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GI 1 Infections
Infections: Bacterial, Viral, Parasitic/Protozoal, Hepatitis
Question | Answer |
---|---|
What are the characteristic features of a pt presenting with pericarditis? | Fever, pleuritic CP relieved by leaning forward, dyspnea, cough. Diffuse ST elevation on EKG, JVD, and pericardial friction rub |
What is an acceptable urine output in a trauma pt? | 50cc/hr (30cc/hr for normal person) |
What are some of the causes of an exudative pleural effusion? | Cancer, vasculitis, infection, TB, PE, and pancreatitis (look for amylase in effusion) |
Name that infectious agent?: food poisoning as result of mayonnaise sitting out too long | staph aureus |
Name that infectious agent?: rice water stools | vibrio cholera. also ETEC |
Name that infectious agent?: diarrhea transmitted from pet feces | yersinia enterolitica |
Name that infectious agent?: food poisoning resulting from reheated rice (Chinese food) | B cereus |
Name that infectious agent?: MCC of traveler's diarrhea | ETEC |
Name that infectious agent?: diarrhea after a course of abx | C diff |
Most likely causative agent of C diff? | Clinda the wicked witch of the west! |
Name that infectious agent?: diarrhea + recent ingestion of water from a stream | entamoeba histolytica, Giardia lamblia |
Name that infectious agent?: mild intestinal infection that can become neurocysticerosis | taenia soleum |
Name that infectious agent?: food poisoning from undercooked hamburger | EHEC |
Name that infectious agent?: diarrhea from seafood | Vibroio parahaemolyticus (seafood, oysters), vibrio cholera (water, seafood) |
Name that infectious agent?: bloody diarrhea from poultry | campylobacter, salmonella |
Name that infectious agent?: diarrhea + pink eye | adenovirus |
Name that infectious agent?: blood diarrhea--> liver abscess | Entamoeba histolytica |
Name that infectious agent?: diarrhea in an AIDS pt | cryptosporidium, isospora |
Name that infectious agent?: dehydrated child with greenish diarrhea in winter months | rotavirus |
What is the tx for entamoeba histolytica? | metronidazole |
What is the tx for giardia lamblia? | metronidazole |
What is the tx for salmonella? | Supportive; quinolones if severely ill |
What is the tx for shigella? | Quinolones or bactrim in severe cases |
What is the tx for campylobacter? | +/- erthryomycin (generally self-limited) |
How does the tx for Hep B differ from Hep C? | Hep B: interferon-alpha (std or peg) or antiviral (lamivudine, adefovir, entecavir, or telbivudine). Hep C: peg IFN + ribavirin |
Which hepatitis confers a high risk of chronic hepatitis? | Hep C |
Which hepatitis confers an increased risk of HCC? | Hep B |
Which type of infection is represented?: Hep BsAg neg, Hep BsAb neg, Hep BcAb pos IgM | Acute infxn, window phase (Ab and Ag cancel each other out; clue is the positive IgM) |
Which type of infection is represented?: Hep BsAg pos, Hep BsAb neg, Hep BcAb pos IgG | chronic hep B infxn (If Hep B E Ag is +, they are infectious. If neg, they have less viral replication and good prognosis.) |
Which type of infection is represented?: Hep BsAg neg, Hep BsAb pos, Hep BcAb neg | Immunized (core Ab is only positive if you've been infected before) |
Which type of infection is represented?: Hep BsAg neg, Hep BsAb pos, Hep BcAb pos IgG | Past infxn, recovered |
Diarrhea outbreak on cruise ship? | Norwald virus |
The beach, cute boys, and trouser chilli? Name 2 common causes of summer diarrhea. :( | Coxsackie virus A1 and echovirus |
Pink eye, URI, and diarrhea. | Adenovirus |
Will you find fecal white blood cells in viral gastroenteritis? | Nope |
How can you differentiate alcohol-induced hepatitis from viral hepatitis with AST and ALT? | In alcohol-induced, AST will be much higher than ALT (higher ratio). Think A Scotch and Tonic for AST. In viral hep, the AST:ALT will not be as high. |
Which bacterial infxn can mimic appendicitis? | Yersinia enterolitica: RLQ pain, fever |
What is the most concerning complication of vibrio cholera? | Death by dehydration |
Which bacterial GI diarrheal illness should NOT be tx with abx? Why not? | EHEC O157:H7. Abx may worsen the condition by causing toxin release |
In which bacterial GI diarrheal illness does abx use prolong the carrier state? | Salmonella. In severe cases, can give flouroquinolones, but want to avoid b/c of risk of spreading infection with prolonged carrier state. |
Which two bacterial GI diarrheal pathogens increase the risk of developing HUS? | EHEC O157:H7 and Shigella (the bloody ones) |
Can botulinum antitoxin be given to babies? | Nope |
First line tx for C diff? Second line? How must second line be given? | 1st line is metronidazole. 2nd line is vanc, but it has to be PO so it won't get absorbed (stays in gut to kill C diff) |
Mariah Carey consumes a plate of raw oysters hoping to spice up her marriage to Nick Cannon. Next thing she knows, the only spicy thing in her life is the trouser chili she's making in her bathroom. Dx? | Vibrio parahaemolyticus |
A 30yo avid hiker is celebrating his birthday at a dinner with friends. During his toast, he states how thankful he is to be well after the recent "stomach" problems he had. After dinner, he feels flushed, nauseous, and short of breath. Dx? | Disulfiram rxn from combining metronidazole and alcohol. He's on the metronidazole because he got giardia drinking out of some dirty lake on a hiking trip. He should be more careful about what he drinks. Oopsies! |
Which hep virus requires another virus to infect someone? | Hep D (needs Hep B to infect someone)-- it's a very need-D virus |
Which hepatitis has a high infant mortality rate when occuring in preggers ladies? | Hep E |