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60 Cards in this Set
- Front
- Back
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Inflammation of the mucous membrane of both stomach and intestine
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gastroenteritis
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What is the primary manifestation of Gastroenteritis?
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diarrhea, Some secondary manifestations include; N/V, abd. Pain
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The acute onset of this term usually causes profuse watery diarrhea, often c nausea and vomiting, but s localized findings.
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acute gastroenteritis
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Where is the vomiting center located?
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the medulla
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What are some of the manifestations the infectious agents that cause gastroenteritis cause to the patient?
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Diarrhea by adherence, mucosal invasion, entertoxin production, cytotoxin production
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What is the MC cause of infantile gastroenteritis?
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rotavirus
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What are the manifestations/TX for Gastroenteritis in young children?
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Rotavirus: especially widespread in winter. 2-4 day incubation. 3-5 days of symptoms of abd pain, diarrhea, fever, vomiting. TX: fluids
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An epidemic, highly communicable but rather mild disease of sudden onset is caused by what virus?
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norwalk virus
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What are the manifestations/TX for the Norwalk epidemic gastroenteritis?
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16-48 hour incubation. Duration of 1-2 days. Symptoms include; abd cramps, N/V, HA
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What are some causes of Vomiting and Diarrhea?
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“gastroenteritis” mneumonic
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What percentage of gastroenteritis is caused by virus and give examples.
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50-70% Norwalk, Rotovirus, Caliciviruses, adenovirus, parvovirus, astrovirus
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What percentage of Gastroenteritis is caused by a bacteria and give examples.
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15-20%; salmonella, shigella and campylobacter. Then aeromonas.
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What percentage of g.e. is caused by parasites ?
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10-15%
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What is the known cause to the majority of food borne illnesses?
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staphylococcus aureus- (then Salmonella and Clostridium)from contaminated food being allowed to stand, producing endotoxins
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In this kind of infection, the organism enters the mucosal cells, destroys them and causes diarrhea usually with bloody stools?
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Invasive Infection
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In this infection, the organisms do not invade the mucosa, but produce enterotoxins of which act as chemical mediators causing hypersecretion fo the fluid. Little tissue damage is done.
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enterotoxic syndromes
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Patient presents with abdominal cramps, vomiting, profuse watery stools, fever, HA + myalgias and arthralgias. What kind of gastroenteritis do they most likely have?
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viral
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Patient presents with suprapubic pain which is relieved by BM, tenesmus, small volume stools, fever, and bloody, mucoid stools. What type of gastroenteritis do they most likely have?
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bacterial
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You suspect your P has gastroenteritis. You request a CBC and it returns with an elevated WBC but the differential contains Eosinophils. What can you rule out?
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parasitic
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How long is the incubation period of Ciguatera or scromboid?
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These are chemical poisons, immediate onset after ingestion (found in fish)
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Patient took ABX 2 weeks ago for an ear infection. What is one of the Labs you would want to rule out?
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C.Diff
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What is the incubation period for Salmonella & Shigella infection?
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24-48 hours
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What is the incubation period for Giardiasis infection?
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one week with recurrent diarrhea
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What is the incubation period for Botulism?
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associated neurological symptoms within 24 hours of eating canned food
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What do you need to rule out if the patient has a H/O homosexuality?
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Aids, shigella, Campylobacter jejuni, salmonella, candida etc.
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What organism causes Hemorrhagic Colitis?
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E.coli 0157H:7
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In classifying diarrhea, which type (general) suggests colonic involvement by invasive bacteria or parasites or by toxin production
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Inflammatory diarrhea
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Generally this type of diarrhea is milder and is caused by viruses or toxins that affect the small intestine and interfere with salt and water balance, resulting in large-volume watery diarrhea, often c N/V and cramps?
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Noninflammatory diarrhea
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What is the leading cause of viral gastroenteritis in the United States?
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norwalk. common year round
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What is the leading cause of gastroenteritis in children?
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rotavirus
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What are some types of viral gastroenteritis?
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norwalk,
rotavirus, Calciviruses, Enterovirus, Coxsackie virus A1, echovirus, adenovirus |
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These Gastroenteritis’ often occur in epidemic fashion, in closed environments and are best indicated by ELISA and PCR assays. Fecal Leukocytes are absent.
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viral
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This causes secretory diarrhea, that is spread by fecal contamination of water, seafood and others. Endemic in gulf coast, Asia, Africa, middle east. “rice water” stools. Severe dehydration.
