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What is a primary cause of primary peritonitis?
Which type of bacteria predominantly causes primary peritonitis?
Which of the following is NOT a cause of secondary peritonitis?
What microbiological profile is characteristic of secondary peritonitis?
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Which of the following conditions could lead to secondary peritonitis?
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What defines acute diarrhea based on duration?
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Which of the following describes noninflammatory diarrhea?
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Which microorganisms are commonly associated with dysenteric diarrhea?
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What is a key manifestation of gastrointestinal infections?
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Which viral pathogens are noted for causing gastrointestinal infections?
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What type of diarrhea is characterized by an increase in stool frequency of more than 3 times per day?
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Which organism is most commonly associated with enterotoxigenic poisoning?
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What is a key factor in designing a management plan for a patient with recurrent C. difficile infection?
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What distinguishes watery diarrhea from dysentery?
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Which of the following is a common complication associated with dysentery?
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What mechanism is primarily responsible for watery diarrhea?
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Which organism is NOT typically associated with watery diarrhea?
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What role does serum C reactive protein (CRP) play in infectious diarrhea diagnosis?
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Which preventative measure can help reduce the risk of infectious diarrhea in children?
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What dietary approach is recommended for managing mild, self-limiting acute gastroenteritis?
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Which symptom is most commonly associated with gastroenteritis?
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What is the initial surgical approach for managing secondary and tertiary peritonitis?
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What is the primary goal of antimicrobial therapy in the context of peritonitis?
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Which agent is primarily recommended for the treatment of primary peritonitis caused by cirrhosis?
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What does source control refer to in the management of secondary or tertiary peritonitis?
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Which of the following is a complication that antimicrobial therapy aims to prevent?
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When managing primary peritonitis, what is an alternative agent if the primary agent fails?
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What is the main focus of hemodynamic resuscitation in the context of peritonitis treatment?
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Why might draining an infected site be important in surgical management of peritonitis?
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In cases of severe dehydration from diarrhea, which solution should be administered initially to restore hemodynamic stability?
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Which of the following symptoms indicates the need for IV rehydration therapy?
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What is the typical oral rehydration therapy repletion range recommended?
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For adults with watery diarrhea caused by enterotoxigenic Escherichia coli, which antibiotic is the first-line treatment?
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Which of the following is NOT a recognized indication for IV rehydration therapy?
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Which antibiotic option is appropriate for treating dysenteric diarrhea caused by Campylobacter species?
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When treating nontyphoidal Salmonella infections, which of the following antibiotics can be used as an alternative?
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What is the recommended treatment duration for immunocompromised patients suffering from dysenteric diarrhea?
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For traveler’s diarrhea, which of the following is a combined treatment and prophylaxis option?
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Study Notes
Peritonitis
- Primary peritonitis (spontaneous bacterial peritonitis) infects the peritoneal cavity without an obvious abdominal source; bacteria typically travel from the bloodstream.
- Secondary peritonitis involves a source within the abdomen, such as GI perforation, post-surgery, or trauma.
Causes of Peritonitis
- Primary: Cirrhosis with ascites, peritoneal dialysis
- Secondary: Abdominal surgeries, intestinal obstruction, GI perforation, malignancy, trauma
Microbiology of Peritonitis
- Primary: Usually monomicrobial; Gram-negative Enterobacteriaceae or Gram-positive streptococci.
- Secondary: Typically polymicrobial; Gram-negative bacilli ( E. coli, Enterobacter, Klebsiella, Proteus, Pseudomonas), Gram-positive cocci (Enterococcus, Streptococcus), enteric anaerobes (Bacteroides, Clostridium), and fungi (Candida).
Gastrointestinal Infections
- Characterized by diarrhea, potentially with nausea, vomiting, fever, and abdominal pain.
- Diarrhea is defined as increased stool water content, volume, or frequency (>3 stools/day). Categorized as acute (<14 days), persistent (14-28 days), or chronic (>28 days).
- Noninflammatory diarrhea produces watery stools; inflammatory diarrhea (dysentery) produces bloody stools.
Etiology of Gastrointestinal Infections
- Viruses (rotavirus, norovirus), bacteria (Shigella, Salmonella, Campylobacter, EHEC, Yersinia, C. difficile), and parasites.
Acute Infectious Diarrhea: Watery vs. Dysentery
- Watery: Watery stools (<10/day), occult blood negative, few fecal polymorphonuclear cells; caused by toxins, reduced absorption; complications can be severe (dehydration, acidosis, shock).
- Dysentery: Bloody stools (>10/day), occult blood positive, many fecal polymorphonuclear cells; caused by toxins and mucosal invasion; complications are generally milder (tenesmus, rectal prolapse).
Clinical Presentation and Diagnosis of Gastroenteritis
- Diarrhea, nausea, vomiting, fever, abdominal pain.
- Diagnosis involves clinical evaluation (travel history, diet, medications), serum C-reactive protein (CRP) for inflammatory vs. noninflammatory differentiation, stool culture, and PCR.
Prevention and Treatment of Gastroenteritis
- Prevention methods include hand hygiene, safe food handling, vaccines, breastfeeding, and oral rehydration therapy (ORT).
- Treatment for mild cases involves ORT and a bland diet (BRAT diet). Severe cases require IV rehydration, antibiotics, and/or antimotility agents. IV lactated Ringer's solution is preferred over normal saline for rehydration.
Antimicrobial Therapy for Gastroenteritis
- Specific antibiotics are chosen based on the identified pathogen (e.g., ciprofloxacin, azithromycin, ceftriaxone for various bacterial infections).
Intra-abdominal Infections (IAIs) Management
- Surgical procedures are crucial for secondary and tertiary peritonitis to address the source of infection (e.g., drainage, repair of perforation).
- Antimicrobial therapy aims to eliminate infection, prevent complications, and reduce spread.
- Empiric management of primary peritonitis in cirrhosis often includes ceftriaxone or cefotaxime; alternative options are available.
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Description
This quiz explores the essential concepts of peritonitis, including the distinction between primary and secondary forms, their causes, and the microbiological aspects. Test your knowledge on what leads to these infections and their characteristics.
