Git j club acute ge adults.

1. Kurdistan Board GEH J Club:
Supervised by:
Dr. Mohamed Alshekhani
Professor in Medicine
MBChB-CABM-FRCP-EBGH 2016
1

2. Introduction:
• Acute diarrheal infection is a leading cause of outpatient visits,
hospitalizations&lost QOL in both domestics &those travellers.
• CDC: 47.8 million cases annually in US, at cost of US$150 million.
• Acute diarrhea: passage of a greater number of stools of decreased
form from the normal, lasting <14 days.
• Other definition: present ing with an abrupt onset 3 or more loose
or liquid stools above baseline in a 24-h.
• Persistent diarrhea: diarrhea lasting between 14 & 30 days,
• Chronic diarrhea: diarrheal symptoms lasting for > month.
• Acute diarrhea of inf etiology is generally associated with other
clinical features; nausea, vomiting, abd pain / cramps, bloating,
flatulence, fever, passage of bloody stools, tenesmus&urgency.
• Acute diarrheal infection is often referred to as gastroenteritis&
some acute GI infections may cause predominant vomiting with
little or no diarrhea.

16. BO5:1
• 1. As a member of a medical mission trip to a developing country
you are asked to see a 50-ys woman with 3 days of severe, watery,
non-bloody diarrhea. She is the first of 10 individuals with similar
symptoms waiting to be seen. She has never seen a doctor before
but seems to have chronic ulcers on her lower legs and ankles
suggestive of complicated DM, PVD&/or heart disease. Her BP
90/70,HR 120 bpm. Her mm dry&she has poor skin turgor. You can
only provide short-term IVF &supplies are limited.
• Which one of the following is the next best trt after short-term IVF?
• A. Provide clean water & encourage aggressive oral rehydration.
• B. Encourage aggressive hydration with juices such as apple juice.
• C. Provide clean water with sports powder mix.
• D. Provide clean water with about 60–75 mEq/L of Na & 75–90
mmol/L of glucose.

17. BO5:2
• 2. A patient of yours is a high-profile dignitary about to
embark on a trip to South Asia. His agenda will require
many meals on the local economy. Developing traveler’s
diarrhea would drastically impair his mission effectiveness.
• Which one of the following preventative measures would
you recommend?
• A. Probiotic use during travel will reduce the risk for
developing traveler’s diarrhea.
• B. Fluoroquinolones are effective in reducing traveler’s
diarrhea with few personal or public health concerns.
• C. Bismuth subsalicylates are very effective in protecting
against traveler’s diarrhea but are dose-dependent.
• D. Rifaximin is just as effective as fluoroquinolones for the
prevention of traveler’s diarrhea.

18. BO5:3
• 3. Which one of the following statements regarding
prevention of traveler’s diarrhea is correct?
• A. Hand washing & alcohol-based sanitizers are likely
to prevent E. coli traveler’s diarrhea.
• B. Hand washing & alcohol-based sanitizers are likely
to prevent traveler’s diarrhea on cruise ships &
institutional outbreaks.
• C. General population routine counseling on
precautions to prevent acute enteric infections is
recommended.
• D. Pre-travel counseling regarding high-risk food
&beverage avoidance does little to change behavior &
prevent traveler’s diarrhea.

19. BO5:4
• 4.Acute diarrhea means diarrhea for:
• 10 days.
• 30 days.
• 45 days.
• 50 days.
• 60 days.

20. BO5:5
• 5.Persistent diarrhea is diarrhea lasting for:
• 14 days & less than 30 days.
• 30 days.
• 40 days.
• 50 days.
• 60 days.

21. BO5:6
• 6.Acute infectious diarrhea can cause all
except:
• A. Fever.
• B. Dehydration.
• C. Vomiting alone.
• D. Bloody stool.
• E. Anemia.

22. BO5:7
• 7.Stool culture is done during acute diarrheal
illness :
• Routinely.
• In dehydrated patients.
• If bloody diarrhea
• During outbreaks.
• In traveller diarrhea.

23. BO5:8
• 8.ORS for acute diarrhea is recommended for:
• A. All patients.
• B. All dehydrated patients.
• C. Dehydrated elderly.
• D All travelers diarrhea.
• E. Feverish patients.

24. BO5:9
• 9.In acute diarrhea stool diagnostic studies is
indicated for all except:
• A. Dysentery.
• B. Moderate severity.
• C. Lasting > 7 days.
• D. Severe cases.
• E. Travellers.

25. BO5:10
• 10.In acute diarrhea, the following are not
routinely recommended except:
• A. Probiotics.
• B. Prebiotics.
• C. Standard stool diagnostic studies.
• D. Stool cultures.
• E. Antibiotics in traveller diarrhea.

26. BO5:11
• 11.In acute diarrhea the FDA approved non-
culture dependent stool tests are indicated:
• Routinely.
• As adjuvant to standard stool tests.
• In all traveller diarrheas.
• In all elderly.
• Non of the above.

27. BO5:12
• 12.Non-ntibiotics treatments that can be used
in acute traveller diarrhea include:
• A. Bismuth & loperamide.
• B. Bismuth& diphenoxylate.
• C.Prebiotics.
• D.Probiotics.
• E.Symbiotics.

28. BO5:13
• 13.Prophylaxix proven effective to prevent
traveller diarrhea include:
• A. Bismuth & quinolones.
• B.Probiotics.
• C. Prebiotics.
• D. Symbiotics.
• E. Hand washing.

29. BO5:14
• 14.The antibiotics used for acute diarrhea can
be given as single dose except:
• A. Levofloxacin.
• B. Olfloxacin.
• C. Ciprofloxacin.
• D. Azithromycin.
• E. Rifaximin.