(2025) || Questions & Answers (Rated A+)
What is the most common viral pathogen causing AGE in pediatrics? - ANSWER -
Rotavirus. This has been greatly reduced since the introduction of the rotavirus vaccine.
T or F: Stool studies are indicated in the absence of bloody diarrhea or systemic
disease - ANSWER - False
T or F: A CBC will help distinguish between viral and bacterial AGE - ANSWER - False
When are stool studies warranted? - ANSWER - Severe or prolonged diarrhea, a fever
> 38.5ºC, bloody stools or stools that test positive for leukocytes or occult blood.
What are common pathogens involved in Traveler's Diarrhea? - ANSWER - Shigella,
Campylobacter, and E. coli.
What should the clinician do if the patient develops diarrhea after initiation of completion
of antibiotic therapy? - ANSWER - Test for C. diff.
What are some DDx of AGE, particularly in patients with persistent or chronic diarrhea
and severe abdominal pain? - ANSWER - IBS, IBD, ischemic bowel disease, partial
bowel obstruction, small bowel diverticulosis.
What are some red flag symptoms that may indicate the need for hospitalization? -
ANSWER - Hypovolemia, dehydration, abnormal electrolytes, decreased renal function,
bloody stool/rectal bleeding, weight loss, severe abdominal pain, prolonged symptoms
greater than 1 week, pregnancy, advanced age, history of hospitalization or antibiotic
use in the last 3-6 months.
What is the usual course of treatment for AGE? - ANSWER - Only supportive treatment
is initiated since AGE is usually self-limiting and resolves within 1 week after onset of
symptoms.
How such patients with evidence of dehydration be treated initially? - ANSWER - Fluid
repletion and nutrition. Sports drinks aren't as effective as specific electrolyte
replenishing drinks.
At what point should a patient be referred to the hospital for dehydration? - ANSWER -
Signs of hypovolemia such as hypotension, tachycardia, pallor, and poor skin turgor.
,T of F: Empiric antimicrobial therapy is recommended for patients with severe diarrhea
suspected form traveling. - ANSWER - True. Bactrim, Ciprofloxacin, Norfloxacin,
Floxacin.
T or F: Antibiotic prophylaxis for patients traveling to high-risk areas is appropriate. -
ANSWER - True
How effective is antibiotic prophylaxis for patients traveling to high-risk areas? -
ANSWER - 90% effective
What does antibiotic prophylaxis treatment consist of? - ANSWER - Bactrim,
Ciprofloxacin, Norfloxacin, or Floxacin given once daily until 2 days after returning
home.
What is an appropriate symptomatic treatment for patients < 65 years or age with
moderate to severe diarrhea? - ANSWER - Two-day course of Loperamide (Imodium)
What are common causes of N/V associated with gastritis? - ANSWER - Alcohol,
NSAIDs, ASA, ABX, and illicit substances
What is the most common cause of nausea and vomiting? - ANSWER - Acute
Gastroenteritis (AGE)
What are some manifestations of AGE? - ANSWER - Nausea, vomiting, and diarrhea,
fever, abdominal pain. May also include fatigue, malaise, anorexia, tenesmus and
borborygmus.
How is the severity of AGE gauged? - ANSWER - Dehydration secondary to profuse
watery diarrhea, fever greater than 101ºF (38.3ºC), vomiting, or dysentery.
What are important parts of a patient's history when AGE is suspected? - ANSWER -
Travel, dining locations, ABX history..
What happens to the pH of the stomach when antacids are taken and how does this
affect bacteria? - ANSWER - High pH can make it easier for bacteria to survive and
cause and infection.
How does motility of the GI tract affect bacteria colonization? - ANSWER - Small bowel
stasis as a result of obstruction, diverticulitis, or blind loop syndrome frequently develop
an overgrowth of bacteria within the stagnant segment.
Which immunoglobulin may protect the GI tract against invading organisms? -
ANSWER - IgA...may also help protect against a future attack by the same pathogen.
, Onset of N/V begin within 6 hours after exposure. Is this bacterial or viral? - ANSWER -
Bacterial: time frame suggests food poisoning resulting from the ingestion of a
preformed toxin such as that of Bacillus cereus.
What two indications are highly suggestive of viral AGE? - ANSWER - Incubation
periods greater than 14 hours and the initial symptom of vomiting.
If a patient presents with AGE and reports bloody stools, what can be understood about
the reason for blood in the stool/ - ANSWER - Mucosal damage and inflammatory
process secondary to invasive pathogens.
What do frothy stools and flatus suggest? - ANSWER - Malabsorption problem.
Patients with prolonged AGE illness who are malnourished may present with edema.
What is the reason? - ANSWER - Hypoalbuminemia
T or F: Chronic diarrhea usually has a noninfectious etiology. - ANSWER - True
T or F: Acute diarrhea usually is caused by infectious agents or toxins - ANSWER -
True
What is the most common viral pathogen causing AGE in adults? - ANSWER -
Norovirus
What is an appropriate symptomatic treatment for patients < 65 years or age with
significant vomiting? - ANSWER - Two-day course of Zofran or Phenergan.
What is the best way to prevent AGE? - ANSWER - Hand washing.
T or F: Kids can attend daycare with infectious diarrhea as long as they're separated
from other children. - ANSWER - False! Not until the diarrhea has stopped.
If pain is present in the right lower quadrant, what might be the etiology related to bowel
disorders? - ANSWER - IBD, IBS, Infectious Colitis, and Constipation
If pain is present in the left lower quadrant, what might be the etiology related to bowel
disorders? - ANSWER - Diverticulitis, IBS, IBD, Constipation, and Infectious Colitis.
If pain is present in the left upper quadrant, what might be the etiology related to bowel
disorders? - ANSWER - Stomach ulcers, pancreatitis, and gastritis.
If pain is present in the right upper quadrant, what might be the etiology related to bowel
disorders? - ANSWER - Gall bladder, hepatitis, and pancreatitis.
T or F: IBS is a disorder of bowel function in the absence of an atomic abnormality. -
ANSWER - True