasteurized dairy and is esp dangerous for pregnant women and immunecompromised

A

listeria monocytogenes

87
Q

listeria can lead to (2)

A

bacteremia

meningitis

88
Q

__ use is a predisposing factor for listeria monocytogenes

A

corticosteroid use

89
Q

tx for listeria

A

ampicillin

90
Q

why is ampicillin effective for listeria

A

crosses bbb for meningitis

91
Q

main cause of travelers diarrhea

A

enterotoxigenic e.coli

92
Q

less severe form of e.coli 0157

A

enterotoxigenic e.coli

93
Q

2 sx of enterotoxigenic e.coli

A

profuse non bloody diarrhea

cramping

94
Q

dx for enterotoxigenic e.coli (2)

A

stool culture

OR

PCR

95
Q

3 possible tx for enterotoxigenic e.coli

A

cipro 500 mg po bid x 5-7 days

OR

bactrim 180/800 mg po bid x 7 days

OR

azithromycin

96
Q

what GI infxn is characterized by massive secretion from small bowel of profuse watery diarrhea (up to 20 L/day)

A

vibrio cholera

97
Q

cholera is spread through __ (2)

and has a __ hr onset

A

poor water sanitation

shellfish

12-72 hr

98
Q

what do you think when you see “rice water stools”

A

cholera

99
Q

__ is rare in cholera

A

fever

100
Q

tx for cholera (2)

A

early and continuous fluid resuscitation

doxycycline OR cipro → can limit but dehydration is main issue

101
Q

viral gastroenteritis has a __ onset

A

rapid

102
Q

mc of gastroenteritis

A

norovirus

103
Q

t/f norovirus gastroenteritis is no longer contagious after symptoms resolve

A

F!

104
Q

sx of norovirus

A

sudden onset

vomiting/diarrhea

abd cramping

105
Q

norovirus lasts _ days

A

1-3

106
Q

norovirus outbreaks are associated with __ settings

A

community

107
Q

gold standard test for norovirus

A

culture

PCR now available too

108
Q

tx for norovirus

A

self limiting

109
Q

guidelines for food handlers post norovirus infxn

A

stay away from work 48-72 hr

Clin Med II - Exam 3 (14 decks)

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