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PANCE Prep Pearls: 3rd Ed. (2019)
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Infectious Diarrhea

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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid

Infectious Diarrhea
18 Picmonics to Learn | 37 mins
Gastroenteritis
Cause/Mechanism
Viruses
Bacteria
Food Intolerances
Assessment
Flu-Like Symptoms
GI Distress
Bloody Stool
Interventions
Oral Rehydration
Considerations
Self-Limiting
Prevention
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2 mins
Norovirus
Characteristics
Calicivirus
RNA Virus
Non-enveloped
Icosahedral
SS Positive Linear
Symptoms
Acute Gastroenteritis
Treatment
Supportive Therapy
Considerations
Often found in Cruise Ships
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1 min
Rotavirus
Characteristics
Reovirus
Non-enveloped
Double-Stranded
RNA Virus
Linear
11 Segments
Triple Icosahedral Capsid
Most Common Cause of Diarrhea Worldwide
Villous Atrophy
Winter Months
Day Care Centers
Treatment
Oral Rehydration
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2 mins
Bacillus Cereus Disease
Signs and Symptoms
Emetic Form
Short Incubation (1-6 Hours)
Nausea and Vomiting
Diarrheal Form
Long Incubation (8-16 Hours)
Diarrhea and GI Pain
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2 mins
Bacillus Cereus Characteristics
Gram-Positive
Bacilli
Endospore Forming
B Hemolytic
Toxins and Enterotoxins
Reheated Rice
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1 min
E. coli Overview
Characteristics
Gram-Negative
Bacillus
Purple Colony with Metallic Green Sheen
Lactose-Fermenting
Pink on MacConkey Agar
Disease
Diarrhea
Lipid A Septic Shock
P Pili Pyelonephritis and Cystitis
K Capsule Neonatal Meningitis
K Capsule Pneumonia
H Antigen Flagella
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2 mins
Vibrio Cholera Disease
ADP Ribosylating AB Toxin
Turn Gs on Causing Increase in cAMP
Secretion of Cl
Blocks Reabsorption of Na
Rice Water Diarrhea
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1 min
Vibrio Cholera Characteristics
Gram-Negative
Bacilli
Glucose Fermenting
Non-lactose Fermenting
Oxidase Positive
Comma Shaped
Thrives in Alkaline Environment
Crustaceans
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1 min
Clostridioides difficile (Clostridium difficile)
Characteristics
Gram-Positive
Bacillus
Anaerobe
Clindamycin and Ampicillin
Toxin A Enterotoxin
Damages Brush Border of Gut
Toxin B Cytotoxin
Damages Cytoskeletal Structure
Signs and Symptoms
Diarrhea
Pseudomembranous Colitis
Toxic Megacolon
Diagnosis
Detect Toxins in Stool
Treatment
Metronidazole
Vancomycin
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3 mins
Clostridium difficile (Clostridioides difficile) Treatments
Oral Vancomycin
Fidaxomicin
Metronidazole
Stool Transplant
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2 mins
Yersinia Enterocolitica
Characteristics
Gram-Negative
Bacilli
Non-lactose Fermenting
Non-H2S Producing
Oxidase-Negative
Day Care Centers
Pork
Raw Milk
Pet (Puppy) Feces
Signs and Symptoms
Bloody Diarrhea
Mesenteric Adenitis
Granulomatous Microabscess in Mesenteric Lymph Nodes
Pseudoappendicitis (Mimics)
Reactive Arthritis
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2 mins
Campylobacter jejuni
Characteristics
Gram-Negative
Bacillus
Flagella
Curved
Corkscrew Appearance
Oxidase-Positive
Grows Well at 42 Degrees
Undercooked Meat
Unpasteurized Milk
Animals with Diarrhea
Signs and Symptoms
Bloody Diarrhea
Guillain-Barre syndrome
Reactive Arthritis
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3 mins
Enterohemorrhagic E. Coli (EHEC)
Characteristics
O157:H7
Non-Sorbitol Fermenting
Hamburger Meat
Produces Shiga-like Toxin
Gram-negative
Lysogeny
Inactivates 60S Ribosome
Disease
Bloody Diarrhea
Hemolytic Uremic Syndrome (HUS)
Hemolytic Anemia
Acute Renal Failure
Thrombocytopenia
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2 mins
Salmonella Typhi
Characteristics
Colonizes Gallbladder
Monocytic Immune Response
Symptoms
Typhoid Fever
Abdominal Pain
Rose Spots on Abdomen
Constipation Followed by Diarrhea
Treatments
Ceftriaxone
Fluoroquinolones
Considerations
Oral Vaccine - Live
IM Vaccine - Capsular Polysaccharide
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2 mins
Shigella
Characteristics
Gram-Negative
Bacilli
Non Lactose Fermenting
White on Macconkey Agar
Oxidase Negative
Non H2S Producing
Day Care Centers
High Virulence
Replicates Intracellularly
Actin Rocket
Signs and Symptoms
Bloody Diarrhea
Shiga Toxin
Inhibits 60S Ribosome
Hemolytic Uremic Syndrome (HUS)
Hemolytic Anemia
Thrombocytopenia
Kidney Failure
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3 mins
Giardia lamblia
Characteristics
Protozoa
Ingestion of Cysts
Seen in Campers
Daycare Centers
Mental Hospitals
Infects Small Intestine
Signs and Symptoms
Bloating
Flatulence
Fatty Diarrhea
Diagnosis
Crescent-shaped Protozoa Adjacent to Epithelial Brush Border
Predisposed if Low IgA
Treatment
Metronidazole
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3 mins
Entamoeba histolytica
Pathophysiology
Protozoa
Amebiasis
Ingestion of Cysts in Food and Water
Signs and Symptoms
Bloody Diarrhea
Flask-Shaped Ulcer
Liver Abscess
Anchovy Paste
RUQ Pain
Diagnosis
RBCs in Cytoplasm of Trophozoite
Cyst With Four Nuclei
Treatment
Metronidazole
Iodoquinol
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3 mins
Whipple's Disease
Tropheryma Whipplei
Gram-Positive
Middle-aged, Caucasian men and Farmers
Malabsorption
Mesenteric Nodes
Arthralgias
Cardiac Symptoms
Neurologic Symptoms
PAS-positive Foamy Macrophages
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1 min

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