infectious diarrhea

Question 1

3 definitions of diarrhea

Answer 1

1. acute - <14d
2. persistent - >14d
3. chronic - >30d

Question 2

what infectious agents can cause acute diarrhea?

Answer 2

1. viral
2. protozoal
3. bacterial

Question 3

what invades small intestines and disrupts normal absorption (no tissue invasion), leaving non-bloody stoool

Answer 3

noninflammatory

Question 4

what invades the colon and causes colonic tissue damage

Answer 4

inflammatory

Question 5

when would you have positive fecal leukocytes

Answer 5

inflammatory

Question 6

what is bloating more common in

Answer 6

noninflammatory

Question 7

common causes of infectious inflammatory diarrhea

Answer 7

most of the time bacterial
1. campylobacter jejuni
2. salmonella
3. shigella
4. enterohemorhagic E. coli
5. C. diff
6. cytomegalovirus
7. entamoebba histolytica

Question 8

common causes of infectious noninflammatory diarrhea

Answer 8

1. B. cereus
2. s. aureus
3. enterotoxigienic E.coli
4. vibrio cholerae
5. noroviruses
6. rotavirus
7. giardia lamblia
8. cryptosporidium
9. cyclospora

Question 9

fever and abd tenderness is commonly seen in

Answer 9

inflammatory

Question 10

volume depletion is more commonly seen in

Answer 10

noninflammatory
vibrio cholerae

Question 11

what has the shortest incubation period compared to other agents for diarrheal infections? longest?

Answer 11

1. toxin producing bacteria
   - preformed: s. aureus, b. cereus = 4-6 hrs
   - intestinal production: E. coli, vibrio sp. = 24 hrs
2. protozoans = 1-2 weeks

Question 12

when do you collect a stool culture?

Answer 12

when it’s been +2 wks and no improvement

Question 13

fecal leukocytes tests for

Answer 13

WBC
positive = inflammatory
negative = noninflammatory

Question 14

stool cultures typically detects?

Answer 14

salmonella
shigella
campylobacter

Question 15

Stool for O & P is for ?

Answer 15

identifying protozoal disorders

Question 16

what is the management for diarrhea

Answer 16

1. supportive = FLUIDS
2. antidiarrheal
   - loperamide, diphenoxylate, bismuth
3. abx
   - fluoroquinolone - cipro, levaquin
   - specific tx pending culture results

Question 17

what antidiarrheal should not be given to kids or pregnant women

Answer 17

loperamide
bismuth (not in inflammatory either)