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Y3- Infections > Diarrhoea & Gastro-enteritis > Flashcards

Diarrhoea & Gastro-enteritis Flashcards

1
Q

What is the definition of diarrhoea?

A

Increased fluidity and frequency of stool

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2
Q

What is the definition of gastro-enteritis?

A

Inflammation of the stomach and intestines

many things come under it

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3
Q

What are the 2 main signs of dysentery?

A

Large bowel inflammation and bloody stools

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4
Q

On the Bristol stool chart, what types are associated with gastro-enteritis?

A

Types 6 and 7

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5
Q

What are the 3 types of diarrhoea illness?

A

Secretory (e.g. cholera)
Inflammatory (e.g. dysentery)
Mixed (e.g. C.diff infection)

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6
Q

What is the main treatment for all types of diarrhoea illness?

A

Rehydration and fluids

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7
Q

What is the difference between secretory and inflammatory diarrhoea illness?

A

Secretory -> no abdominal pain or fever

Inflammatory -> abdominal pain and fever

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8
Q

What other treatments can be used for inflammatory diarrhoea illness?

A

Antibiotics

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9
Q

What type of hypertension is associated with hydration?

A

Postural hypertension

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10
Q

What are the signs of Systemic Inflammatory Response Syndrome (SIRS)?

A

Fever
Tachycardia
Increased WCC

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11
Q

In diarrhoea, is it only water that is lost?

A

No, Na and K are also lost which means you are at risk of hyponatraemia and hypokalaemia

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12
Q

What is the main type of virus that causes diarrhoea in children (under 5)?

A

Rotavirus

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13
Q

What type of virus commonly causes diarrhoea in hospitals, schools, care homes etc?

A

Norovirus

very infectious

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14
Q

How is norovirus diagnosed?

A

PCR

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15
Q

What are the S & S of gastro-enteritis?

A 
Diarrhoea (main)
Vomiting 
Abdominal pain 
Dehydration
Hyponatraemia
Hypokalaemia
Fever
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16
Q

What investigations can be undergone for gastro-enteritis?

A 
Bristol Stool Chart 
Stool culture
Blood culture
Molecular/antigen detection 
RFTs
Bloods
Abdominal X-rays/CT
PCR
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17
Q

How does the Bristol Stool Chart describe stool?

A

With increasing fluidity i.e. Type 1 is constipation, whilst Type 7 is diarrhoea

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18
Q

What are the treatments for gastroenteritis?

A 
Rehydration (salt/sugar solution)
IV saline
Antibiotics
Stool transplants
Oral vancomycin 
Metronidazole
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19
Q

What are the risk factors for gastroenteritis?

A 
Over-seas travel
Deprived areas 
Poor hygiene
Antacids
Antibiotics
Immunosuppressants
Poor diet
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20
Q

What is involved in the differential diagnosis with gastroenteritis?

A

IBD
Spurious diarrhoea (secondary to constipation)
Carcinomas

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21
Q

What are some of the causes of gastroenteritis?

A 
Viruses (main)
Food poisoning 
Bacteria
Parasites
Immunosuppression 
Sepsis
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22
Q

Give examples of types of bacteria that can cause gastroenteritis.

A 
Campylobacter (main)
Salmonella
E. coli O157
Shigella
C. diff
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23
Q

Give examples of ways in which food poisoning can occur.

A

Poor farming
Poor storage (not chilled)
Poor cooking

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24
Q

Why do antacids increases your susceptibility for gastroenteritis?

A

As stomach acid usually digests most bacteria, but if this acid is limited then bacteria can assert its affects more easily

25
Q

Why do antibiotics increases your risk of enteric infections?

A

As they affect normal gut flora

26
Q

If symptoms last for more than 2 weeks, is it likely to be gastroenteritis?

A

No, as it is unlikely to be an infection

27
Q

What type of diarrhoea occurs as a result of gastroenteritis?

A

Inflammatory

28
Q

What presents along with dehydration?

