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38 Cards in this Set
- Front
- Back
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How does gastroenteritis differ specifically from diarrhea?
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gastroenteritis refers to an inflammation of the entire GI tract, and thus involves both diarrhea AND vomiting
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What are some reasons for an incresaed susceptibility to gastroenteritis?
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young age
immunocompromise malnutrition travel lack of breastfeeding contaminated food or water sources |
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What are a few bacterial causes of gastroenteritis?
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Campylobacter
Salmonella Shigella E coli |
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so even hemorrhagic diarrhea causes are considered
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gastroenteritis
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What is the number one cause of gastroenteritis in developing countries?
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ETEC
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2 parasitic causes of gastroenteritis
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Giardia
Crypto think immunosuppression here |
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The history includes things like
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frequency and volume of symptoms
general patient appearance associated findings like cramps, emesis, malaise, and fever UTI conjunctivitis etc. |
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When do you suspect an inflammatory diarrhea?
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when they have severe crampy abdominal pain, tenesmus, fever. may also show blood and mucous in the stool
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Vs. inflammatory dirrhea
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which may show emesis, but usully not fever
the abdominal pain is just crampy and gives watery diarrhea |
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What are some labs to order for gastroenteritis?
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stool sample to look for mucus, blood and leukocytes
fetal leukocytes stool cultures C diff toxins maybe sigmoidoscopy to diagnose an inflammatory colitis |
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When would you want to test for C diff toxins?
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when the pt has a hx of recent antibiotic use
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What are two reasons that a stool would have minimal leukocytes with gastroenetritis?
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EHEC
or Entamoeba |
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What is the tx for gastroenteritis?
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rehydration is the key
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Do you use IVs for gastroenteritis?
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no- unless it's very severe and rapid loss of fluid
you want them to take things in orally |
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Why not use juices, teas, sodas?
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because of the high osmolality it can make diarrhea a lot worse
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What diet do they start with GE?
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the BRAT diet- bananas, rice, applesauce, and toast
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Do we use loperamide etc. in kids?
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NO
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What is another essential step of admission for these kids?
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they should be on contact precautions
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What is the treatment for campylobacter?
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erythromycin early in the disease course
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What is the treatment for C diff?
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Flagyl or oral vanc
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What is the treatment for EPEC, ETEC, and EIEC?
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Bactrim but this is for certain specific indications
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Where does EPEC tend to concentrate infections
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in nurseries, daycare epidemics
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Do you treat Salmonella?
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actually yes in cases of bacteremia, immunodeficiency, or in infants under 3 years of age
use ampicillin or Bactrim |
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Do you treat Shigella?
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yes- use bactrim or ceftriaxone
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Do you treat Vibrio cholerae?
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yes, you use tetracycline or doxy
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treatment for aeromonas?
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BActrim if diarrhea is prolonged
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little kid with perianal itching worst at night
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Enterobius vermicularis (pinworm)
scotch tape test |
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What is the tx for Enterobius?
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albendazole or mebendazole or pyrantel pamoate
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symptoms of the whipworm
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this is Trichuris trichuria
is usually asx with mild anemia, abdominal pain, diarrhea, tenesmus, and perianal itching |
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tx for Trichuris trichuria?
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albendazole
mebendazole |
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What is the worm involved if there is both GI AND pulmonary symptoms?
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probably Ascaris because this is how they swallow the worm and it spreads or whatever
Called Loeffler pneumonitis |
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other problems with Ascaris
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obstructions
liver failure |
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What is the worm if it gives an intense dermatitis, pneumonitis, and significant anemia?
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Necator americanus or Ancylostoma duodenale
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What is a permanent result of Necator americanus infection?
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irreversible developmental delay
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What is the likely infection if there is superimposed sepsis?
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Strongyloidesq
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And how strongyloides gain infection?
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through skin penetration, usually of the feet
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Tx for Strongyloides?
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ivermectin 200 ug/kg/day for 2 days
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What is the source of infection for Trichinosis?
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pork
gives myalgias, facial and periorbital edema, conjunctivitis, pneumonia, myocarditis, encephalitis, nephritis, meningitis |
