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52 Cards in this Set
- Front
- Back
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Gut fluid intake - saliva
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1L/day
Neutral pH Antibacterial components |
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Gut fluid intake - stomach
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2-3L/day
Harsh pH prevents infection |
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Small bowel - physiology
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Reabsorptive mucosa
Villi - tip reabsorbs Na and Cl, crypts secrete fluid Neutral pH About 80% reabsorption Bidirectional transport |
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Large bowel - physiology
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Unidirectional transport
Reabsorbs salt and water to dry out stool |
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Small bowel - pathophysiology
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Hypersecretion
Impaired absorption Invasion and destruction of villi |
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Stomach - pathophysiology
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Impaired acid secretion
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Colon - pathophysiology
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Hypermotility
Impaired absorption |
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Watery diarrhea
3-5 day illness Toxin-mediated |
Cholera
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Cholera toxin - structure
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AB5 toxin
ADP ribosylase irreversibly activates adenylyl cyclase High levels of cAMP, increased HCO3 and Cl secretion Inhibits small bowel absorption and increases secretion |
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Cholera - treatment
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Replenish salt and water
Attenuate with antibiotics Add glucose to help reabsorb Na |
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Normal gut flora
Diarrhea from antibiotic pressure |
Clostridium difficile
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Clostridium difficile - treatment
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Vancomycin
Metranidazole Probiotics for prevention Good hygiene |
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Clostridium difficile - complications
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Pseudomembranous colitis
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Traveler's diarrhea - moderately severe non-bloody diarrhea
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Enterotoxic E coli
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ETEC - toxins
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Labile toxin
Stable toxin |
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ETEC - treatment
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Antibiotics
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Severe infantile diarrhea
Chronic diarrhea in under 18 |
Enteropathogenic E coli
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Severe colitis with bloody diarrhea
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Enterohemorrhagic E coli
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EHEC - toxins
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Shiga toxin - AB5
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EHEC - diagnosis
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Sorbitol MacConkey agar
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EHEC - complications
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Small vessel thrombi
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Bacterial diarrhea
From poultry, milk, or animals |
Campylobacter
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Campylobacter - treatment
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Macrolides if given early
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Campylobacter - complications
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Guillain-Barre
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Invasive diarrhea
Worst in children, elderly, and immunocompromised |
Salmonella enterica
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Salmonella enterica - treatment
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No antibiotics
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Chronic febrile illness
Several week history of weight loss, joint pain, fever, and rashes |
Salmonella typhi
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Salmonella typhi - pathogenesis
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Invades M cells in small bowel and replicates in Peyer's patches
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Salmonella typhi - treatment
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Antibiotics
Vaccine prevention |
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Shigella - clinical
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Bloody diarrhea
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Shigella - treatment
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Antibiotics
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Seasonal around holidays
Associated with pork |
Yersinia
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Yersinia - complications
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Pseudo-appendicitis
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GI viruses
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Rotavirus
Adenovirus Astrovirus Norovirus |
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GI viruses - pathogenesis
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Invade small bowel mucosa and cause damage
Limit ability of small bowel to absorb fluid Non-bloody diarrhea |
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Rotavirus - treatment
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Leading cause of diarrhea worldwide
Vaccine prevention |
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Amebiasis
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E histolytica
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E histolytica - treatment
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Metranidazole
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Non-bloody wasting diarrhea
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Giardia
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Giardia - treatment
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Metranidazole
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Severe chronic non-bloody diarrhea in immunocompromised patients
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Cryptosporidium parvum
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Cryptosporidium parvum - treatment
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Nitazoxanide
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Vomiting - causes
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Toxin
Virus |
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Non-bloody diarrhea - causes
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Small bowel dysfunction
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Bloody diarrhea - causes
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Colon dysfunction - EHEC
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Antibiotics indicated
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Shigella
Vibrios ETEC Campylobacter Yersinia Salmonella typhi |
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Antibiotics contraindicated
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EHEC
Salmonella except typhi |
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Treatment for viruses
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Salt and water replenishment
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Treatment for parasites
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Metranidazole
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Oral rehydration
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Salt and water
Short chain fatty acids Glucose |
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Vaccine preventable
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Salmonella typhi
Rotavirus Cholera |
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Complications of chronic diarrhea
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Stunting
Nutrient and medicine malabsorption |
