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GI Infections

GI Infections (Traveler's Diarrhea, Food Posioning)

QuestionAnswer
What are the 3 important host defenses normal flora, gastric pH, and intestinal motility
What patients are at the greatest risk of GI infection immunocompromised (HIV/AIDS, cancer, etc.), genetic determinants (type O blood increased risk of V. cholorae, Shigella, E. coli O157, and norovirus)
What are the 4 steps to management of GI infection Prevention Rehydration Symptomatic Relief Antimicrobial Therapy
What is the cornerstone of therapy for diarrhea Rehydration
What are 3 ways to prevent GI infections personal hygiene/safe food prep (hand washing, rinse produce, do not leave foods at room temp that can spoil) improve water sanitation regulations on prep and storage of commercial food
When do you use Oral Rehydration Therapy and when do you useIV therapy? ORT for mild-to-moderate diarrhea IV therapy for severe diarrhea
What 5 things should ORT contain glucose, sodium, potassium, chloride, water
Why should you avoid soft drinks, fruit juice, broth, and sports drinks? high osmotic content may worsen diarrhea WHO recommends reduced osmolarity solutions (Osm=245 mmol/L)
Which is preferable for IV therapy and why LR or NS LR helps to correct metabolic acidosis
When should you avoid the use of antimotility agents (ie loperamide) if patient has fever, bloody stools, and/or fecal leukocytes
When is loperamide contraindicated and why? toxin-producing infections (EHEC, pseudomembranous colitis, shigellosis, etc.) may cause increased exposure to toxins, increasing further damage
What is Hemalytic Uremic Syndrome (HUS) kidney failure due to toxin produced by EHEC
How is non-inflammatory and inflammatory diarrhea described non-inflammatory: watery diarrhea inflammatory: dysenteric diarrhea (presence of blood and mucus)
Where do non-inflammatory and inflammatory diarrhea occur non-inflammatory: proximal small bowel inflammatory: colon/distal small bowel
fecal leukocytes and lactoferrin? non-inflammatory: FL (-), lactoferrin no to mild inflammatory: FL (+), lactoferrin elevated
What are the common pathogens of non-inflammatory diarrhea Vibrio cholerae, ETEC, Clostridium perfringens, S. aureus, rotavirus, Cryptosporidium
What are the common pathogens of inflammatory diarrhea Shigella, Salmonella, Campylobacter, EHEC, Listeria, C. diff
What is the DOC for campylobacter infection? What is 2nd line? azithromycin Fluoroquinolones
What 2 pathogens usually resolve in 5-7 days and don't require antibiotics in most cases Salmonella and Shigella
When are antibiotics recommended for Salmonella and Shigella severe diarrhea, bloodstream infections, hospitalized patients
What pathogen is a microscopic parasite commonly transmitted by water cryptosporidium
What is the difference between normal gut E. coli and EHEC EHEC produces toxins and is transmitted through contaminated food
What complications are caused by the toxins produced by EHEC bloody diarrhea, kidney failure (HUS)
How can transmission of EHEC be prevented cooking foods thoroughly
What is the most common viral cause of gastroenteritis and what is its incubation period rotavirus 1-3 days
What are 2 possible management strategies of rotavirus gastroenteritis rehydration and probiotics
Other than rotavirus, what other viruses can cause gastroenteritis norovirus, enteric adenovirus, astrovirus
What are the most common pathogens for Traveler's Diarrhea EHEC, Shigella, Campylobacter, Salmonella
What countries are cosidered low-risk for Traveller's Diarrhea US, Canada, Australia, NZ, Japan, Northern and Western Europe
What countries/areas of the world considered high-risk for Traveller's Diarrhea Asia, Middle East, Africa (other than South Africa), Mexico, Central/South America
Traveler's Diarrhea classification: mild 1-3 loose stools/dy abdominal cramps lasting <14dys
Traveler's Diarrhea classification: moderate >4 loose stools/dy associated w/ dehydration
Traveler's Diarrhea classification: severe any number of loose stools in the presence of fever or blood in stools
Bismuth Subsalicylate dosing for PREVENTION of Traveler's Diarrhea 524 mg po QID for up to 21dys
Why are antibiotics not routinely recommended for prophylaxis concern for increasing resistance false sense of security
What would be appropriate circumstances for antibiotics to prevent Traveler's Diarrhea if patient is high-risk for mortality of infection (immunocompromised) or traveling to high-risk area for military mission
What is the most common class of antibiotics used for prophylaxis Fluoroquinolones
When would you use azithromycin as prophylaxis instead of FQ's when traveling to South and Southeast Asia due to increased FQ resistance
Bismuth Subsalicylate dosing for TREATMENT of Traveler's diarrhea 525mg po q30min up to 8doses
What the DOC regimen for TREATING Traveler's Diarrhea cipro 500mg po BID x3-5dys
WHat is the azithromycin regimen for TREATING Traveler's Diarrhea 500mg po qd x7dys
What 2 antibiotics are NOT recommended for treatment and why? Bactrim and doxycycline resistance
What 5 things should traveler's take with them when traveling to a high risk area thermometer loperamide 3dys of antibiotics ORT solution salts water purification system
What are the six most common bacterial causes of food poisoning campylobacter, salmonella, shigella, E. coli, yersinia, vibrio
What is the difference between Type A and Type C Clostridium perfringens syndromes Type A: western countries, 24hr illness, watery diarrhea epigastric pain Type C: pork consumption in underdeveloped tropical regions, intestinal rupture, sepsis
What 3 bacteria can cause food poisoning where antibiotic therapy may not be effective S. aureus, C. perfringens, B. cereus
Created by: 1450725958