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GI Nutrition 2a


Most important agent of gastroenteritis in infants Rotavirus A
Other agents of gastroenteritis in infants Adenovirus (serotypes 40/41); Coxsackie Virus
Most important viral agent of gastroenteritis in children/adults Calicivirus
Other viral agents of gastroenteritis in children/adults Norwalk virus; Astrovirus; Reovirus
Bac agents of cholecystitis/biliary disease: Enterobacteriaceae, Enterococcus, Bacteroides Clostridium spp.
E. coli groups = small bowel processes Enterotoxigenic; enteropathogenic; enteroaggregative
E. coli groups = colon processes (bloody diarrhea): enterohemorrhagic; enteroinvasive
AIDS-associated diarrhea 2/2: Mycobacterium avium-intracellulare (MAI)
E coli group = in developed countries Enterohemorrhagic
E coli group = more common in pediatric populations (usu developing countries) Enteropath & enteroaggregative
E coli group = most common in developing countries Enteroinvasive
Severe cases of ETEC can be treated with: SMZ/TMP or quinolone; prophylaxis not recommended
Most common cause of BACTERIAL gastroenteritis C. jejuni
Neurotoxin; types A, B, and E Clostridium botulinum
Toxin A = enterotoxin; Toxin B = cytotoxin C. diff
Parasitic GI Syndromes in AIDS patients/protracted diarrhea: MAI, Giardia lamblia, Cryptosporidium parvum, Isospora belli
Parasitic GI causes of diarrheal disease G. lamblia, C. parvum, B. hominis
Intestinal amoebiasis Entamoeba histolytica
Rice-water stools; poss hypotensive shock within 2 hrs; dose effects = Vibrio cholera
HUS may be due to: E coli; shigella ETEC: tx travelers diarrhea
Shigella Sx Lower abd cramps, diarrhea, fever, bloody, purulent stools & tenesmus; usu self-ltg (7 days)
Gastroenteritis: Antimicrobial tx: used for: shigellosis, traveler’s diarrhea, C.difficile, campylobacter; can prolong salmo/C diff shedding, or worsen shiga toxin course
PUD sx Burning pain localized to the epigastrum, non-radiating; gastric ulcer: worse with meals; duod ulcer: better with meals, more often pain at night (wakes pt 2-3 AM)(DU>GU)
Virchow & Sister Mary Joseph nodes = gastric ca
Gastric ca: histo 95% adenocarcinoma; other: lymphoma, SSC
Barrett esophagus: pathophys change of squamous epi cells to columnar epi; stomach creeping up into esophagus
Plummer Vinson Syndrome Symptomatic proximal webs in middle-aged women with evidence of Fe deficiency anemia; increased risk of cancer
Schatzki ring = a web that occurs in the DISTAL esophagus
Zenker diverticulum Outpouching of upper esophagus; always involves posterior wall of pharynx; most common cause of transfer dysphagia; Men >60 yo
Achalasia: absence of esophageal smooth mx peristalsis w/ inc tonus of lower esophageal sphincter
Achalasia: S/S Gradual, progressive dysphagia; regurg; substernal discomfort/fullness
Gall stones: Etiology related to: increasing conc of cholesterol (chol stones: 80%) or bile salts (pigments stones: 15%)
Direct inguinal hernia: directly thru inguinal triangle (do not occur in infants)
Indirect inguinal hernia: abd viscera pass thru internal ring within a patent processus vaginalis
Acute panc: most common complication pseudocyst: collection of panc juice encased by granulation tissue; > 4 wks
Panc ca: RFs = tobacco; chronic panc; exposure to dyes; non-IDDM in pt >50; h/o partial gastrectomy or cholescystectomy; genetics
Panc ca: clinical findings jaundice, wt loss; Courvoisier sx; Trousseau sx
Panc cancer most common location: head; painless jaundice (compresses CBD); body/tail: abd pain d/t retroperitoneal invasion into celiac plexus
Meds assoc w/GI bleed NSAIDs; Steroids (in setting of NSAID); Warfarin; Heparin, Enoxaparin; Clopidogrel (Plavix)
Created by: Abarnard