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Questions and Answers
What is the most feared complication of pseudomembranous colitis?
What is the most feared complication of pseudomembranous colitis?
What condition is typically indicated by the combination of a peripheral WBC count greater than 25,000 and rising serum lactate?
What condition is typically indicated by the combination of a peripheral WBC count greater than 25,000 and rising serum lactate?
How are abdominal abscesses best managed?
How are abdominal abscesses best managed?
Which bacteria are most commonly cultured in hepatic abscesses?
Which bacteria are most commonly cultured in hepatic abscesses?
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What is a characteristic finding suggesting the development of spontaneous peritonitis?
What is a characteristic finding suggesting the development of spontaneous peritonitis?
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What is the proper treatment for severe pseudomembranous colitis?
What is the proper treatment for severe pseudomembranous colitis?
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Which of the following is a major complication of viral hepatitis?
Which of the following is a major complication of viral hepatitis?
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What should be done if a patient's ileus is severe during treatment for pseudomembranous colitis?
What should be done if a patient's ileus is severe during treatment for pseudomembranous colitis?
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What is the most common cause of peptic ulcer disease?
What is the most common cause of peptic ulcer disease?
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Which adenovirus serotypes are most commonly associated with diarrhea in infants and young children?
Which adenovirus serotypes are most commonly associated with diarrhea in infants and young children?
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What is a common feature of astroviruses as seen under an electron microscope?
What is a common feature of astroviruses as seen under an electron microscope?
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During which season do enteric adenovirus infections typically occur?
During which season do enteric adenovirus infections typically occur?
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What is the primary goal of therapy for viral diarrhea?
What is the primary goal of therapy for viral diarrhea?
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What duration differentiates chronic diarrhea from acute diarrhea?
What duration differentiates chronic diarrhea from acute diarrhea?
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What method allows for the identification of specific viral agents in cases of diarrhea?
What method allows for the identification of specific viral agents in cases of diarrhea?
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Which organism is NOT typically associated with viral gastroenteritis-like symptoms?
Which organism is NOT typically associated with viral gastroenteritis-like symptoms?
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In cases of mild viral diarrhea, what symptoms might be presented?
In cases of mild viral diarrhea, what symptoms might be presented?
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How long can viral diarrhea symptoms last, depending on the viral agent?
How long can viral diarrhea symptoms last, depending on the viral agent?
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Which type of diarrhea lasts for more than 14 days but less than 30 days?
Which type of diarrhea lasts for more than 14 days but less than 30 days?
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What is the most common clinical manifestation of acute cholecystitis?
What is the most common clinical manifestation of acute cholecystitis?
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Which organism is least likely to be cultured from biliary drainage in cholangitis?
Which organism is least likely to be cultured from biliary drainage in cholangitis?
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What diagnostic method is preferred for detecting gallstones and bile duct dilation?
What diagnostic method is preferred for detecting gallstones and bile duct dilation?
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Which test has a significantly higher sensitivity for detecting common duct stones, particularly when liver function tests are elevated?
Which test has a significantly higher sensitivity for detecting common duct stones, particularly when liver function tests are elevated?
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What laboratory finding is most commonly associated with a cholestatic pattern in liver function tests during cholecystitis?
What laboratory finding is most commonly associated with a cholestatic pattern in liver function tests during cholecystitis?
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What condition may present in elderly patients without typical pain symptoms during cholecystitis?
What condition may present in elderly patients without typical pain symptoms during cholecystitis?
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What is the primary species responsible for amoebiasis?
What is the primary species responsible for amoebiasis?
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Which of the following characteristics best describes E. histolytica trophozoites?
Which of the following characteristics best describes E. histolytica trophozoites?
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What mechanism do E. histolytica trophozoites utilize to crawl?
What mechanism do E. histolytica trophozoites utilize to crawl?
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Which structural feature is associated with the pathology of E. histolytica?
Which structural feature is associated with the pathology of E. histolytica?
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How do E. histolytica trophozoites kill host cells?
How do E. histolytica trophozoites kill host cells?
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Which of the following amoebic species does NOT cause disease in humans?
Which of the following amoebic species does NOT cause disease in humans?
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What potential complication can arise from the spread of E. histolytica trophozoites?
What potential complication can arise from the spread of E. histolytica trophozoites?
