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18 Cards in this Set
- Front
- Back
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caustive agents
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viruses 80% (rotovirus under 2, norovirus over 2)
bacteria 10-15% parasites 10-15% |
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diarrhea pathophys
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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 |
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clues that dx may be bacterial
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persistant fever/diahhrea
crampy abdominal pain tenesmus bloody, mucousy stools recent foreign travel pet reptiles raw milk/undercooked hamburger farm animal exposure |
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rotavirus
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most common cuase of vomitting/nonbloody diarrhea under 2
winter to spring peak incidence fecal oral spread w/ 2-4 day incubation |
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viruses similar to rotavirus
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astrovirus
enteric adenovirus norovirus |
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norovirus
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most common cause of enteric illness older than 2 years
fecal oral transmission cruise ship outbreaks no commercial test |
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norovirus sx
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non-bloody diarrhea
n/v abdominal pain myalgia headache 12-60 hours |
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norovirus very contagious
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low infectious dose
prolonged asymptomatic shedding environmental stability substantial strain diversity lack of lasting immunity |
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salmonella sx
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fever and non-blood diarrhea
6-48 hours incuvation 45% excrete for over 12 weeks |
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shigella
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watery, loose stools progress to dysentry
human fecal oral spread small amount of innocolum can carry for 4 weeks |
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shigella complications
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bactremia, toxic megacolon, reiters (post inflammation urethritis, conjunctivtis, arthritis)
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shigella tx
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exclude from daycare for 24 hours after treatmetn and diarrhera has stopped
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c. difficile
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antimicrobial associated with diarrhea & pseudomembranous colitis
can occur while on abx or weeks after |
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c diff toxins
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watery diarrhea or bloody mucousy stools
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c. diff tx
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metrondiazole or vancomycin (flagyl is cheaper)
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food poisoning toxins
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staph or bacillus cereus
abrupt onset of vomiting/severe cramps incubate 2-4 horus duration 1-2 days |
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gorelick scale signs
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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 |
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lab tests for food poisoning
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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 |
