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Gastroentrology > 2: Infections of GI tract > Flashcards

2: Infections of GI tract Flashcards

1
Q

Define gastroenteritis

A

Diarrhoea cause by infection of GI tract with bacteria, virus or parasite

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2
Q

Define diarrhoea

A

More than 3 episodes of partially formed watery stool for <14d

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3
Q

Define dystentry

A

Infective gastroenteritis with blood

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4
Q

What is persistent diarrhoea

A

Diarrhoea >14d

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5
Q

What 6 infections are know to cause dysentry

A

SECCSY (Sexy)

Salmonella
E.Coli
Campylobacter jejuni
Clostridium difficile 
Shigella
Yersinia
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6
Q

What bacteria have an incubation period of 1-6h

A

Staph.A

Bacilleus Cereus

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7
Q

What bacteria have an incubation period 12-48h

A

E.Coli

Salmonella

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8
Q

What bacteria have an incubation period of 48-72h

A

Campylobacter.J

Shigella

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9
Q

What two organisms have an incubation period for more than 7 days

A

Giardiasis

Amoebiasis

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10
Q

What are two risk factors for Norovirus

A
  1. Contact with infected food, person or surface

2. Outbreaks in hospitals

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11
Q

What is the incubation period of norovirus

A

12-48h

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12
Q

How will norovirus present clinically

A

Acute-onset vomiting and watery diarrhoea

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13
Q

When is norovirus infection common

A

Winter outbreaks at hospitals and nursing homes

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14
Q

What type of organism is norovirus

A

ssRNA

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15
Q

how is norovirus diagnosed

A

Clinically

rt-PCR

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16
Q

how is norovirus infection managed

A

Oral rehydration solution

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17
Q

In which population is rotavirus infection more common

A

Most common cause of gastroenteritis in children

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18
Q

How will rotavirus present clinically

A

Vomiting and diarrhoea

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19
Q

What is the incubation period of rotavirus

A

1-3d

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20
Q

How is rotavirus investigated for

A

Clinical

ELISA Stool toxin

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21
Q

What is used to manage rotavirus

A

Oral rehydration solution

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22
Q

How can rotavirus be prevented

A

Oral live-attenuated vaccine given at 2,3m as part of immunisation schedule in the UK

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23
Q

What food substance can cause clostridium pefringens infection

A
  • Undercooked meat
  • Refrigerated meet
  • Legumes
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24
Q

What is the incubation of clostridium pefringens

A

6-24h

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25
Q

How does clostridium pefringens present clinically

A

Crampy abdominal pain and watery diarrhoea

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26
Q

What organism is clostridium pefringens

A

Gram positive anaerobe

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27
Q

What is a complication of clostridium pefringens

A

B toxin - can cause necrotising fulminant enterocolitis. Presents as abdominal pain, bloody diarrhoea and sepsis.

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28
Q

Where is bacillus cereus obtained from

A

re-heated rice

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29
Q

What are two sources of cholera

A
  • Contaminated water

- Undercooked sea-food

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30
Q

How will cholera present clinically

A

Rice-water stools
Vomiting
Low-grade fever

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31
Q

What type of organism is cholera

A

Gram negative

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32
Q

How can cholera be diagnosed

A

Rapid stool test

MC+S

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33
Q

What is first-line to manage cholera

A

Oral rehydration solution. If severe, IV fluids

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34
Q

If severe, what antibiotics may be given in cholera

A

Doxycycline

Tetracycline

35
Q

What is given to children with cholera and why

A

Zinc - as this shortens disease duration

36
Q

What is a major complication of cholera

A

Major dehydration.

