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Step III

Step III - GI 5

QuestionAnswer
Surgery is curative under what circumstances for Crohn’s dz Stricture OR obstruction
Stress ulcer prophylaxis is used under what circumstances using what drug(s) head trauma/mechanical intubation/coagulopathy + steroid use combo/burns; H2 (-)/PPI/sucralfate
What is the most important feature of diarrhea that directs you to infectious type BLOOD = invasive
What is the MCC of food poisoning Campylobacter
Campylobacter is also a/w with what other dz Reactive arthritis/Guillain Barre
Where is salmonella typically found Eggs and chicken
Seafood is a/w what infectious diarrhea bug Vibrio parahemolyticus
Which E. coli type is a/w HUS E. coli 0157:H7
Undercooked beef is a/w what bug E. coli 0157:H7
Pt has liver dz, skin lesions, ate clams/oysters, and now has bloody diarrhea. Dx Vibrio vulnificus
Beside campylobacter what other bug is a/w reative arthritis Shigella
Rodents, infected vegetable/meat/milk w/ urine/feces of rodent. Bug Yersinia
If case does not mention blood in diarrhea what test can you order that will allow you to link dx with infectious diarrhea bugs Fecal leukocytes
Best initial test for bloody diarrhea Fecal leukocytes
Most accurate test for bloody diarrhea Fecal cx
Tx for mild bloody diarrhea IVF
Best initial Tx for severe bloody diarrhea Fluoroquinolone eg cipro
What is defined as severe diarrhea Fever/blood/ab pain/HYPOtension/tachy
What are the bugs that more likely present w/ bloody diarrhea (but can also be non-bloody, shitballz!) campylobacter, salmonella, vibrio para, e. coli, yersinia, amebia, shigella, vibrio vulnificus
Which bugs NEVER produce bloody diarrhea rotavirus/norwalk/giardia/scombroid/b. cereus/s. aureus/cryptosporidiosis
Pt w/ non-bloody diarrhea + vomiting. Bug S. aureus
Pt w/ non-bloody diarrhea + camping/hiking OR men having sex w/ men + c/o flatus/bloating/steatorrhea. Bug Giardia
Most accurate test for Giardia ELISA Ag >>>> 3 stool ova parasite test
Tx for Giardia metro
Pt w/ non-bloody diarrhea + HIV w/ CD< 100. Bug Cryptosporidiosis
Pt w/ non-bloody diarrhea onset 10 minutes of eating tuna/mahi mahi/mackerel + wheezing, coughing, flushing/vomiting. Bug Scombroid (histamine fish poisoning)
Tx for scombroid Benadryl
Dx for cryptosporidiosis is made by Modified acid fast stain
Pt w/ bloody diarrhea + hx antibx days/weeks ago + fecal luekocytes. Bug C. dif
Best initial test for C. dif Stool TOXIN assay
Best initial tx for c. dif Metro
If metro fails for tx of C. dif then next tx PO vanc (NOT IV)
Pt has C. dif and tx w/ metro. Resolves only to come back again. Tx Metro again (not vanc)
Flushing, wheezing, chr diarrhea + episodes HYPOtension Carcinoid syndrome
Diagnose Carcinoid syndrome with Urinary 5-HIAA level
Tx for Carcinoid syndrome Octreotide (somatostatin analogue)
Created by: DrINFJ