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