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Gastrointestinal Block > Common infections and parasites of the GIT > Flashcards

Common infections and parasites of the GIT Flashcards

1
Q

Compare the following terms:

  • Acute gastritis
  • Enteritis
  • Gastroenteritis
A

Acute gastritis: inflammation of the stomach, presents with nausea and vomiting

Enteritis: inflammation of the intestines, presents with diarrhoea

Gastroenteritis inflammation of the stomach to the intestines, presents with nausea, vomiting and diarrhoea

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2
Q

Is gastroenteritis more commonly bacterial or viral?

A

Viral

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3
Q

How do we prevent spread, in a hospital setting, for a patient with gastroenteritis?

A

It is essential to isolate the patient

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4
Q

List 3 viral causes of gastroenteritis

A
  1. Rotavirus
  2. Norovirus
  3. Adenovirus
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5
Q

What is the most common causative organism of food poisoning in the UK?

A

Campylobacter jejuni (bacteria)

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6
Q

Typical presentation of a of Norovirus infection?

A

Projectile vomiting and non-bloody diarrhoea around 12-24 hours after consuming seafood

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7
Q

Describe the shape of Campylobacter jejuni

A

Gram-negative rods with characteristic ‘seagull’ shape

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8
Q

Typical presentation of a Campylobacter jejuni infection

A

Abdo pain and bloody diarrhoea around 16-48 hours after consuming chicken

Vomiting is rare

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9
Q

Characteristic presentation of Campylobacter jejuni?

A
  1. Abdominal pain
  2. Can cause bloody diarrhoea
  3. Vomiting is rare
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10
Q

How does Campylobacter jejuni cause gastroenteritis?

A

Releases enterotoxin in the gut and also invades the mucosa

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11
Q

Complications of Campylobacter Jujuni infection?

A

Guillain-Barre syndrome

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12
Q

Typical presentation of a Salmonella enteritidis/typhimurium infection?

A

Watery diarrhoea (+/-mucus or blood), abdominal pain and vomiting around 16-48 hours after consuming eggs and foods contaminated on kitchen preparation surfaces

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13
Q

How does salmonella cause gastroenteritis?

A

Bacteria multiplies locally in the small and large intestines, invades mucosa and causes inflammation

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14
Q

Typical presentation of a Bacillus cereus infection?

A

Profuse vomiting around 30mins to 6 hours after eating contaminated rice

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15
Q

How does Bacillus cereus cause gastroenteritis?

A

Produces 2 toxins

  1. an emetic pre-formed enterotoxin that is absorbed into the blood-stream from the stomach
  2. a diarrhoea-causing enterotoxin that acts on receptors in the small intestine and large bowel
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16
Q

Typical presentation of Staphylococcus aureus food infection

A

Perfuse vomiting, diarrhoea, abdominal cramps and fever. Begin around 1-6 hours after consumption of contaminated milk products and foods contaminated through contact with food workers carrying the bacteria

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17
Q

How does Staphylococcus aureus cause gastroenteritis?

A

Produces a heat-stable enterotoxin

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18
Q

Typical presentation of E.coli food infection

A

Watery stools, abdominal cramps and nausea which is common amongst travellers and presents around 16-48 hours after contact with infected faeces, unwashed salads or water

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19
Q

Which strain of E.Coli is most concerning and why?

A

E. coli 0157, produces the Shiga toxin and causes abdominal cramps, bloody diarrhoea and vomiting

The Shiga toxin destroys blood cells and leads to haemolytic uraemic syndrome(HUS)

20
Q

What is Haemolytic Uraemic Syndrome (HUS)?

A

A thrombotic microangiopathy characterized by hemolytic anaemia, thrombocytopaenia and acute renal failure (with normal clotting profile)

Usually affects the very young or old, and is

21
Q

Typical presentation of Shigella?

A

Bloody diarrhoea, abdominal cramps and fever around 1-2 days following contact with drinking water, swimming pools and food contaminated by faeces

22
Q

How does Shigella cause gastroenteritis?

A

Can produce the Shiga toxin and cause haemolytic uraemic syndrome

23
Q

Typical presentation of Giardiasis (parasite - Giardia lamblia)

A

Explosive, watery, non-bloody diarrhoea with an incubation period of 1-3 weeks

Typical history of access to contaminated water, uncooked fruit or vegetables or a lack of hand hygiene (spread via faecal-oral route)

24
Q

Management of gastroenteritis?

A

Fluid and electrolyte replacement, food poisoning is usually self-limiting

25
Q

When do we prescribe antibiotics for gastritis?

A
  1. Elderly (or very young)
  2. Immunocompromised
  3. Systemically unwell (signs of toxicity)
26
Q

What antibiotic do we use for Salmonella and shigella?

A

Ciprofloxacin

27
Q

What antibiotic do we use for Campylobacter?

A

A macrolide ie erythromycin

28
Q

What antibiotic do we use for Cholera?

A

A tetracycline, to reduce transmission.

29
Q

Treatment of Giardiasis?

A

Metronidazole

30
Q

What bacteria causes Whipple’s disease?

A

Tropheryma whipplei (+)

31
Q

List 3 clinical features of Whipples disease

A
  1. Malabsorption: diarrhoea, weight loss
  2. Large-joint arthralgia
  3. Lymphadenopathy
32
Q

Gold standard diagnosis for Whipple’s disease?

What would it show?

A

Jejunal biopsy

Foamy macrophages containing Periodic acid-Schiff (PAS) granules

33
Q

Treatment of Whipple’s disease?

A

Long term course of co-trimoxazole

34
Q

Describe the Clostridium difficile bacteria

A

Gram (+) rod

35
Q

What condition does Clostridium difficile cause?

A

Produces an exotoxin which causes intestinal damage

Leading to a syndrome called pseudomembranous colitis

36
Q

In what group of people is infection with C.diff most common?

A

Patients who have recently been on a course of broad spectrum antibiotics

37
Q

List 4 risk factors for developing a C.diff infection

A
  1. Treated with broad-spectrum antibiotics
  2. > 65 yrs
  3. underlying conditions (IBD, cancer, CKD)
  4. weak immune system
  5. PPIs
  6. long stay in a healthcare setting
38
Q

List 2 antibiotics associated with C.diff

A
  1. Clindamycin
  2. Ciprofloxacin
  3. Cephalosporins
  4. Penicillins
39
Q

How does an infection with C.diff present?

A
  1. Watery diarrhoea (can be bloody)
  2. Painful abdominal cramps
  3. Nausea
  4. Fever

+ Loss of appetite and weight loss, confusion, signs of dehydration. Ranges from asymptomatic to life threatening

40
Q

How is C.diff diagnosed?

What characteristic finding is seen?

A

Clostridium difficile toxin (CDT) in the stool

Characteristic ↑ WCC

41
Q

First line antibiotics for C.diff?

A

Vancomycin or Metronidazole

42
Q

What bacteria causes Cholera?

A

Vibro cholerae Gram (-)

43
Q

How does Cholera present?

A
  1. profuse ‘rice water’ diarrhoea
  2. dehydration
  3. hypoglycaemia
  4. nausea and vomiting
44
Q

Management of Cholera?

A

Aggressive fluid replacement

Antibiotics: Doxycycline or co-trimoxazole

45
Q

How do we prevent Cholera?

A

Access to safe water and sanitation

Two oral cholera vaccines are available

Gastrointestinal Block (26 decks)

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