GI Infectious Diarrhea
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| Acute Diarrhea | Duration less than 14 days
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| Chronic Diarrhea | Duration is more than a month
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| Persistent diarrhea | Duration between 14-30 days
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| How to assess dehydration | General appearance, vitals (pulse, bp,orthostatics), mucous membranes, skin turgor, capillary refill
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| First sign of dehydration | decreased urine output
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| tenesmus | painful evacuation of poop
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| Main component of oral rehydration solutions | Sodium
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| BRAT diet | bananas, rice, applesauce and toast. Avoid milk
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| Good history questions | Travel, day care, hobbies, sexual practices, abx history
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| 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%
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| Fecal leukocyte sensitivity | 73% sensitive and 84% specific for inflammatory diarrhea
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| Enteropathogens to keep in mind | E. Coli, Salmonella, Shigella, Yersinia, Vibrio, Listeria, Cyclospora, Campylobacter, Cryptosporidium, C. difficile, Giardia, etc
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| When does diarrhea occur most commonly? | October to April (winter)
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| Which virus is associated with nursing homes, cruise ships and familial outbreaks? | Norovirus
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| ____ virus is associated with pediatric hospitalizations | rotaviruses
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| ______ is associated with water transmission | Giardia. Associated symptoms: foul-smelling watery diarrhea, cramps and flatulence
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| ____ 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)
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| 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
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| Small gram negative rod associated with seafood, particularly raw oysters | Vibrio. Watery diarrhea. Vibrio can also cause wound infections from contaminated sea water
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| 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.
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| Infection associated with fried rice | Bacillus Cereus
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| Abx makes kids more susceptible to get | hemolytic uremic syndrome
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| Four top causes of diarrhea | E. Coli, Campylobacter, Salmonella, Shigella
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| Poultry, eggs and dairy are associated with | Salmonella. Salmonella causes enteritis 6-14 hours after ingestion
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| Osteomyelitis, endocarditis and arthritis are associated with | salmonella
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| The infection associated with pulse-temperature discordance | S. tyhpi. Usually, with a fever, pulse increases
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| ____ 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
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| Most common cause of traveler's diarrhea | Entero-toxigenic E. Coli (ETEC). Watery diarrhea
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| When should you not use anti-motility agents? | With toxic bacteria. Shigella, C. Difficile, E. coli 0157
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| Bloody Diarrhea Pneumonic: MESSY CACA | Medical disease, E. Coli, Shigella, Salmonella, Yersinia, Campylobacter, Amoeba (entamoeba histolitica), C. Dificile, Aeromonas
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| Which viral agents are high on the list of suspicion with watery diarrhea? | Rotavirus, Norovirus, Adenovirus
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| Which Bacterial agents are high on the list of suspicion with watery diarrhea? | Staph aureus, Bacillus cereus, Vibrio
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| Which Parasites are high on the list of suspicion with watery diarrhea? | Giardia, "Spora's"
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| _______ is a flagellate Protozoa often found in streams and stagnant water and causes watery diarrhea | Giardia.
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