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Medicine 2 > Diarrhoea > Flashcards

Diarrhoea Flashcards

1
Q

What infection may cause acute watery diarrhoea?

A

Cholera

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2
Q

What infection may cause acute bloody diarrhoea?

A

Shigella is the most common

E. Coli 0157: H7

Salmonella

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3
Q

What type of bacteria is Escherichia? and what is a distinguishing feature about it?

A

Coliform

Ferments glucose and lactose

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4
Q

Proteus bacteria are from which sub group? what is the most infectious type of it?

what is a distinguishing feature of Proteus?

A

Coliform

Proteus Mirabilis

It can hydrolyse urea via urease enzyme.

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5
Q

What is the serious reaction that may happen if E.Coli 0157 enters the blood, and what are the sub groups of this syndrome?

A

Haemolytic Uraemic Syndrome

  • Microangiopathic Haemolytic Anemia
  • Acute renal failure
  • thrombocytopenia
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6
Q

Does Salmonella fermentate lactose?

A

No.

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7
Q

Salmonella Typhi when it ferments carbohydrates what does it produce?

A

Only acid - it produces no gas with it.

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8
Q

What may Clostridium Difficile lead to?

A

Pseudomembranous Colitis

Toxic Megacolon

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9
Q

What toxin is produced by Vibrio Cholerae and what does it do?

A

Zonulae Occludens

  • loosens tight junctions
  • promotes vasodilation, dramatically increasing secretions
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10
Q

How is campylobacter pathogenic?

A

Mucus invading bacterial causing damage and inflammation to the enterocytes

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11
Q

What Gastroenteritis infection uses invasion into the mucus, enterotoxins and cytotoxins?

A

Salmonella

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12
Q

What are two serious complications of campylobater infections?

A

Gullain Barre syndrome

Reactive arthritis

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13
Q

What toxin does the E.Coli 0157: H7 use and what type of toxin is it?

A

Shiga - like toxin -1

Cytotoxic

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14
Q

C. Diff is pathogenic how?

A

Produces enterotoxin which promotes the shedding of the enterocytes of the mucus.
leaving unregulated gaps in the mucosa where fluid can leak.

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15
Q

What is the typical stool seen in C.Diff patients?

A

Pseudomembraneous colitis

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16
Q

What is a serious complication of C.Diff?

A

Toxic Mega Colon

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17
Q

What are the broad types of diarrhea

A

Secretory
Osmotic
Inflammatory
Motility - via a neurotoxin

18
Q

Name three common types of parasites that can cause diarrhea?

A

Cryptospordium

Giardia

Entamoeba Histolytica

19
Q

What is the definition of diarrhea?

A

3 or more water stools a day

The stools are able to mold to the container in which they are placed.

+200ml

20
Q

What is the main treatment for Diarrhoea in children?

A

Fluid replacement - that contain Na2+ and glucose

Zinc supplements

Feeding

21
Q

What are the broad types of intravenous Solutions?

A

Colloids - Large molecular weight

Crystalloids - water plus electrolytes - saline, dextrose

22
Q

What investigations can be done in someone with diarrhoea?

A

Faecal leukocyte - demonstrate if there is inflammation

Faecal Occult blood - identifies Haem in faeces - rare steak can set it off though

Stool Cultures - microscopy

Full blood count – anaemia

Examination for ova or cysts of protazol

endoscopy

23
Q

How does cholera cause diarrhoea?

A

Increases cAMP levels - activating Protein kinase A, which promotes the release of Cl- out the Cystic fibrosis trans-membrane regulatory protein - causing massive secretions of Cl-.

24
Q

Name two prominent bacteria infections that cause inflammatory diarrhoea

A

Shigella

Salmonella

25
Q

Name 3 infection that cause acute watery diarrhoea

A

Cholera
E.coli (not 0157)
Rotavirus

26
Q

Outwith good hygeine and clean water sources, what other thing can mother’s do to help their children avoid entero-infections?

A

Breast- feeding. IgA

27
Q

How much fluid in saline stays in the intravascular space?

A

25%

28
Q

In operations, what is the post operative schedule for fluids?

A

2:1

saline to dextrose

29
Q

What is the standard fluid replacement schedule?

A

500mL every 6 hours. - 2L in 24 hours.

30
Q

Outline some treatments involved in D&V

A

Re-hydration

infection control

antibiotics - contra- indicated for E.Coli 0157:H7

31
Q

What is the infectious dose of E.coli 0157:H7?

A

10 Organisms

32
Q

What is the infectious dose of Campylobacter?

A

9000

33
Q

What is the infectious dose of Salmonella?

A

10000

34
Q

If there is sudden onset vomiting, what are likely causes?

A

Pre-formed toxins from:

  • Staph Aureus
  • Bacillus Cereus

or

Norovirus

35
Q

In C.Diff infection what antibiotic is used?

A

Metronizadole

36
Q

Where is 0157:H7 found?

A

poorly butchered meat

37
Q

What are risk factors for C.Diff infection?

A

> 65 years

Hospitalisation

Anti-biotic use

PPI use

38
Q

How is C.Diff tested for?

A

C.Diff toxin

C.Diff antigen

39
Q

How many infectious particles of norovirus is needed?

A

10-100

40
Q

What type of antibiotics are used for D&V ?

A

Quinilones

Medicine 2 (28 decks)

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