32 terms

GI Flashcards Day 10

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Most common bacteria in gut
Bacteroides
Treatment of cholera
main thing is Fluid/electrolytes, drugs like tetracycline/fluoroquinoline/doxycline to shorten course of infecdtion if severe
V parahaemolyitics transmission/treatment
Found in seawater/shellfish/rawfish (can have blood!)... treat symptoms, generally don't ned meds but cna use tetracylin
Aeromonas treatment/info
SUpportative care, for sever use TMP/SMX, flurouqinolones, tetracylince, cephalosporins, but NOT beta-lactman antibitoics...freshwater... lasts longer in adults than children
Enterpathogenic E.Coli info
Watery diarrha, bind via adhereance factors to mucosal surface, dossluioon of lgycoalyx flattens/destroys microvilli, rare cause of traveler's diarrhea, can treat w/ tetracylin/cipro if needed but mainly just restore luid and electrolytes
Enteraggregative E.Coli info
Acute/prlonged diarrhea, adheres to cell surface in aggregate stacked brick appearance, prolly fecal/oral route, similar ot EPEC, but FLUORQUINOLONES s can reduce duraoitn of disease (im assumign supportive treatmetn if u dot' wanna shorten lenght)
Enterotoxigenic E.Coli
Adhere, secrete toxi nsimlar to v. cholera, small intestine.. toxin lead sto traveler's diarrea, occurs in children mainly, huma nto human spread... self-limited and not antibiotic requiring, can use most antibiotics but worr aboyt fluid/electrolcytes
EHEC stuff
bloody diarrhea, HUS/TTP, bloody diarrhea after severe crampiness and non-bloody diarrha, low-grade fever and hcills, can havevomiting... daycare centers, bad meet, etc... LARGE bowel (compare dto toxigenic)... produces shiga-toxin and another cytotoxin, DONT" GIVE ANTIBIOTICS, use supportive care
EIEC stuff
TMP-SMX for susceptible strains, replete flud/electolytes mainly... shiga-like toxin, watery diarrea, soemtimes dysentery w/ blood mucous diarrhea, CAN do HUS/TP, can have lower abdominal pain, recdtal bunring, diarrhea... invade colonic epitheilaum leading to inflammatory exudate, cna also secrete cytotoxic toxins, neurotoxins, netertoxins.. fecal-oral... Replete fluid/electrolytes, quinolones are drugof choice which shoudl be used for moderate/severe dysentery cases or persistent diarrhea
Salmonella info
gneg rod, gastroenteritis, BACTEREMIA, bone/oint abscess ,meningies, tyhpoid fever (Hectic fever, delirum, persistent bacteremia, splenic enlargment), carrier state... illeum/colonn, mucosal ulcertian, facultative intracellular... 5 Fs, eggs and pultry... antibiotics don't hlep, use fluoroquinolone when immunocomporomised/malignancy comlicates the gastroenteritis... can also cause viral-hepatitis-like illness w/ fever and heaptomegaly and mild ALT/bilirubin elevations
Camplybacter
Frank diarrhea/dysentery/fever, may trigger guillain barrre syndrome, targets peyers patches m cells ot invade epithelium, chicken issue (infected animals and food products), VERRY COMMON (most common enterpoathogen in developed countries), erythrmoycin/ffluoroquinolones if dysentery of suspecdt bacteremia
Yersinia entercolticia
Non-lactose fermenting, urease positive... risk facdtor in diabetes, cirrhosis, hemochromatosis... profuse diarhea related to enterotoxin, can have if lasting for al ong time can be thought to be IBD... bacteremia uncommon, can mimic appendicities, found in streams/lakes... ASSOCIATD W/ ERYTHEMA NODSOUM AND REACDTIVE POLYARRHTIS, can last long time... treatmetn generally dont alter course so just use in severe cases (standard ones)... hepatic abscess former too
Rotavirus does what
Causes watery diarrhea by entertoxin that activates enteric nervous system, hits children waordlward, fecal oral (protected in first 3 months)... infecdtion gives immunity.. .treat w/ fluids/elecdtrolytes
Norovirus
other name is calicivirus, non-bloody diarrhea, abdomonail cramps, vomiting, msucle aches, person/erpson and fecal oral, curise ships, nurisng homes, hospitals... usually mild disease just do symtpoms
Adenovirus
