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Infectious Diarrhea

GI Infectious Diarrhea

QuestionAnswer
Acute Diarrhea Duration less than 14 days
Chronic Diarrhea Duration is more than a month
Persistent diarrhea Duration between 14-30 days
How to assess dehydration General appearance, vitals (pulse, bp,orthostatics), mucous membranes, skin turgor, capillary refill
First sign of dehydration decreased urine output
tenesmus painful evacuation of poop
Main component of oral rehydration solutions Sodium
BRAT diet bananas, rice, applesauce and toast. Avoid milk
Good history questions Travel, day care, hobbies, sexual practices, abx history
When do you order stool studies? Only if diarrhea is persistent or recurring, or if there is a hx of fever or tenesmus. Diagnostic Yield of stool cultures is only 1.5-5.6%
Fecal leukocyte sensitivity 73% sensitive and 84% specific for inflammatory diarrhea
Enteropathogens to keep in mind E. Coli, Salmonella, Shigella, Yersinia, Vibrio, Listeria, Cyclospora, Campylobacter, Cryptosporidium, C. difficile, Giardia, etc
When does diarrhea occur most commonly? October to April (winter)
Which virus is associated with nursing homes, cruise ships and familial outbreaks? Norovirus
____ virus is associated with pediatric hospitalizations rotaviruses
______ is associated with water transmission Giardia. Associated symptoms: foul-smelling watery diarrhea, cramps and flatulence
____ is a protozoa that causes diarrhea that may be quite bloody and is associated with travelers and homosexual men Entamoeba histolytica (protozoa). It stands for the last A in messy cacA. Amoeba (entamoeba histolitica)
Which population is more susceptible to infection with protozoa Immunocompromised. Examples: cyclospora, Isospora, cryptosporidium, microsporidia. Many of these organisms are present in the environment and water supply
Small gram negative rod associated with seafood, particularly raw oysters Vibrio. Watery diarrhea. Vibrio can also cause wound infections from contaminated sea water
If a patient present with diarrhea and pain (within 4 hours of eating) immediately follwoing a picnic, consider Staph areus, and Bacillus cereus. Preformed toxin, so symptoms come right away. There is no more toxin production after ingestion so sx are short lived.
Infection associated with fried rice Bacillus Cereus
Abx makes kids more susceptible to get hemolytic uremic syndrome
Four top causes of diarrhea E. Coli, Campylobacter, Salmonella, Shigella
Poultry, eggs and dairy are associated with Salmonella. Salmonella causes enteritis 6-14 hours after ingestion
Osteomyelitis, endocarditis and arthritis are associated with salmonella
The infection associated with pulse-temperature discordance S. tyhpi. Usually, with a fever, pulse increases
____ is associated with day cares, nurseries and long term care (fecal-oral transmission) Shigella. Attach and invade M cells in Peyer's patches. Sx start 1-3 days after ingestion
Most common cause of traveler's diarrhea Entero-toxigenic E. Coli (ETEC). Watery diarrhea
When should you not use anti-motility agents? With toxic bacteria. Shigella, C. Difficile, E. coli 0157
Bloody Diarrhea Pneumonic: MESSY CACA Medical disease, E. Coli, Shigella, Salmonella, Yersinia, Campylobacter, Amoeba (entamoeba histolitica), C. Dificile, Aeromonas
Which viral agents are high on the list of suspicion with watery diarrhea? Rotavirus, Norovirus, Adenovirus
Which Bacterial agents are high on the list of suspicion with watery diarrhea? Staph aureus, Bacillus cereus, Vibrio
Which Parasites are high on the list of suspicion with watery diarrhea? Giardia, "Spora's"
_______ is a flagellate Protozoa often found in streams and stagnant water and causes watery diarrhea Giardia.
Created by: ltm12
 

 



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