Gastroenterology- Internal Medicine
Exam Questions with Correct Answers
What is the most common form of Salmonella infection? - Answer-Gastroenteritis
What presents with fever, nausea, vomiting, crampy abdominal pain and bloody
diarrhea for 3-5 days?
Diagnostic testing? - Answer-Gastroenteritis
Confirmed via stool culture (shows salmonella)
What is treatment for Gastroenteritis? - Answer-Symptomatic and specific treatment is
with Bactrim, ampicillin, or Ciprofloxacin
What is referred to as the stomach flu? - Answer-Gastroenteritis
What presents with sudden onset anorexia, nausea, vomiting, abdominal discomfort
and diarrhea?
Diagnostics? - Answer-Gastroenteritis
Diagnostics: Clinical or through stool culture
What are the most common cause of viral gastroenteritis? - Answer-Rotavirus,
Norovirus, Astrovirus, Adenovirus (CMV, enterovirus)
What is the most common cause of sporadic, severe, dehydrating diarrhea in children
worldwide? - Answer-Rotavirus! (Gastroenteritis)
What is the most common cause of gastroenteritis in general? - Answer-Viral
What is the most common cause of bacterial gastroenteritis? - Answer-Salmonella,
Campylobacter, Shigella, E coli, and C diff.
What are the main pathogens associated with parasitic gastroenteritis? - Answer-
Giardia, Cryptosporidium
What is treatment for gastroenteritis? - Answer-Symptomatic:
Rehydration--> via Oral or IV fluids
Antidiarrheals (for c. diff or e. coli)--> Loperamide (Imodium) or Diphenoxylate
,Antiemetics --> Odansetron (Zofran), Promethazine (Phenergan),
What is antibiotic prophylactic treatment for travelers diarrhea?
What organisms are you covering for? - Answer-Clindamycin
Organisms: Shigella or Campylobacter (also ecoli)
What is management of C diff ? - Answer-Stop causative antibiotic
Mild cases: Oral Metronidazole (Flagyl)
Severe cases: Oral Vancomycin or Fidoxomycin
What are examples of antiemetics? - Answer-Promethazine (Phenergan)
Odansetron (Zofran)
What are examples of antidiarrheals? - Answer-Loperamide (Imodium)
Bismuth Subsalicylate (Pepto-Bismol)
Koapectate
What presents with vomiting, watery, voluminous (involved small intestine), no fecal
EBCs or blood? - Answer-Noninvasive (Enterotoxin) Infectious Diarrhea
What presents with diarrhea w/in 6 hours of eating dairy products, mayonnaise, meats,
eggs with prominent vomiting, abdominal cramps, headaches and dizziness?
Tx? - Answer-Staphylococcus Infectious (Noninvasive) Diarrhea
Tx:
Self-limiting (lasts 1-2 days)
Supportive Tx
What presents with vomiting*, cramps, diarrhea w/in 1-6 hours of eating fried rice? -
Answer-Bacillus Cereus!
What presents with copious watery diarrhea "rice water stools" (grey, no fecal odor,
blood or pus), that may rapidly produce severe dehydration?
Tx? - Answer-Vibrio Cholerae & Parahemolyticus
Tx:
Fluid replacement!! --> Mainstay
,Fluoroquinolone, doxycycline
Vibrio Parahemolyticus--> associated w/ raw shellfish especially in Gulf of Mexico
What presents with abdominal cramps, diarrhea, fever, abdominal tenderness, and
strikingly increased lymphocytosis pseudomembranous colitis and toxic megacolon?
Tx? - Answer-Clostridium Difficile!
Also strongly associated with CLINDAMYCIN antibiotic usage
Tx:
Metronidazole**
Vancomycin PO--> 2nd line
What is the most common cause of traveler's diarrhea with unsanitary water/ice that
presents with abrupt onset watery, diarrhea, abdominal cramping, vomiting?
Tx? - Answer-Enterotoxigenic E Coli!
Tx:
Fluoroquinolone!
What presents with crampy lower abdominal pain, high fever, tenesmus (straining),
explosive watery diarrhea, mucoid and bloody that manifests in young children (febrile
seizures) and may cause a leukemoid reaction (>50,000 WBC)?
Dx and Tx? - Answer-Shigella
Highly virulent
Dx:
Stool culture
Fecal WBC/RBC
Sigmoidoscopy:
Punctate areas of ulceration
Tx:
Bactrim** tx of choice!
, What presents with fever, abdominal pain mimicking acute appendicitis and can cause
tenderness,guarding ?
Tx? - Answer-Yersinina Enterocolitica
Tx:
Fluoroquinolones
What presents with abdominal pain, fever, cramping, mucuous diarrhea "pea soup
stools" (watery brown-green) after earring poultry products **(dairy, meat, eggs), exotic
pets (reptiles, especially turtles**)?
Tx? - Answer-Salmonella!!
Tx:
Fluoroquinolones, Ceftriaxone x weeks if severe
What presents with watery diarrhea early that turns to bloody, crampy abdominal pain
with vomiting, fever after ingesting undercooked ground beef, unpasteurized milk/apple
cider, day care center exposure?
Tx? - Answer-Enterohemorrhagic E Coli!
TX:
Supportive
Antibiotics are controversial (because increases incidence of Hemolytic Uremic
Syndrome in Children)
What presents with fever, headache, abdominal pain that can mimic acute appendicitis
and has watery diarrhea initially that turns bloody after ingesting poultry, raw milk,
water, or being around dairy cattle?
Tx? - Answer-Campylobacter Enteritis
Most common bacterial enteritis in the US!
Most common event in post-infectious Gullian Barre Syndrome
Dx:
Stool culture:
gram negative "S or SEAGUL shaped" organisms
Tx:
Erythromycin, Fluoroquinolones