Diff from the ones tht cause resp illness.... hits hchildren but can effect adults w/ aids, person to person, self-limited and supportive care
Staph aureus info
toxin mediated in food, usually clustred w/i na fam... 1-4 hrs after ingestion u have nasuea vomiting abodminal cramps diarhrea for 1-2 days, no fever
Chlostridium perfringens
Pultry or other meet as infecdtion source... watery diarrhea/cramping abdominal pain due ot cytotoxin and enterotoxin... sypmstoms last 24 hours after 10 hours
Chlostridum botulinum
IRREVERISLY bind ot cholingeric nerve endings (ACH release inhibited), most lethal toxin mediated food borne illness... antitoxin available but otherwise treatemt just supportive
Bacillus serious info
aerobic spore former, gram pos rod... diarhea syndrome from entertoxin similar to cholera.... abdominal cramps, vomiting, fever uncommon, spores can wisthand extreme temperatures... vomiting syndroem is from different preformed toxin, usually contaminated rice... the vomitng entertoxin is heat stable
Listeria findigns
Highly motile bacilli, soft cheese, assocatw/ bacteremia to meningites to heart valves, etc... diarreha nd cramping preced fever and bacteremia... cna have neuroligc sequelae
Treatment /info for chlostridium dificile
Metronidazole (watch out or acetaldyhde DH blockign effecdt), vancomycin, probitoics... nosomical infecdtions, pseudomonas colitis, toxic megaclon/colonic performation/death, fecal oral transmsion w/ spores difficult to kill
most common intestinal parasite in us
giardia
Giardia lamblia
Most common intestinal parasite in US,... extracellular intestinal protozoan, can be asymptomatic, or sever diarrhea/malbsrotipn... attach to bursh border of duodenal and jeunal epithelium... cysts in contaminated water (campers, kids places)... TREAT w/ MERONIDAZOLE... not invasive (entemoeba is)
Treatment for amoebiasis
Iodoquinol or paromomycin, for lumen... metronidazole for absess (Dependso n location)
Tropheryma whipplei
Gram positive stains w/ PAS... malabsroption w/ weight loss, diarrhea, abodminal pain, cNS invasion (demetnia and cogntiive changes)< cardiac manifestioatins (endocardiits, mycardities, percarditiesis0, arthralgias too... antibiotics for ONE YEAR
Risks associated w/ celiac disease
Type 1 diabetes, AI thyroid disease, Down's syndrome, williams' syndorme, turner's sydnrome, sleecdtive IgA deficinecy, first degree relaives of affected individuals
Symptoms of pyogenic abcesses
Abdominal pain in L or R (Dependign on lobe) upper quadrant, peritonits diffsue badomonial pain if it's developed, diarrhea, weightloss, fever, chills, cough occasionally, pleuritic hest pain, R shoulder pain, enlarged liver, jaunice uncommon
Important liver abcess bugs
E.coli, klebsiella, bacteroides, clostridium, enterococcus
Brucellosis causes what
granulomas in liver... pigs cattle goat sheep
Info about entamoebia
Cysts ingested (food/water), gets to small bowel, open up, atach to colonic epithelium to cause colitis (raised borders w/ ulcer)... chornic vs indolent (leukocytosis and all the nonsepcific symptoms vs increasd alkphos and anemia and enlarged liver and minimal elevation of WBCs)... males more than females... METRONIDAZOLE for abscesses, iodoquinol/paromycin for lumilal infection
Shitosomiasis info
Eggs released in stool, go miracida, miracida to snailes, snails release cercaria for humans to get penetration (systemic ciruclation)... lay eggs in intestinal mucosa... GRANULOMA formation against eggs, redness at sin pneetration site (Swimmer's itch), chorinc infection is major complication, which is asytmpomatic until overt liver failure or variceal bleeding, uhave hepatosplenomegaly, osinophilia... USE PRAZIQUANTEL.... treat water and snail contorl to help out
Echinococcus stuff
Dogs and sheep (dog is main host, sheep intermediate), and we eat the eggs by accidnet... liver cysts develop sLOWLY... u dont' ge tmuch hepatomegaly and only mild elevation of liver enzymes.. u ahve hyatid cysts 9single/multpile watery cysts), bursts mean anaphylaxis/death risk.... drugs are PRAZIQUANTEL and MEBENDAZOLE