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30 Cards in this Set
- Front
- Back
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1. Causes of GI bleeds in children in addition to bacterial enteritis?
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1. Meckel diverticulum
2. Intussusception 3. HSP 4. HUS 5. C. diff 6. Polyps. |
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2. Dysentery?
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a. Intestinal infection resulting in severe bloody diarrhea w/mucus
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3. Salmonella organisms bacterial characteristics?
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a. Aerobic gram-negative rods.
b. Can survive as facultative anaerobes c. They are motile and do NOT ferment lactose |
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4. In what months is salmonella infection more common?
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a. Warmer months!
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5. 2 types of Salmonella infections?
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a. Nontyphoidal disease
b. Typhoid (or enteric) fever. Primarily caused by salmonella typhi. |
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6. Nontyphoidal salmonella infections?
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a. Gastroenteritis
b. Meningitis c. Osteomyelitis d. Bacteremia |
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7. Salmonella outbreaks?
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a. Usually occur sporadically but can be food related and occur in clusters.
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8. Most common source of human infection w/salmonella?
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a. Exposure to poultry and raw eggs.
b. Other sources: iguanas and turtles. |
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9. What does infection w/salmonella require?
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a. Ingestion of many organisms.
b. Person-to-person spread is uncommon. |
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10. Most common Nontyphoidal disease presentation of salmonella?
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a. Gastroenteritis.
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11. Sx of salmonella gastroenteritis in children?
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a. N/V
b. Emesis c. Cramping abdominal pain d. Watery or bloody diarrhea e. Most develop a low-grade fever f. Some have neurologic symptoms! (confusion, HA, drowsiness, and seizures). |
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12. Subsequent symptoms of transient bacteremia w/Nontyphoidal salmonella (transient bacteremia occurs in 1-5% of pts)?
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a. Extraintestinal infections:
1. Osteomyelitis 2. Pneumonia 3. Meningitis 4. Arthritis b. These findings are more common in immunocompromised pts and infants. |
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13. Bacteria characteristics of Shigella?
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a. Small gram-negative bacilli.
b. Non-lactose fermenting facultative anaerobes c. Have recently been shown to be motile. |
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14. 4 Shigella species that cause human disease? (just fyi)
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1. S. dysenteriae
2. S. boydii 3. S. flexneri 4. S. Sonnei |
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15. In what months do Shigella infections most commonly occur?
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a. Warmer months and in the first 10 yrs of life (peaking in the 2nd and 3rd years).
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16. How is Shigella usually transmitted?
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a. Person to person but may occur via food and water.
b. Relatively few Shigella organisms are required to cause disease (this makes it easier for person to person). |
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17. Sx of Shigella in children?
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a. Fever
b. Cramping abdominal pain c. Water diarrhea (often progressing to small blood stools) d. Anorexia e. They appear ill. f. May have neurologic findings. |
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18. Neurologic findings with Shigella infection?
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a. HA
b. Confusion c. Seizure d. Hallucinations e. Shigella meningitis is infrequent. |
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19. Uncommon complications of Shigella infection?
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a. Rectal prolapse
b. Cholestatic hepatitis c. Arthritis d. Conjunctivitis e. Cystitis. f. Rarely, causes a rapidly progressive sepsis-like presentation that quickly leads to death. |
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20. What is the rare rapidly progressive sepsis-like presentation of Shigella called?
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a. Ekiri sy
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21. Course of Shigella?
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a. Untreated diarrhea typically lasts 1-2 weeks and then resolve.
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22. Tests for Salmonella or Shigella?
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a. Stool culture, although results frequently are negative even in infected subjects.
b. Fecal leukocytes usually are positive!!!, but this nonspecific finding only suggests colonic inflammation. c. White count is usually normal d. A Remarkable Left shift is often seen w/more bands than PMNs!!!! e. Salmonella infection usually causes mild leukocytosis. |
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23. Tx of Salmonella and Shigella infection?!?
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a. Treatment focuses on fluid and electrolyte balance correction.
b. Abx tx of salmonella usually is not necessary. |
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24. Risk w/abx tx of salmonella?
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a. Does not shorten the GI disease course
b. And c. May increase the risk of HUS!!!!! |
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25. Who should be treated w/abx for salmonella?
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a. Infants younger than 3 months of age and immunocompromised people are often treated for GI infection, as they are at increased risk for disseminated disease.
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26. Should abx be used to tx shigella?
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a. Shigella is a self-limited disease as well, but abx shorten the course and decrease the duration organisms are shed.
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27. Antimotility agents for salmonella and Shigella?
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a. Not indicated!
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28. What 3 other agents can cause dysentery w/fever, abdominal cramps, and bloody diarrhea?
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1. Enteroinvasive E. coli
2. Campylobacter sp 3. Yersinia enterocolitica. |
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29. Which of the above agents can cause an “acute abdomen”-like picture?
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a. Yersinia.
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30. Which bug causes bloody diarrhea but usually NO fever?
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a. Enterohemorrhagic (or shigatoxin-producing) E coli.
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