Anyone with watery diarrhoea >5 who died in an known epidemic is diagnosed as having cholera

37
Q

What is the incubation period of Giardiasis

A

> 7d

38
Q

How can Giardiasis infection be differentiated from Amoebiasis infection

A

Giardiasis has diarrhoea without blood. Whereas, amoebiasis has dysentry

39
Q

How does shigella present clinically

A

Dystentry
Tenesmus
Fever

40
Q

What type of organism is shigella

A

Grame negative

41
Q

How can shigella be investigated

A

Stool Culture

42
Q

What is shigella managed

A

Oral rehydration solution

Green bananas or zinc if under 6-years

43
Q

What is given to children under 6 with shigella

A

Zinc

44
Q

What are three complications of shigella infection

A

Haemolytic Uraemic Syndrome
Reactive arthritis
Bacteraemia

45
Q

Where is enterohaemorrhagic E.coli obtained from

A

Undercooked meat

46
Q

How will EHEC present

A

Diarrhoea

Haemorrhagic colitis

47
Q

How is EHEC diagnosed

A

Stool MC+S

48
Q

Why should antibiotics not be given for EHEC

A

Increases risk of HUS

49
Q

What is the most common cause of haemolytic uraemia syndrome

A

Shiga toxin produced by EHEC:O157: H7

50
Q

What are two sources of campylobacter jejuni

A

Unpasteruised milk

Undercooked meat

51
Q

How does campylobacter jejuni infection present

A

Dysentry
Headache
Low grade fever

52
Q

What type of organism is campylobacter

A

Gram negative

53
Q

how is campylobacter investigated

A

Stool MC+S

54
Q

what is a major complication of campylobacter infection

A

Gullian Barre Syndrome

55
Q

What are three sources of salmonella

A

Poultry
Raw eggs
Milk

56
Q

What is the incubation period of salmonella

A

12-48h

57
Q

How does salmonella present

A

Headache
Dysentry
Vomiting

58
Q

What is used to investigate salmonella

A

Stool MC+S

59
Q

What is a complication of salmonella

A

Bacteraemia can lead to osteomyelitis

60
Q

What are two sources of yersinia

A
  • Pork

- Milk

61
Q

How can yersinia present

A

Pseudo-appendicitis

62
Q

What are two complications of yersinia

A

Erythema nodosum

Reactive arthritis

63
Q

How does amoebiasis present

A

Gradual onset bloody diarrhoea + abdominal pain that can last weeks

64
Q

What is the most common hospital acquired infection

A

C.difficle

65
Q

What is a risk factor for C.difficle infection

A

Broad-spectrum antibiotics suppress gut flora leading to overgrowth of C.diff

66
Q

What antibiotics are the main cause of C.difficle infections

A

Second and third generation cephalosporins

67
Q

What other antibiotic is associated with causing C.difficle

A

Clindamycin

68
Q

What is a risk factor for C.difficle

A

Antibiotic-use

PPIs

69
Q

How will C.difficle present clinically

A

Crampy abdominal pain

Foul-smelling diarrhoea

70
Q

What test is used to diagnose C.difficle

A

Two-phase test

71
Q

Explain the two-phase test

A
  1. ELISA for glutamate dehydrogenase

2. ELISA for toxin A and toxin B

72
Q

Why is glutamate dehydrogenase tested for

A

Presence of GDH indicates clostridium

73
Q

Why is toxin A and B tested for

A

If present, indicates infection opposed to colonisation

74
Q

What is first-line management of C.difficle

A

Oral vancomycin (14d)

75
Q

If C.difficle toxic megacolon is suspected what should be done

A

Contact colorectal surgeons urgently

76
Q

If unable to take oral food/medication what should be given to treat C.difficle

A

IV metronidazole

77
Q

What is the mnemonic to remember infection control with C.difficle

A 
S
I
G
H
T
78
Q

What is SIGHT

A

Suspect infection

Isolate + contact Infection control

Gloves and apron

Hand washing

Two-phase test

79
Q

Once lab has confirmed C.difficle what antibiotic should vancomycin be switched to

A

Oral fidoxamicin (10d)

80
Q

Which 3 areas is it common to obtain traveller’s diarrhoea from

A

Asia
Africa
South America

81
Q

What causes traveller’s diarrhoea

A

Enterotoxigenic E.coli (ETEC)

82
Q

What are 3 presentations of traveller’s diarrhoea

A
  • Watery diarrhoea
  • Abdominal cramps
  • Nausea
83
Q

How can traveller’s diarrheoa be prevented

A 
Wash hands
Peel fruit and veg 
Boil water
Avoid: ice, salads, shellfish
Drink through straw
84
Q

How is traveller’s diarrhoea managed

A

Oral rehydration solution. Ciprofloxacin (3d) can be given to individuals if need diarrhoea to stop asap

Gastroentrology (18 decks)

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