4: Gastroenteritis clinical management

Question 1

What are the core clinical symptoms of gastroenteritis?

Answer 1

Fever

Abdominal pain

Diarrhoea +/- blood

Question 2

Acute diarrhoea lasts less than ___ weeks and is likely to be due to ___.

Answer 2

two , infection

Question 3

Chronic diarrhoea lasts for more than ___ weeks.

Answer 3

four

Question 4

What else can cause acute diarrhoea?

Answer 4

Medication

Laxatives

Toxins

Ischaemic colitis

Question 5

What is gastroenteritis?

Answer 5

Inflammation of the stomach / small intestine / large intestine

Question 6

90% of gastroenteritis is due to ___.

Answer 6

infection

Question 7

In who is acute gastroenteritis common?

Answer 7

Children

Elderly

Immunocompromised

Question 8

Gastroenteritis is commonly caused by poor ___ hygiene.

Answer 8

food

Question 9

Which class of drug inhibits acid secretion and makes patients much more susceptible to GI infection?

Answer 9

PPIs (omeprazole, lanzoprazole)

H2 antagonists (cimetidine, ranitidine)

Question 10

Which organisms cause food poisoning within 1-6 hours after the ingestion of contaminated food?

Answer 10

Staph. aureus

Bacillus cereus

Question 11

Which organisms produce gastroenteritis 1-2 days after eating contaminated food?

Answer 11

Campylobacter

C. perfringens

Salmonella

E. coli 0157

Question 12

Which organism produces enteric fever?

Answer 12

Salmonella typhi and paratyphi

Question 13

Are enterotoxigenic and enterohaemorrhagic E. coli the same thing?

Answer 13

No

obviously

Question 14

Which organism can cause traveller’s diarrhoea in foreign countries?

Answer 14

E. coli

usually enterotoxic, not enterhaemorrhagic

Question 15

In which animal is E. coli 0157 common?

Answer 15

Cattle

Question 16

Which symptoms are seen in enterohaemorrhagic E. coli infection?

Answer 16

Abdominal pain

Little/no fever

Watery, bloody diarrhoea

Question 17

Which syndrome is a complication of E. coli 0157 infection?

Answer 17

HUS

see printout for how to recognise it

Question 18

Which pets carry Salmonella spp?

Answer 18

Reptiles

this is why it’s important to ask about pets

Question 19

What animal products may contain Salmonella?

Answer 19

Poultry

Eggs

Question 20

Other than Salmonella, which pathogen can be found in poultry?

Answer 20

Campylobacter jejuni

Question 21

Which pathogen is the most likely cause of infective gastroenteritis?

Answer 21

Campylobacter jejuni

Question 22

In which way does Campylobacter infection mimic appendicitis?

Answer 22

Central abdominal pain

Question 23

What is the main symptom of Campylobacter infection?

Answer 23

Bloody diarrhoea

Question 24

What syndrome, associated with paralysis, is associated with Campylobacter infection?

Answer 24

Guillain-Barre syndrome

Question 25

slide 29 - left colon doesn't have haustral markings, very indented --\> **mucosal oedema** (thumbprint sign?)

Question 26

What are some non-infective causes of bloody diarrhoea?

Answer 26

**IBD** **Malignancy** **Ischaemia**

Question 27

Which type of gastroenteritis **penetrates** the bowels into the blood?

Answer 27

**Enteric fever / Typhoid fever**

Question 28

What are the symptoms of **enteric fever**?

Answer 28

**Abdominal pain** **Fever** **Constipation but little diarrhoea**

Question 29

What causes **enteric fever**?

Answer 29

**Salmonella typhi** and **paratyphi**

Question 30

Which test is used to diagnose enteric fever?

Answer 30

**Blood cultures** since enteric fever penetrates into the blood

Question 31

Which drug is used to treat enteric fever?

Answer 31

**Azithromycin**

Question 32

Which test is done to test for protozoa like giardia and amoeba?

Answer 32

**Stool MICROSCOPY**

Question 33

Which test is done to identify the type of bacteria involved in gastroenteritis?

Answer 33

**Stool culture**

Question 34

Which specific test is done to check for the presence of *C diff*?

Answer 34

**Toxin test**

Question 35

What common bowel syndrome can be triggered by infective gastroenteritis?

Answer 35

**Irritable bowel syndrome**

Question 36

amoebic liver abscess is diagnosed through serology treated with metronidazole