Diarrhoea, gastroenteritis & C.diff Flashcards
what antibiotics commonly cause C.diff
the Cs
Clindamycin
Ceftriaxone
Cipro
Cephalo
Co-amox
+ PPIs & other antiboitcs (e.g. tazocin)
what are the 2 types of toxins involved in C.diff
Enterotoxin
Cytotoxin
whats the 1st thing you do for C.diff
stop the bloody antibiotic lol
how may cdiff present
watery diarrhoea (10-15 tiems a day)
abdo pain
loss of appetite
fever & tachy
high WCC
what the main test do you do for C.doff
check for C. diff toxin from stool sample
cause it spreds via toxin production
(not the anitgen)
what can untreated c.diff lead to
Toxic megacolon
Pseuodomonas colitis
Bowel perf
for any diarrhoea in hospital, why must you always consider c.dff
cause evryone is on bloody antibiotics lol
what 2 things can’t you take if on metronidazole
Alcoholol
Oramorph
what med must you stop if you get C.diff
(other than the bloody antibiotic)
PPI
how is C.diff treated
Normal -> PO metronidazole
severe -> IV metronidazole & PO vanc
what in the GI tract provides defense to pathogens
Lymphoid tissue (peyers patches & appendix)
Stomach acid
Large amounts of bacteria already in colon (hard for new ones to fit)
how may GI pathogens work
3 ways
Localised infection & inflammation
Toxin production
Syetemic infection +/- bacteriema
how do these common GI pathogens work:
- chlorea, noravirus, rotavirus
- campylobacter, entamoeba histoloyca
- c.diff, E.coli, staph A
- local infection
- systemic infection
- toxin production
what bacteria can come from this…
- animal poo & farming
- travelers diarrhoea
- contamined animal products
- contamined chicken
- water in developing countries
- E.coli 0157
- enterotoxigenic e.coli
- salmondella
- campylobacter
- chlorea
what types of e.coli are realted to…
- travelers
- farming & animal poo
- heamolytic ureameia syndrome (HUS)
- enterotoxigenic
2 & 3. E.coli 0157
e.coli 0157 can cause haemolytic aneamia, what is the triad
Anaemia
Thromnocytopenia
AKI
where is C.diff normally present in gut flora
in kids
not obvs in adults
how is c.diff spread
fecal oral
airborne (spores ingestion)
can you have c.diff in your gi tract and be fine
yeah
it can lie dormant and only cause issues if on antibiotics
rice-water stools
mad secreatary diarrhoea
what causes this
chlorea
what can cause post-infective IBS
salmonella
what diarrhoea causing viruses & protozoa come from…
- young kids (<5yo)
- contamined water
- hospitals, curise ships & care homes (highly contagious)
- rotavirus
- giardia lamblia (protozoa)
- noravirus
what protozoas can cause diarrhoea
Giardia lamblia
Entamoeba histoyica -> dysentery & liver cysts
what are the only 2 commonish causes of diarrhoea diagnosed via a blood culture & why
will probs have to do one anyways to exclude these
Camplyobacter & salmonella
cause these one cause systemic infection and bacteremia
when are stool cultures useful
to isolate bacterial pathogens
camplyobacter and samlonella need this done even tho they may spred to blood, although that is rare
when are these diarrhea investigations useful…
- blood culture
- stool culture
- stool microscopy
- viral PCR & antigen testing
- camplyobacter or samlonella
- bacteria causes
- protozoa causees
- viral causes
does alcohol gel kill C. diff sprores
no way
need soapy water
if a pt gets C.diff, what happens ASAP
Put into isolation
only allowed out if diarrhoea free for 48hrs
how long does a pt with C.diff need to be in isolation
48hours with no diarhroea
whats essentially the main way to manage diarrhoea
fluid control
sodium & glucose rehydration
if a pt who has had severe diarrhoea becomes hypotensive, what is the first thing you do
lift their legs up
has the same effect as a 500ml fluid challenge lol
like all infectins, what must you always ask in the history
has anyone at home/work been feelign the same
protozoa causing diarrgoea…
- forein travel & contamined food with shit
- contamined water, greasy stool, treated with metronidazole
- entameba histolyica
- giralambia histolyica
if you get HUS from E.coli 0157, how is it traeted
are antiboitcs used?
Fluids & monitor kidney function
No antiboitics
what is the commonest bacteria cause of diarrhoea
camplyobacter
camplyobacter
- what antiboitics can be used to treat
- complications
- shape of rods
- Clarithromycin or eyrthoromycin
- GBS & reactive arthritis
- seagul shaped rods
if you have HIV and get diarrhoea, whats the likley cause
cryptosporidium
diarrhoea + rose spots
treated with ceftriaxone
whats this
Typhoid fever
what causes of diarrhoea have the shorted and longest incubatoin time
shortest -> bacillis cerus & staph A
longest -> protozoa causes
what causes these gastroenteritis presentatins…
- prolonged, watery, maybe been to SE asia, bloating
- very watery & profuse, hypoglycemia
- bloody, vomitng & abdo pain
- vomiting quickly after eating
- flu-like prodrome
- from rice
- giradiasis
- chlorea
- shigella
- staph A
- camplyobacter
- bacillis cerus
what are the main 2 symptoms of gasteroenteritis
vomiting & diarrhoea
dont need both
what cause of diarrhoea ofetn has a low BG
Chlorea
vomiting after having some reheated rice is a cause of
bacillus cerus
diarrhoea & abdo pain
was constipated for a while
Abdo mass felt
Maybe on long term opioids or has cerebral palsy
what is this gonna probs be
Overflow diarrhoea
what is the critiera to have diarrhoea
>3 loose or watery stools per day
diarrhoea from heavy straining is called
spurious diarrhoea
what chart do you always use for anything poo related
bristol stool chart
what investigation can you do for C.diff
fleixible sigmoidosocopy
does e.coli ferment lactose
yeah lol
unlike salmonella apparently
what diarrhoea causing bacteria can cause osteomyleitis in kids with SCD
salmonella
what type of toxin does E.coli 0157 release
shiga-like toxin
rice-water stools is caused by
vibrio cholerae
