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SURGERY

Gastroenteritis

QuestionAnswer
Gastroenteritis - define inflammation of the mucous membrane of both stomach and intestine; most commonly used for infectious processes
How does gastroenteritis cause death? dehydration
Viruses that cause diarrhea and enterocolitis rotavirus, Norwalk virus, coronavirus, adenovirus
Bacteria that cause secretory diarrhea vibrio cholerae, E. coli, Bacillus cereus, Yersinia enterocolitica, M. tuberculosis, C. perfringens, C. difficile [antibiotic-associated pseudomembranous colitis
Bacteria that cause dysentery Shigella, Salmonella, Campylobacter, E. coli
Dysentery Diarrhea with mucus or blood
Parasites that can cause gastroenteritis E. histolytica, Giardia lamblia, and various worms
Gastroenteritis/Infectious Diarrhea is responsible for what % of worldwide deaths in pts <5yo? 0.5
Can gastroenteritis mimic the acute abdomen? Why? Yes because presents w similar sx's, esp if enteroinvasive organisms; infection can produce extreme pain without being life-threatening if appropriate steps are taken to avoid dehydration.
Which organism closely mimic appendicitis? Yersinia enterocolitica
Can gastroenteritis cause an acute abdomen? In which cases? (3) Y. Surg emerg: 1. In severe GE, mucosal damage & inflam may cause perforation, 2. Necrotizing enterocolitis (low-birth-weight neonates within the first 3 months of life), 3. Pseudomembranous colitis (C. difficile) can lead to toxic megacolon
Pt with nausea vomiting and watery diarrhea; what is it?; location; organisms Gastroenteritis from viruses, toxins (S. aureus, B. cereus), any enteric; stomach and small intestine
Pt with volumnious watery diarrhea, upper abd pain and cramps; what is it?; location; organisms secretory diarrhea; small intestine, maybe colon; any enteric organism
Pt with frequent, small volume stools, fecal urgency, tenesmus, and dysentery; what is it?; location; organisms Colitis and proctitis; colitis >15cm of inflammation, proctitis 15cm of distal colon; Shigella, Campylobacter, Salmonelle, Ecoli 0:157 H:7
Layers of the small intestine (5) 1. serosa, 2. longitudinal muscle, 3. Circular muscle, 4. Submucosa, 5. Mucosa; SLCSM
What is the difference between the mucosa in the jejunum vs. the ileum? jejunum - has many more circular folds - waves of Kerckring; ileum has many more lymphoid nodules and peyer's patches
Bacteria that is considered normal flora in the oropharynx Viridans strep., S. mutans, anaerobes in gingivae
Bacteria that is considered normal flora in the stomach and small bowel relatively sterile
Bacteria that is considered normal flora in the colon Bacteroides, E. coli
Bacteria that is considered normal flora in the urinary tract S. epidermidis, E. coli, diphtheroids
Bacteria that is considered normal flora in the vagina Lactobacillus, E. coli, group B strep
Bacteria that cause dysentery Shigella, Salmonella, Campylob.
Bacteria that cause diarrhea V. cholerae, E. coli, C. difficile
Abx for dysentery or diarrhea Fluoroquinolones (ciprofloxacin/levofloxacin), TMP/SMX (Bactrim for MRSA); Metronidazole or vanco PO for C. difficile
Bacteria that frequently cause UTI's E. coli, enterococci, S. saprophyticus, etc.
Abx for UTI's Fluoroquinolones, TMP/SMX
Abdominal pain from opportunistic infections in immunocompromised pts disseminated fungal infections, CMV, etc.
Abdominal pain from unusual infections in immunocompromised pts strongyloides, bacillary peliosis hepatis
Neutropenic enterocolitis causes abdominal pain in immunocompromised pts
Created by: christinapham
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