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18 Cards in this Set

  • Front
  • Back
caustive agents
viruses 80% (rotovirus under 2, norovirus over 2)
bacteria 10-15%
parasites 10-15%
diarrhea pathophys
cytotoxic - viral destruction of mucosal cells and villi
osmotic - malabsorption of nutrients and electrolytes prevents h2o absorption
dysenteric - invasion and inflammation of bowel wall with mucous and blood
secretory - enterotoxins cause large amounts of Na to be secreted - water too
clues that dx may be bacterial
persistant fever/diahhrea
crampy abdominal pain
tenesmus
bloody, mucousy stools
recent foreign travel
pet reptiles
raw milk/undercooked hamburger
farm animal exposure
rotavirus
most common cuase of vomitting/nonbloody diarrhea under 2
winter to spring peak incidence
fecal oral spread w/ 2-4 day incubation
viruses similar to rotavirus
astrovirus
enteric adenovirus
norovirus
norovirus
most common cause of enteric illness older than 2 years
fecal oral transmission
cruise ship outbreaks
no commercial test
norovirus sx
non-bloody diarrhea
n/v
abdominal pain
myalgia
headache
12-60 hours
norovirus very contagious
low infectious dose
prolonged asymptomatic shedding
environmental stability
substantial strain diversity
lack of lasting immunity
salmonella sx
fever and non-blood diarrhea
6-48 hours incuvation
45% excrete for over 12 weeks
shigella
watery, loose stools progress to dysentry
human fecal oral spread
small amount of innocolum
can carry for 4 weeks
shigella complications
bactremia, toxic megacolon, reiters (post inflammation urethritis, conjunctivtis, arthritis)
shigella tx
exclude from daycare for 24 hours after treatmetn and diarrhera has stopped
c. difficile
antimicrobial associated with diarrhea & pseudomembranous colitis
can occur while on abx or weeks after
c diff toxins
watery diarrhea or bloody mucousy stools
c. diff tx
metrondiazole or vancomycin (flagyl is cheaper)
food poisoning toxins
staph or bacillus cereus
abrupt onset of vomiting/severe cramps
incubate 2-4 horus
duration 1-2 days
gorelick scale signs
dehydration
decreased skin elasticity
cap refill greater than 2 seconds
ill or apathetic apeparancde
no tears
abnormal resp (acidosis)
dry mucous membranes
sunken eyes
abnormal radial pulse
tachycardia
decreased urine output
lab tests for food poisoning
serum electrolytes - dehydration, rehydration with IV fluids
stool rotavirus, giardia/cryptosporidium (hx of prlonged d), c diff (hx of abx)
CBC if stools bloody
CRP- elevated if inflammation