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Infection > Diarrhoea > Flashcards

Diarrhoea Flashcards

1
Q

define gastro-enteritis?

A

three or more loose stools/ day with accompanying features

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2
Q

define dysentery

A

large bowel inflammation with bloody stools

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3
Q

what is the most common foodborne pathogen?

A

campylobacter

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4
Q

Our defence against enteric infections?

A

stomach acidity,
normal gut flora,
Immunity

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5
Q

clinical feature of diarrhoeal illness

A

frequent watery stools with little abdo pain

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6
Q

causes of non-inflammatory diarrhoeal illness?

A

cholera,

enterotoxigenic E.coli

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7
Q

treatment of inflammatory diarrhoea?

A

rehydration therapy

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8
Q

Clinical features of inflammatory diarrhoeal illness?

A

mucosal destruction,
pain,
fever

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9
Q

Treatment of diarrhoeal illness?

A

antimicrobials,

rehydration

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10
Q

Questions to ask a patient with diarrhoea?

A

symptoms,
duration,
food poison risk eg diet, contact, travel

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11
Q

Key features to assess in a patient with diarrhoea?

A

hydration- postural BP, skin turgor, pulse

Inflammation features- fever, raised WCC

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12
Q

Define hyponatraemia and its cause

A

Low blood sodium due to sodium loss with fluid replacement by hypotonic solutions

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13
Q

Define hypokalaemia and its cause

A

loss blood K due to loos in stool

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14
Q

Investigations of a patient with diarrhoea?

A 
stool culture, 
Ag testing, 
renal function, 
blood culture, 
blood count,
abdominal Xray/ CT
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15
Q

DD of infectious diarrhoea?

A

IBD,
spurious diarrhoea,
carcinoma,
sepsis

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16
Q

GI presentation outside of gut?

A

diarrhoea,
fever,
lack of abdo pain/ tenderness,
no blood/ mucus in stools

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17
Q

why is dietary history in campylobacter gastroenteritis unreliable?

A

cambylobacter gastroenteritis has up to 7 days of incubation

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18
Q

Post-infection sequelae to campylobacter gastroenteritis?

A

Guillain-Barre syndrome,

Reactive arthritis

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19
Q

what are the 2 most common species od campylobacter likely to cause infection?

A

C.jejuni,

c.coli

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20
Q

Through what are you likely to be infected with campylobacter?

A

chickens,
contaminated milk,
puppies

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21
Q

after exposure to salmonella gastrienteritis how long till symptom onset?

A

<48hours

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22
Q

how long does diarrhoea last in salmonella gastroenteritis?

A

<10 days

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23
Q

What post-infection disease is common after a salmonella gastroenteritis infection?

A

post-infectious irritable bowel.

24
Q

commonest isolates of salmonella causing infection in UK?

A

salmonella eneritidis,

salmonella typhimurium

25
Q

How is E.coli o157 infection spread?

A

contaminated meat,

person-person spread

26
Q

Characteristic presentation of e.colio157?

A

frequent bloody stools

27
Q

what toxin does e.coli o157 produce?

A

shiga toxin

28
Q

what disease is caused if shiga toxin gets into the blood?

A

hemolytic-uraemic syndrome

29
Q

Presentation of hemolytic uraemic syndrome?

A

renal failure,
haemolytic anaemia,
thrombocytopenia

30
Q

Treatment of e.coli o157 infection?

A

supportive

NOT antibiotics

31
Q

why can e.coli o57 strain be distinguised from normal e.coli?

A

o157 is a non sorbitol fermenters

32
Q

eating re-fried rice can cause food poisoning due to?

A

bacillus cereus

33
Q

can staph aureus and clostridium perfringens cause food poisoning?

A

yes

34
Q

when should you give a patient with gastroenteritis antibiotics?

A

immunocompromised,
severe sepsis,
invasive infection,
chronic illness

35
Q

what toxins does c.diff produce?

A

enterotoxin,

cytotoxin

36
Q

treatment for clostridiodes difficile diarrhoea?

A 
metronidazole,
oral vancomycin, 
fidaxomicin, 
stool transplant, 
surgery
37
Q

the 4Cs associated with c.diff?

A

cephalosporins,
co-amoxiclav,
clindamycin,
ciprofloxacin

38
Q

when do you give a patient with c.diff oral vancomycin?

A

if they have 2 or more severity markers

39
Q

Investigations for diarrhoea caused by parasitology?

A

stool sample with P,C and O

40
Q

main UK protozoa causing diarrhoea infection?

A

giardia duodenalis,
Cryptosporidium parvum,
Entamoeba histolytica

41
Q

Presentation of giardia duodenalis infection?

A

Diarrhoea,
gas,
malabsorption,
failure to thrive

42
Q

how are parasites transmitted?

A

direct contact with cattle, cats, dogs and other people,

food/ water contaminated with faeces

43
Q

Investigations for giardia duodenalis?

A 
Stool microscopy (will see cysts),
Duodenal biopsy (will see trophozoites)
44
Q

treatment of giardia duodenalis infection?

A

metronidazole

45
Q

presentation of cryptosporidium parvum?

A

diarrhoea,
nausea,
vomiting,
abdo pain

46
Q

Presentation of entamoeba histolytica?

A

amoebic dysentery,

invasive extraintestinal amoebiasis (live/pleuropulmonary/ brain abscess)

47
Q

Investigations for entamoeba histolytica

A

stool microscopy,

antibody detection

48
Q

Treatment for entamoeba histolytic infection?

A

metronidazole,

luminal agent to clear colonisation

49
Q

what age group is rotavirus common?

A

under 5 years

50
Q

Investigations of rotavirus?

A

antigen detection in stool

51
Q

Investigation for diagnosis of noravirus?

A

PCR

52
Q

Investigations for c.diff?

A 
Temp (fever)
WCC (increased)
serum creatinine (increased)
Serum lactate (increased)
ELISA (detect A or B toxins)
53
Q

Symptoms of mild and severe c.diff?

A 
Mild:
Moderate watery diarrhoea,
Abdominal pain, 
Fever,
Nausea
Severe:
Watery diarrhoea up to 15 times daily,
Blood in stool,
Abdominal pain,
Fever,
Nausea,
Dehydration
54
Q

Complications of c.diff?

A 
Pseudo-membranous colitis,
Toxic megacolon,
Perforation of colon,
Sepsis,
Death
55
Q

What is the largest cause of traveller’s diarrhoea?

A

Enterotoxigenic e.coli
(gram -ve)
Transmission person to perosn and contaminated food and water

Infection (15 decks)

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