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D&D Infectious Disease FINAL > Therapeutics - Infectious Diarrhea > Flashcards

Therapeutics - Infectious Diarrhea Flashcards

1
Q

4 bacterial causes of infectious diarrhea

A

salmonella
shigella
campylobacter
traveler’s diarrhea

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2
Q

2 viral causes of infectious diarrhea

A

norovirus
rotavirus

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3
Q

2 parasitic causes of infectious diarrhea

A

cryptosporidium, giardia

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4
Q

infectious diarrhea is caused by….

A

ingesting food/water contaminated with pathogens

(whether it’s bacteria, viruses, parasites, fungi, or protozoa)

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5
Q

define diarrhea

A

3 or more episodes of loose stool in 24 hours

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6
Q

define:

acute vs prolonged vs persistent vs chronic

A

acute - symptoms present for less than 7 days

prolonged: symptoms last 7-13 days

persistent symptoms present for 14-29 days

chronic: symptoms present for greater than 30 days

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7
Q

true or false

infectious diarrhea is not really a clinical concern worldwide

A

FALSE - IT IS

one of the leading causes of death in developing countries AND mainly affects kids and infants in poverty bc of poor sanitation

however, only 5,000 deaths in US annually

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8
Q

name some predisposing factors to infectious diarrhea

A

bad sanitation
foreign travel
immunosuppressed
day care centers
animal handlers
medications that INCREASE GASTRIC PH

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9
Q

true or false

infectious diarrhea caused by salmonella, campylobacter, and shigella all have similar symptoms, so we can’t distinguish the likely pathogen based on symptoms alone

A

TRUE

all have similar symptoms of bloody or non bloody diarrhea

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10
Q

most infections caused by this bacteria are associated with poultry and live stock

A

salmonella

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11
Q

infectious diarrhea caused by this bacteria is HIGHLY CONTAGIOUS and linked to outbreaks, so day care centers are at risk

A

shigella

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12
Q

infectious diarrhea caused by this bacteria is associated with undercooked poultry, meat, dairy, and contaminated water

A

campylobacter

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13
Q

how is infectious diarrhea caused by shigella so contagious and severe

A

bc of formation of the SHIGA TOXIN - extremely virulent

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14
Q

E. coli O157:H7 vs E. coli NON O157:H7

which produces the shiga toxin?

how are they each transmitted?

difference in symptoms?

A

causes SEVERE bloody diarrhea bc it’s enterohemmoraghic. PRODUCES SHIGA TOXIN
transmitted thru contaminated meat

non - traveler’s diarrhea. spread through FECALLY contaminated food and water. more WATERY DIARRHEA and resolves within 3 days without treatment

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15
Q

true or false

e. coli O157:H7 is associated with traveler’s diarrhea

A

FALSE

NON O157:H7 is associated with traveler’s diarrhea

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16
Q

presentation of viral diarrhea

A

watery, noninvasice of acute onset

low grade fever, headache, myalgia

self limiting and lasts less than 48 hours but may persist longer in kids, elderly, or immunocompromised

17
Q

____ is the most common cause of acute diarrhea in adults

____ is the most common cause of SEVERE diarrhea in children less than 2 years old

A

acute diarrhea in adults = norovirus

severe diarrhea in children under 2 = rotavirus

18
Q

____diarrhea is less common in the developed world.

most cases are due to ___ and ___

A

PARASITIC

cryptosporidium or giarda lamblia

19
Q

clinical presentation of parasitic diarrhea caused by cryptosporidium vs giarda

A

cryptosporidium - not as bad. self limiting, watery, happens within hours of fecal-oral ingestion. however, can be severe and prolonged in immunocompromised and the elderly

giarda - presents as steatorrhea large volume (fat in stool) and weight loss occurs, occurs 7-14 days after ingestion!! usually self limiting but lasts more than 7 days a lot

20
Q

rehydration is a treatment component for infectious diarrhea

explain when oral vs IV rehydration should be given

A

oral - to alleviate MILD dehydration

IV - moderate-severe dehydration OR mild dehydration but can’t take things PO

21
Q

explain what SHOULD and SHOULD NOT be used for oral rehydration for infectious diarrhea

A

SHOULD - oral rehydration salts mixed with water (pedialyte). should be 1.5-2 times the volume of stool lost/day

SHOULD NOT USE - sports drinks, fruit juices, and chicken broth (NOT ENOUGH FOR REHYDRATION)

22
Q

Explain what is/is not sufficient for IV rehydration from infectious diarrhea

A

is - CRYSTALLOIDS (lactated ringer’s, normal saline)

NOT SUFFICIENT - dextrose 5% in water

1/2 the estimated volume deficit should be replaced within the 1st 4 hours after presentation

23
Q

true or false

rehydration is needed for ALL diarrhea patients

A

TRUE

additional treatment depends on the cause, but ALLLLL need rehydration whether oral or iv

24
Q

can antimotility or antiemetic agents be used in patients with diarrhea?

A

they can be considered ONLY AFTER THE PATIENT HAS BEEN REHYDRATED

IT IS NOT A SUBSTITUTE FOR FLUID AND ELECTROLYTE REPLACEMENT

25
Q

name an antimotility agents

A

loperamide

26
Q

name 2 patients in which anti motility agents (loperamide) should NOT be given to

A

children less than 18 with acute diarrhea

patients with suspected or proven cases of toxic megacolon

overall tho, they’re not really recommended because you’re containing the bacteria/virus/parasite and not expelling it (but at the same time u also have to live lulz)

27
Q

name an antiemetic agent

A

ondansetron

28
Q

when may antiemetic agents be given in diarrhea patients

A

to help them tolerate the oral rehydration OR in acute gastroenteritis when the pt is vomiting

29
Q

true or false

for the average, immunocompetent person, empiric antibiotic therapy is NOT recommended

A

TRUE

infectious diarrhea is, most of the time, SELF LIMITING

30
Q

3 infectious diarrhea patients in which empiric antimicrobial therapy IS recommended

A

-infants less than 3 months with suspected BACTERIAL cause

-immunocompromised with severe illness

-immunocompetent ppl but they’s ILL WITH FEVER in a medical care facility or have sepsis

31
Q

what is the empiric choice for bacterial infectious diarrhea

A

either a fluoroquinolone or azithromycin

32
Q

empiric therapy for infectious diarrhea caused by:

-cryptosporidium
-giarda

A

both are parasites

cryptosporidium: nitazoxanide

giarda - tinidazole, nitazoxanide
alternative is metronidazole

HOWEEVER, WE USUALLY DONT TREAT - SELF LIMITING,

33
Q

pt is 25 years old who retuned from haiti 2 days ago

since returning, she’s had acute onset watery diarrhea around 3-4 times a day. no other systemic symptoms

she asks for recommendation for rehydration. what is your response

A

PEDIALYTE

replaces both the salts and electrolytes needed for hydration

34
Q

c diff infection has had increasing incidence where

A

in the community

35
Q

1st line treatment for initial c diff infection is ___or ___

A

fidaxomicin or vancomycin

36
Q
A

D&D Infectious Disease FINAL (21 decks)

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