1: Tropical diseases of the GI tract

Question 1

Patients who present with GI tract infections tend to have travelled ___ recently.

Answer 1

abroad

Question 2

What will be seen on examination of a patient with an GI infection?

Answer 2

Fever - most common

Rash - particularly in HIV

Hepato/splenomegaly

Lymphadenopathy

Insect bites

Wounds

Question 3

What “mundane” infection may cause fever in returning travellers?

Answer 3

Pneumonia / Influenza

Question 4

What is the vector for malaria?

What family of organisms cause malaria?

Answer 4

Mosquitoes

Plasmodium spp.

Question 5

Which organism causes enteric / typhoid fever?

Answer 5

Salmonella typhi

Question 6

Which viruses cause dengue fever and chikungunya?

Answer 6

Arboviruses

Question 7

Travellers with infectious GI diseases should be ___ until the cause is known.

Answer 7

isolated

Question 8

What is acute traveller’s diarrhoea?

Answer 8

3 loose stools in 24h

Question 9

Which organism typically causes acute traveller’s diarrhoea?

Answer 9

Enterotoxic E. coli

Question 10

Other than E. coli, which organisms cause acute traveller’s diarrhoea?

Answer 10

Campylobacter

Salmonella

Shigella

Norovirus

Rotavirus

Question 11

What is the main symptom of acute traveller’s diarrhoea?

Answer 11

Diarrhoea

:)

Question 12

Which disease causes profuse watery diarrhoea?

Answer 12

Cholera - outbreaks, refugee camps

Question 13

Which organism tends to cause dysentery?

Answer 13

Enterohaemorrhagic E. coli 0157

Shigella

Question 14

How is acute traveller’s diarrhoea investigated?

Answer 14

Stool culture

Question 15

How is acute traveller’s diarrhoea treated?

Answer 15

Fluid replacement (oral/IV)

Question 16

Bloody diarrhoea/high fever would very rarely indicate the use of ___ to treat the underlying cause.

Answer 16

antibiotics

Question 17

What are the two types of enteric fever?

Answer 17

Typhoid fever / paratyphoid fever

Question 18

Which family of organisms cause enteric fever?

Answer 18

Salmonella spp.

Question 19

Who tends to get enteric fever?

Answer 19

People visiting India / SE Asia

Question 20

What is the incubation period of Salmonella in enteric fever?

Answer 20

1-3 weeks

Question 21

What are some symptoms of enteric fever?

Answer 21

Fever

Headache

Constipation/diarrhoea

Dry cough

Question 22

Which antibiotic would be tentatively used if an enteric fever patient was extremely ill?

Answer 22

IV Ceftriaxone

Question 23

Which specific organisms cause typhoid and paratyphoid fever (enteric fever)?

Answer 23

Salmonella typhi

Salmonella paratyphi

Question 24

Vaccination against enteric fever offers (complete / incomplete) protection.

Answer 24

incomplete

Question 25

Which infectious disease causes haemolytic jaundice?

Answer 25

Malaria

Question 26

Which disease occurs as a complication of diarrhoea related to E. colo 0157, Shigella infection?

Answer 26

HUS

Question 27

What is a common post-hepatic cause of jaundice?

Answer 27

Gallstones

Helminth infection

Question 28

What organism commonly causes amoebic dysentery?

Answer 28

Entamoeba histolytica

Question 29

What are the symptoms of amoebic dysentery?

Answer 29

Abdominal pain

Fever

Bloody diarrhoea

leading to complications - colitis, perforation, peritonitis

Question 30

What investigation is done to diagnose amoebic dysentery?

Answer 30

Stool microscopy

Question 31

What is a longer-term presentation of E. histolytica infection?

Answer 31

Amoebic liver abscess

Question 32

Which drug is used to treat ameobic infection of the GI tract?

Answer 32

Metronidazole

Question 33

What should be done to an ameobic liver abscess before using a drug like metronidazole?

Answer 33

Drain abscess

Question 34

What are helminths?

Answer 34

Wormy parasites

Question 35

Which immune cell count is raised in helminth infection?

Answer 35

Eosinophils (eosinophilia)

remember that eosinophils fight parasites

Question 36

How is helminth infection diagnosed?

Answer 36

Worm passed in faeces

or

Eggs found in stool