4: Gastroenteritis clinical management Flashcards
What are the core clinical symptoms of gastroenteritis?
Fever
Abdominal pain
Diarrhoea +/- blood
Acute diarrhoea lasts less than ___ weeks and is likely to be due to ___.
two , infection
Chronic diarrhoea lasts for more than ___ weeks.
four
What else can cause acute diarrhoea?
Medication
Laxatives
Toxins
Ischaemic colitis
What is gastroenteritis?
Inflammation of the stomach / small intestine / large intestine
90% of gastroenteritis is due to ___.
infection
In who is acute gastroenteritis common?
Children
Elderly
Immunocompromised
Gastroenteritis is commonly caused by poor ___ hygiene.
food
Which class of drug inhibits acid secretion and makes patients much more susceptible to GI infection?
PPIs (omeprazole, lanzoprazole)
H2 antagonists (cimetidine, ranitidine)
Which organisms cause food poisoning within 1-6 hours after the ingestion of contaminated food?
Staph. aureus
Bacillus cereus
Which organisms produce gastroenteritis 1-2 days after eating contaminated food?
Campylobacter
C. perfringens
Salmonella
E. coli 0157
Which organism produces enteric fever?
Salmonella typhi and paratyphi
Are enterotoxigenic and enterohaemorrhagic E. coli the same thing?
No
obviously
Which organism can cause traveller’s diarrhoea in foreign countries?
E. coli
usually enterotoxic, not enterhaemorrhagic
In which animal is E. coli 0157 common?
Cattle
Which symptoms are seen in enterohaemorrhagic E. coli infection?
Abdominal pain
Little/no fever
Watery, bloody diarrhoea
Which syndrome is a complication of E. coli 0157 infection?
HUS
see printout for how to recognise it
Which pets carry Salmonella spp?
Reptiles
this is why it’s important to ask about pets
What animal products may contain Salmonella?
Poultry
Eggs
Other than Salmonella, which pathogen can be found in poultry?
Campylobacter jejuni
Which pathogen is the most likely cause of infective gastroenteritis?
Campylobacter jejuni
In which way does Campylobacter infection mimic appendicitis?
Central abdominal pain
What is the main symptom of Campylobacter infection?
Bloody diarrhoea
What syndrome, associated with paralysis, is associated with Campylobacter infection?
Guillain-Barre syndrome
slide 29 - left colon doesn’t have haustral markings, very indented –> mucosal oedema (thumbprint sign?)
What are some non-infective causes of bloody diarrhoea?
IBD
Malignancy
Ischaemia
Which type of gastroenteritis penetrates the bowels into the blood?
Enteric fever / Typhoid fever
What are the symptoms of enteric fever?
Abdominal pain
Fever
Constipation but little diarrhoea
What causes enteric fever?
Salmonella typhi and paratyphi
Which test is used to diagnose enteric fever?
Blood cultures since enteric fever penetrates into the blood
Which drug is used to treat enteric fever?
Azithromycin
Which test is done to test for protozoa like giardia and amoeba?
Stool MICROSCOPY
Which test is done to identify the type of bacteria involved in gastroenteritis?
Stool culture
Which specific test is done to check for the presence of C diff?
Toxin test
What common bowel syndrome can be triggered by infective gastroenteritis?
Irritable bowel syndrome
amoebic liver abscess is diagnosed through serology
treated with metronidazole