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V.Cholera
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Presents with dysentery, fecal leukocytes, spread through foods, flies and fecal/oral route. Within 3 days, diarrhea becomes severe and bloody, often c pus and mucus?
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Shigellosis (shigella) Tx: critical fluid replacement. Bactrim or cipro can shorten course. DO NOT GIVE ANTI-DIARRHEAS
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What are the 3 types of salmonella?
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1. Gastroenteritis
2. Enteric Fever-Typhoid Fever 3. Bacteremia |
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How is salmonella transmitted?
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From eating foods produced from infected animals; meat, milk, poultry, eggs, contaminated water; from fecal/oral transmission.
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What is the incubation period for salmonella?
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8-48 hours
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Patient presents with N/cramps/ watery (or) bloody diarrhea/ fever and some vomiting x 1 day. She mentions that she made cookies from scratch 3 days ago using the eggs from her grandpa’s farm. What do you expect?
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salmonella. tx: supportive IV fluids
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This gastroenteritis produces water diarrhea that progresses to bloody d, severe abdominal cramps, low grade fever and lasts about a week. The patient will have been exposed to an organism that produces a toxin that damages GI mucosa and vascular endothelial cells/vessels, other organs (esp kidneys). What do you expect to find?
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hemorragic gastroenteritis.caused by E.coli0157H:7
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Which organism develops in a bovine reservoir; unpasteurized milk and undercooked beef?
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E.coli 0157H:7
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This is caused by a history of ABX usage as they change the balance of the normal intestinal flora, and cause overgrowth of pathogens?
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Pseudomembranous Colitis caused by C. Diff
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The most common cause of traveler’s diarrhea?
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Bacterial 80%; Enterotoxigenic E.coli, Shigella, Campylobacter jejuni
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What are some symptoms of traveler’s diarrhea?
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Chronic watery diarrhea, up to 10 or more loose stools a day, with out blood or mucus.
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What can be used as a “traveler’s prophylaxis”?
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Cipro if there is an underlying ds OR Pepto if they are not taking certain other meds. (tetracycline/doxycycline: used for malaria prophylaxis)
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What are the ABX that commonly cause pseudomembranous colitis?
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Clindamycin, ampicillin and cephalosporins
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What is the TX for pseudomembranous colitis?
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D/C use of ABX if applicable. Metronidazole or PO vanco in severe cases.
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What is the syndrome caused by eosinophilic pulmonary infiltrates, often associated c parasitic migration?
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Loffler Syndrome (pulmonary eosinophilia)
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What are some S/S of a protozoal infection?
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Abdominal pain, wheezing or hemoptysis (lofflers) dermatitis, diarrhea, dysentery, pruritis, rectal prolapse, steatorrhea, passage of parasites, bowel obstruction
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5 y/o patient that goes to daycare presents with rectal pruritis. Scotch tape test is performed to dx and what parasite will you see in the am?
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pinworms
Enterobius Vermicularis TX: vermox, antiminth |
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Patient complains of fatty, greasy, foul smelling stool (steatorrhea), abd. Pain and cramps. What do you suspect?
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Giardia: Giardia Lamblia. Transmitted fecal-oral. TX: flagyl
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What is the MC water borne infection?
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Giardia
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This is a rare parasite that is found mostly in the cecum and ascending colon that invades the mucosa. It can travel to the liver, lung and brain. It is transmitted through the fecal/oral route. Bloody diarrhea. Perianal ulcers. RUQ tenderness
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Amebiasis. Entamoeba hitolytica. TX: flagyl
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What is the MC intestinal helminth?
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Ascarasis
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What is the tx for ascaris lumbricoides` the large intestinal round worm?
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Albendazole and pyrantel pamoate
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Humans are the only host for this whipworm that lives in the cecum and appendix?
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Whipworm (Trichuriasis)
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How can you get whipworm?
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Fecal-oral transmission, uncooked veggies and water
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What is the tx for whipworm (trichuriasis)
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Albendazole, mebendazole
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what are the two main types of acute diarrhea?
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inflamm VS. non-inflamm.
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what are some causes of non-inflamm diarrhea?
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viral, protozoal, bacterial, intra-intestinal entertoxin prod, new meds, laxative abuse, fecal impaction, malabsorbtion
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what are some causes of inflammatory diarrhea?
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viral (cytomegalovirus)
Bacterial Protozoal Intestinal ischemia IBD Radiation Colitis |
