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29 Cards in this Set

  • Front
  • Back
At what point is it persistent diarrhea?
14 days
At waht point is it chronic?
30 days
What is diarrhea?
200g of stool/24 hours, 3 watery stools/24 hours
What causes most diarrhea?
virus
What bacteria cause most bacterial diarrhea?
salmonella, campylobacter
What are the specifics of viral diarrhea?
lasts less than 72 hours, no epi clues, no fever, blood, < 6 stools/day, no severe ab pain
What viruses cause viral diarrhea?
rotavirus, calcivirus, atrovirus, adenovirus, CMV, torovirus
What parasites cause diarrhea?
entamoeba histolytica, giardia, crypto
What do you do for infectious diarrhea?
rehydration, H&P, stool studies, therapy when appropriate, avoid anti-motility agents
What do you check if hospitalized?
c dif
What do you check if a hiker?
protozoa like giardia or cryptosporidia
What do you check if stool is bloody?
E coli O157 H7
What do you check if they've had shellfish or been to 3rd world country?
vibrios
What do you check if they have abdominal pain or mesenteric adenitis?
Yersinia
What do you check if they have HIV?
MAC, CMV, cyclospora, isospora
Tow hom do you give antimicrobials?
after stool cultures, not to kids with bloody diarrhea
What do you give to adults with diarrhea?
quinolones
What do you give to kids with diarrhea?
trimethoprem sulfate
What does loperamide do?
inhibits peristalsis, reduced diarrhea by 1 day
What shoudl you avoid loperamide in?
toxic megacolon, HUS, prolonged fever
Why do you use bismuth subalicylates for kids?
reduces diarrhea from 27 to 20 hours in kids
For whom should you perform a stool culture in hospitalized patients?
C di > 65 yo with preexisting conditions, neutropenic, HIV, systemic manifestation of enteric
What should you give for travelers diarrhea?
loperamide, levafloxacin or azithromycin
What is rifaximin?
oral rifamycin, as effective as fluroquinolones, more rapid cessatioon of diarrhea, less resistance
What does C dif Toxin A do?
enterotoxic and cytotoxic, binds carb receptors on cell surface, cell destruction and fluid accumulation, attracts granulocytes
What C dif strain is especially bad?
BI/NAPI/027 NAP-1/027
Whay does BI/NAPI/027 cause more disease?
produces 10x as much toxin, doesn't produce TcdA gene inhibitor
What do you get with serious C dif disease?
high fever, high WBC count, more severe diarrhea
What happens with the msot serious C dif?
pseudomembranous colitis, dehydration, electrolyte imbalance, hypotension, anasarca, toxic megacolon