Diarrhoea Flashcards
What are some lower GI red flags?
Age >50 Rectal bleeding Recent change in bowel habit Nocturnal symptoms Unexplained weight loss Iron deficienct anaemia Family history of colorectal cancer
What antibiotics can lead to c diff infection?
Clindamycin or broad spectrum antibiotics
How does cholera present?
Profuse watery diarrhoea without abdo pain or fever
What is the presentation of norovirus?
Predominantly vomiting but is accompanied by watery non-bloody diarrhoea for 1-2 days
What are some non infective causes of diarrhoea?
Hyperthyroidism Malabsorption IBS Crohns Ulcerative colitis (bloody) Constipation with overflow diarrhoea
What are some of the infective causes of bloody diarrhoea?
Campylobacter jejuni - bloody diarrhoea with fever and cramps
Salmonella - 4-7 days of bloody diarrhoea, fever and cramps
E coli usualy mild but can lead to haemorrhagic colitis
What do polymorphs on a faecal smear suggest?
This suggests shigella or campylobacter
No polymorphs suggest salmonella or c diff
How is c diff treated?
Moderate - metronidazole 500mg TDS for 10 days
Severe - vancomycin 125mg QDS for 10 days
What is a complication of c diff?
Pseudomembranous colitis - this can lead to toxic megacolon and bowel perf
It requires urgent ABG and AXR
When is the peak incidence of coeliac disease presentation?
50s more common in women
What rash can be associated with coeliac disease?
Dermatitis herpetiformis rash (looks like eczema)
What autoantibodies are associated with coeliac disease?
IgA TTG
How is coeliac diagnosed?
With postitve antibodies and then have endoscopy with duodenal biopsy showing villous atrophy
What is the management of coeliac disease?
Managed with gluten free diet and supplementation as nessessary e.g. iron
What are the iron study findings in iron deficiency anaemia and anaemia of chronic disease?
IDA: Total iron binding capacity - high Transferrin saturation - low Ferritin - low ACD: Total iron binding capacity - low Transferrin saturation - low Ferretin - high