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What is the size range of E. histolytica trophozoites?
What is the size range of E. histolytica trophozoites?
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What type of receptors do E. histolytica trophozoites attach to on host cells?
What type of receptors do E. histolytica trophozoites attach to on host cells?
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What is a common laboratory finding in patients with liver abscesses?
What is a common laboratory finding in patients with liver abscesses?
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What is the most sensitive diagnostic test for identifying liver abscesses?
What is the most sensitive diagnostic test for identifying liver abscesses?
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In which scenario is open surgical drainage recommended for patients with liver abscesses?
In which scenario is open surgical drainage recommended for patients with liver abscesses?
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What type of fluid is associated with amoebic liver abscess during needle aspiration?
What type of fluid is associated with amoebic liver abscess during needle aspiration?
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What initial empiric therapy should be used for liver abscesses?
What initial empiric therapy should be used for liver abscesses?
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Which area of the liver is liver abscesses most commonly found?
Which area of the liver is liver abscesses most commonly found?
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What is the recommended follow-up if a patient continues to have fever after two weeks of treatment?
What is the recommended follow-up if a patient continues to have fever after two weeks of treatment?
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Which condition is typically ruled out when diagnosing a single liver abscess?
Which condition is typically ruled out when diagnosing a single liver abscess?
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What is a potential complication in patients with liver abscesses related to pulmonary examination?
What is a potential complication in patients with liver abscesses related to pulmonary examination?
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What is a common systemic manifestation in patients presenting with liver abscesses?
What is a common systemic manifestation in patients presenting with liver abscesses?
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Study Notes
Infectious Diarrhea
- Infectious diarrhea can be life-threatening in infants, young children, and elderly people.
- Most individuals with infectious diarrhea can be managed as outpatients.
- Diarrheal illness is one of the leading causes of death among children under five years old.
- Clostridium difficile is a common cause of infectious diarrhea and can lead to pseudomembranous colitis, which can be diagnosed using stool studies.
- Pseudomembranous colitis can be potentially fatal due to the complications of toxic megacolon and bowel perforation.
- For treating severe pseudomembranous colitis, consider oral vancomycin (500 mg q6h) combined with intravenous metronidazole (500 mg IV q8h).
- Severe cases may require surgical intervention, such as subtotal colectomy or diverting ileostomy.
Liver abscess
- A liver abscess may present as a fever of unknown origin, right upper quadrant pain (with tenderness), leukocytosis, and elevated alkaline phosphatase.
- A CT scan is the preferred diagnostic test for liver abscess.
- If a single abscess is present, perform serology to rule out amoebiasis.
- Treatment typically involves percutaneous drainage and broad-spectrum antibiotic coverage (similar to secondary peritonitis).
- Open drainage is considered in patients with biliary obstruction, multiloculated abscesses (excluding Echinococcus), or viscous exudate.
Cholangitis and Cholecystitis
- The organisms most commonly seen in cholangitis and cholecystitis are part of the bowel flora, similar to the organisms in secondary peritonitis.
- Common bacteria cultures include Escherichia coli, Klebsiella species, enterococci, and anaerobes.
- The classic symptoms of cholangitis include acute right upper quadrant pain, high fever, chills, and jaundice (known as Charcot's triad).
- Physical examination often reveals tenderness in the liver area.
- Hypotension may indicate early gram-negative sepsis.
- Elevated white blood cell count with an increase in neutrophils and bands is a common finding.
- Liver function tests are often consistent with obstruction and show elevated serum alkaline phosphatase, gamma-glutamyl transpeptidase, and bilirubin.
- Ultrasound is the recommended diagnostic test, which can identify gallstones, gallbladder dilatation, and biliary duct dilation.
- Other tests like CT scans or MRIs may be considered, but not for initial screening.
- MRCP can detect common duct stones with higher sensitivity than ultrasound (100% vs. 14%).
- ERCP can confirm the diagnosis, dilate the sphincter of Oddi, remove stones, and place stents to maintain biliary flow.
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Description
This quiz covers essential information about infectious diarrhea and liver abscesses, focusing on causes, symptoms, and management options. Gain insights into the impact of diarrheal illnesses on vulnerable populations and the critical steps in treating severe conditions like pseudomembranous colitis and liver abscesses.
