Infectious Diarrhea Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
| Question | Answer |
| Defn diarrhea | >3/day; 200 g or ml; loose/liquid consistency |
| Acute/ persistent/ chronic | Acute <14 days; Chronic >1 month |
| Chronic diarrhea: etiology | Malabsorption; motility disorders; inflammation |
| Assessing severity of illness | dehydration; duration of sx; inflammation (fever, blood, tenesmus) |
| Order stool studies if: | Diarrhea is persistent or recurring; h/o fever or tenesmus |
| E. histolytica | necrosis of lg intestine; tropical; abd pain, cramping, colitis; can be bloody/fevers; travelers, MSM |
| Vibrio | watery dia, abd cramping; V para: also wound infxn; heat to >75C to destroy; susceptible: liver dz & Fe overload states |
| V cholera MOA | activates adenylate cyclase (cAMP regulates Na & Cl absorpn/secretion) |
| V cholera S/S | rice-water stools; poss hypotensive shock within 2 hrs; dose fx; tx rehydrate & 1 dose Cipro; untx’d 50% mortality |
| Pre-formed toxins: organisms | S aureus; B Cereus; Clostridium Perfringens |
| Giardia: most susceptible | immunocompromised; immunocompetent w/Ig def |
| Dx giardiasis with: | giardia antigen stool assay |
| C perfringens sx | Abd cramps & watery diarrhea without fever or N/V; lasts <24 hr |
| Invasive pathogens (most common causes of infxs diarrhea) | Salmonella, shigella, campy, hemorrhagic E coli |
| E coli: most likely from: | undercooked beef; unpasteurized juice; spinach; in warm weather |
| E coli: hemorrhagic colitis: | severe abd pain, bloody diarrhea (no fever usually) caused by shiga or shiga-like toxin |
| HUS may be due to: | E coli; shigella |
| ETEC: tx | travelers diarrhea; Abx after sx onset may decrease duration; Cipro or rifaximin |
| Salmonella Sx | fevers, myalgias, abd cramping, HA; |
| Salmonella complications | Septicemia/Bacteremia; poss osteomyelitis, endocarditis, arthritis |
| Salmonella typhi Sx | 10-14d post-ingestion: fever, HA, myalgia, malaise, anorexia; followed by GI sx (GB colonization & intestine reinfxn); typhoid fever: pulse-temperature discordance; 1-5% chronic carriers |
| Shigella Sx | Lower abd cramps, diarrhea, fever, bloody, purulent stools & tenesmus; usu self-ltg (7 days) |
| Shigella Tx | Abx recommended (FQ or Bactrim) |
| Yersinia Sx: | Diarrhea, fever, abdominal pain for 1-2 wks (chronic: poss for mos); fx terminal ileum; lg lymph nodes (mimics appy); systemic dz: high mortality |
| Campy Sx: | dysentery; poss bacteremia; usu self ltg (may last 1 wk/longer); assoc w/GBS & Reiters |
| Most common cause of nosocomial diarrhea | C diff (Abx-induced diarrhea); tx w/Flagyl or oral vanco |
| Loperamide | opiate w/o systemic fx; inhibits peristalsis; can use w/Abx for traveler’s diarrhea |
| DO NOT use anti-motility agents in: | pts w/shigella, C diff, E coli O157 (inflammatory diarrhea) |
| Antimicrobial tx: used for: | shigellosis, traveler’s diarrhea, C.difficile, campylobacter; can prolong salmo/C diff shedding, or worsen shiga toxin course |
| Tx of choice for more severe infxs diarrhea: | FQ; TMP-SMX = 2nd-line tx; Add azithro for Campy |
| Common antibiotic causes of colitis: | Ampicillin, clindamycin, tetracycline, cephalosporins |
| C diff mgmt: | IV/PO Flagyl or PO vanco. 20% relapse in 1-2 wks after DC of therapy; relapses respond well to 2nd course of tx. Multiple relapses: consider taper & pulsed therapy |
| Diarrhea | >3/day or 200 mL; osmotic vs secretory; dx: fecal WBC, occult blood, flex sig/bx, upper GI |
| Diarrhea: inflam vs non-inflammatory agents | inflam: cMV, E histo, EHEC, C diff, SSC; non-inflam: noro, rota, giardia, crypto, SA, B cereus, vibrio cholera |
| Diarrhea: Abx for: | Shigella, cholera, ETEC, C diff; No Abx for salmo, campy, EHEC, Yersinia |
| Oral Rehydration Solution: | 3.5 g NaCl, 2.5 g Na HCO3, 1.5 g KCl, 20 g glucose, in 1L water |
| Traveler’s Diarrhea is caused by: | E. coli (ETEC); tx is hydration & Cipro |
| Greasy, foul smelling, floating stools. Pear-shaped flagellated protozoan w/ 2 “eyes”. Water, travel, camping history | Giardia |
| Afebrile, watery or loose stool. No blood or mucus | Viral Gastroenteritis |
| Abdominal pain, diarrhea after picnic/party. Eaten ham, cream, custards, mayonnaise | Staphylococcus aureus infectious diarrhea |
| Acute bacterial diarrhea w/ prodrome of HA, F, then crampy abd pain & diarrhea | Campylobacter jejuni (most common cause of acute bacterial diarrhea) |
| 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 |
| 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 |
| Parasitic GI Syndromes in AIDS patients/protracted diarrhea: | MAI, Giardia lamblia, Cryptosporidium parvum, Isospora belli |
| Toxin A = enterotoxin; Toxin B = cytotoxin | C. diff |
| 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 |
| Vibrio cholera MOA | stimulates adenyl cyclase in intestinal epithelial cells to overproduce cAMP => H2O & Cl- hypersecretion => diarrhea |
| salmonella: 3 patterns | Enteric (typhoid) fever; gastroenteritis; bacteremia |
| Salmonella: Enteric (typhoid) fever S/S | 5-14d incubation, insidious (kids abrupt); F, HA, ST, myalgia, malaise; abd pain, pea soup diarrhea; pulse-temperature discordance; freq relapse; 1-5% chronic carriers |
| Salmonella: gastroenteritis S/S | most common salmonella type; 8-48 hr incubation; F, N/V, crampy abd pain, bloody diarrhea 3-5d; +stool cx |
| Salmonella: bacteremia S/S | usually in immunocompromised pt; recurrent fever, local infxn (bone, joints, lungs) |
Created by:
Abarnard
Popular Medical sets