Term
| How do enteropathogens evade the normal defenses of the GI |
|
Definition
Acid Resistance
Ingestion of large numbers
Protected in food
Adherence and colonization of mucosa |
|
|
Term
| What are the major differences between inflammatory and Non-Inflammatory diarrhea |
|
Definition
Inflammatory:
Blood
Leukocytes
Frequent, small volume movements
Large Bowel |
|
|
Term
| What are the major pathogens causing inflammatory diarrhea |
|
Definition
Salmonella
Shigella
Camylobacter
E.coli(EIEC, EHEC)
Yersinia
C.difficil
CMV
E.histolytica |
|
|
Term
| What is the first symptom of food poisoning and is it inflammatory |
|
Definition
Vomiting
Non-inflammatory |
|
|
Term
What are the clinical features of Food poisonings with
Staph aureus
Bacillus cereus
Clostridium perfringens
Scromboid Fish poisoning
Ciguatera
Pufferfish |
|
Definition
Staph: Prominent vomiting
Bacillus(rice)(presentation depends on toxin): Emetic
Diarrheal- Longer Incubation
Clostridium: diarrheal form store meat
Scromboid: Preformed histamine
Ciguatera: Neurotoxin in Barracuda, Red snapper, Grouper
Pufferfish: Neurotoxin with CV features |
|
|
Term
| What are the major causes of anti-biotic associated diarrhea and how can they be differentiated? |
|
Definition
C.diff
Inflammatory: WBC, Blood, Fever
Pseudo membranes
No dose-related response
Altered Gut Flora
Watery, Non-inflammatory
Dose Related |
|
|
Term
| What is the most common cause of traveler's diarrhea and is it an inflammatory diarrhea? |
|
Definition
Enterotoxigenic E.coli
Not Inflammatory |
|
|
Term
Typical diarrheal organism for:
Bone absess?
Guillan Barre?
Reactive Arthritis?
Small bowel progressing to large bowel?
Hamburger?
Cruiseships?
Chicken/Poultry?
Raw Seafood?
Contaminated Water to immunocompromised? |
|
Definition
Chicken/Poultry/Bone abscess: Salmonella-Metastatic(vascular, bone, meninges)
Reactive Arthritis/Guillian Barre: Campylobacter
Small->large bowel: Shigella
Undercooked hamburger/Hemolytic Uremic Syndrome: E.coli o157:H7
Cruiseships: Norovirus
Raw seafood: Vibrio parahaemolyticus
Water/Immunocompro: Cryptosporidium |
|
|
Term
| Are stool cultures common and when are they run |
|
Definition
No, because of low sensitivity
Run early in admittence, never during prolonged in-patient |
|
|
Term
| What are the common treatments for infectious diarrhea? |
|
Definition
Fluid/Electrolytes: Most common
Symptomatic: Loperamide, Colloidal Bismuth
Antibiotics: |
|
|
Term
| When can anti-biotics be used for infectious diarrhea and when should they not be used |
|
Definition
Not in: E.coli O157:H7 bc of HUS
Uncomplicated salmonella
Used for:
C. diff
Traveler's Diarrhea
Shigellosis
Risk for Metastasis of Salmonella infection |
|
|
Term
| When can loperamide be used and when is it contraindicated |
|
Definition
Used for:
Traveler's Diarrhea
Salmonella
Not for:
Children
Shigellosis
C.diff
E.coli- bc of HUS |
|
|
Term
|
Definition
Metronidizaole or
Vancomycin |
|
|
Term
| What should be considered if there is persistant diarrhea(>7 days) |
|
Definition
|
|
Term
| What bacterial causes of diarrhea are not inflammatory in nature? |
|
Definition
Cholera
ETEC
EPEC
Food Poisonings |
|
|