A

Hyponatraemia

Hypokalaemia

29
Q

Why should an abdominal X-ray or CT be undergone for abdominal pain or tenderness?

A

To check for potential perforation or acute appendicitis

30
Q

What type of diarrhoea is secondary to constipation?

A

Spurious

31
Q

Why is glucose provided along with fluids?

A

As glucose has a co-transporter with Na

32
Q

Why is it difficult to find the causative bacteria in a stool sample?

A

As there is a vast number of both non-pathogenic and pathogenic bacteria

33
Q

What investigations are used alongside stools cultures?

A

Antigen detection

Molecular detection

34
Q

What is the difference between O and H antigens?

A

O: occur on the body of the bacteria
H: occur on the flagella of the bacteria

35
Q

What is the most common causative bacteria for gastroenteritis?

A

Campylobacter

36
Q

What condition can campylobacter gastroenteritis occur after?

A

Gullian-Barre Syndrome

37
Q

What is a classic symptom of campylobacter gastroenteritis?

A

Sever abdominal pain

so it can be confused with acute appendicitis and perforation

38
Q

What are the 2 main species of campylobacter?

A

C. jejuni and C. coli

C= campylobacter

39
Q

What bacteria is the most common cause of food poisoning?

A

Campylobacter

40
Q

Where can campylobacter be found?

A

Contaminated chicken and milk

41
Q

What is the difference between salmonella gastroenteritis and campylobacter gastro-enteritis?

A

Salmonella -> presents quicker, more likely to spread into blood (but still not common)

Campylobacter -> presents slower, less likely to spread into blood

42
Q

What are the 2 main species of salmonella?

A

S. enterica and S. bongori

(S= salmonella)

43
Q

What are the most common infection types of salmonella?

A

S. enteritidis and S. typhimurium

44
Q

What is the difference between E.coli O157 and salmonella?

A

E.coli O157 -> ferments lactose

Salmonella -> does not ferment lactose

45
Q

What is the difference between E.coli O157 and other types of E.coli?

A

E.coli O157 doesn’t spread into blood

46
Q

Where can you get E.coli O157?

A

Contaminated meat

47
Q

What is the main symptom of E.coli O157 gastroenteritis?

A

Frequent bloody stools

48
Q

What type of bacterium is E.coli O157?

A

A toxin-mediated bacterium, so the bacterium itself stays in the gut but the toxins it produces can spread into blood

49
Q

What is the name of the toxins produced by E.coli O157?

A

Shiga

50
Q

What can the Shiga toxins produced by E.coli O157 cause?

A

Haemolytic-Uremic Syndrome

51
Q

What are the S&S of Haemolytic-Uremic Syndrome?

A

Renal failure
Haemolytic anaemia
Low platelet count

52
Q

Why are antibiotics not used to treat E.coli O157 gastro-enteritis?

A

As antibiotics break down the bacteria, which would result in more toxins being produced and Haemolytic-Uremic Syndrome occurring

53
Q

Where is Shigella common?

A

In children nurseries

54
Q

When treating gastroenteritis, when are antibiotics indicated and contraindicated?

A

Indicated: immunocompromised, severe sepsis and chronic illnesses (e.g. cancer)

Contraindicated: healthy patients with a non-invasive infection

55
Q

What is the likely cause of gastroenteritis if the patient has previously undergone antibiotic treatment of the 4 C’s?(cephalosporins, co-amoxiclav, clindamycin and ciprofloxacin )

A

C. diff

56
Q

What type of toxins does C. diff produce?

A

Type A -> enterotoxin

Type B -> cytotoxin

57
Q

What drugs can be used to treat C. diff gastroenteritis?

A

Metronidazole

Vancomycin (oral)

58
Q

Give examples of viruses that can cause gastro-enteritis?

A

Rotavirus (common in children)

Norovirus (common in community areas)

59
Q

How is norovirus usually diagnosed?

A

PCR

Y3- Infections (6 decks)

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