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Bugs and Drugs GI
Question | Answer |
---|---|
Clostridium dificile type of bacteria | anaerobic |
How does C. diff spread | spores-need to wash hands with soap and water |
Symptoms C. diff | diarrhea, no blood, crampy pain esp with BM |
Complication C. diff | toxic megacolon- peristalsis stops and dilates, leads to colectomy because of necrosis |
Risk factors for C. diff | -abx use, hospitalization |
Diagnosis of C diff | 2 step testing: ag in stiool, then PCR for toxin (not all C diff make toxins) |
Treatment C diff | Well: Flagyl 500 PO TID X14 d. Sick: Vanco 125 PO QID X14d, consult gen surg |
Relapse tx of C. diff? | First: Flagyl. 2nd: Vanco. 3rd: HELP! |
Peds and C. diff? | Commonly colonized, but unlikely to be causing diarrhea. Don't test for. |
When to do stool O&P? | Bloody, travel history, longer than 1 week, fever (also consider blood culture) |
Typhoid fever organism and mode of infection | Salmonella typhi, GN rod, fecal-oral (incl water) |
Symptoms of typhoid fever | Starts with low grade fever, liver enzymes rise, GI tract weeks later, diarrhea/constipation |
Complications tyhoid fever | Perforation, GIB, osteomyelitis, septic arthritis |
Diagnosis typhoid fever | Blood culture, stool culture (3rd week on), bone marrow (CALL ID) |
Treatment typhoid | Call ID! Ceftriaxone |
Risk factors for thrush | AIDS (normal in babies), inhaled steroids, immunocompromised |
Liver abscess causes | *diverticulitis, appendicitis or biliary tree obstruction |
Bugs in liver abscess | anaerobes, GN |
Treatment of liver abscess | Drain!! Pip-tazo OR ceftriaxone + metronidazole |
Entamoeba histolytica organism type | amoeba!! protozoan |
Risk factors for Entamoeba | Travel history, Mexico, tropical, fecal-oral transmission |