Abdominal: Infective Gastroenteritis

Question 1

what is gastroenteritis?

Answer 1

nflammation of the gastrointestinal tract due to enteric infection with viruses, bacteria, or protozoa

Question 2

what is the most common cause of gastroenteritis?

Answer 2

viral

Question 3

which virus is the most common cause of gastroenteritis in the UK?

Answer 3

norovirus

Question 4

which virus is the most common cause of gastroenteritis in children?

Answer 4

rotavirus

Question 5

which strain of E.coli causes infective gastroenteritis?

Answer 5

E.coli. 0157 produces shiva toxin

Question 6

how is E.coli spread?

Answer 6

thought contact with infected faeces, unwashed salads or water

Question 7

why should antibiotics be avoided if E.coli. gastroenteritis considered?

Answer 7

The shiga toxin destroys blood cells and leads to haemolytic uraemic syndrome (HUS). The use of antibiotics increases the risk of HUS therefore antibiotics should be avoided if E.coli gastroenteritis is considered.

Question 8

how is shigella spread?

Answer 8

by faeces contaminating drinking water, swimming pools and food

Question 9

what is the incubation period for shigella?

Answer 9

1-2 days

Question 10

how is giardiasis spread?

Answer 10

faecal-oral transmission

Question 11

how do you treat giardiasis?

Answer 11

metronidazole

Question 12

how do you treat shigella?

Answer 12

azithromycin or ciprofloxacin

Question 13

what are risk factors for infective gastroenteritis?

Answer 13

• Poor personal hygiene (hand washing).
• Immunocompromised (e.g. HIV/AIDs).
• Achlorhydria (lack of gastric acid secretions).
• Poorly prepared food (e.g. undercooked food, unwashed salad and veg).

Question 14

what are clinical features of infective gastroenteritis?

Answer 14

• Nausea.
• Sudden onset of vomiting.
• Blood or mucus in stool.
• Systemic features (for example fever or malaise).
• Tenesmus.
• Dehydration.

Question 15

what is Tenesmus?

Answer 15

the feeling that you need to go to the toilet, even though you have just been

Question 16

what are clinical features of dehydration? (16)

Answer 16

• anorexia
• nausea
• light headedness
• postural hypotension,
• dizziness
• muscle cramps
• headache
• reduced skin elasticicty
• dry tongue
• sunken eyes tachycardia
• uraemia
• oliguria
• anuria
• weakness
• confusion
• shock

Question 17

what is uraemia?

Answer 17

a raised level in the blood of urea

Question 18

what is oliguria?

Answer 18

the production of abnormally small amounts of urine

Question 19

what is anuria?

Answer 19

failure of the kidneys to produce urine

Question 20

what other conditions present in a similar way to infective gastroenteritis?

Answer 20

• Non-gastrointestinal infections
• IBS
• IBD
• Side effect to drugs e.g. antibiotic over use, laxative abuse
• non-enteral infections e.g. HIV/AIDs
• malignancy

Question 21

what investigations would you use to diagnose infective gastroenteritis?

Answer 21

Investigations not often necessary as diagnosis can be made on the basis of. clinical symptoms and signs.

• stool sample analysis (consider the need for antibiotics)

Question 22

what advise would you give to a patient with infective gastroenteritis?

Answer 22

hand washing and personal hygiene

isolate from other family members/people

don’t return to school/work until 48 hours post last episode of D/V

stay hydrated/plenty of fluids

Question 23

Antidiarrhoeal (or antimotility) drugs may be useful for symptomatic control in adults with mild-to-moderate diarrhoea, when must you not use these drugs?

Answer 23

if there is blood/mucus in the stool, high fever, infection

Question 24

how would you treat infective gastroenteritis?

Answer 24

Adequate fluid intake should be maintained

Antidiarrhoeal (or antimotility) drugs may be useful for symptomatic control in adults with mild-to-moderate diarrhoea (loperamide)

antibiotics if you know the microbiological cause - not recommended if diarrhoea is of an unknown pathology

Question 25

Antidiarrhoeal (or antimotility) drugs may be useful for symptomatic control in adults with mild-to-moderate diarrhoea, which drug would you prescribe?

Answer 25

loperamide