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Oh no- Infections > Diarrhoea, gastroenteritis & C.diff > Flashcards

Diarrhoea, gastroenteritis & C.diff Flashcards

1
Q

what antibiotics commonly cause C.diff

A

the Cs

Clindamycin

Ceftriaxone

Cipro

Cephalo

Co-amox

+ PPIs & other antiboitcs (e.g. tazocin)

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2
Q

what are the 2 types of toxins involved in C.diff

A

Enterotoxin

Cytotoxin

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3
Q

whats the 1st thing you do for C.diff

A

stop the bloody antibiotic lol

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4
Q

how may cdiff present

A

watery diarrhoea (10-15 tiems a day)

abdo pain

loss of appetite

fever & tachy

high WCC

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5
Q

what the main test do you do for C.doff

A

check for C. diff toxin from stool sample

cause it spreds via toxin production

(not the anitgen)

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6
Q

what can untreated c.diff lead to

A

Toxic megacolon

Pseuodomonas colitis

Bowel perf

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7
Q

for any diarrhoea in hospital, why must you always consider c.dff

A

cause evryone is on bloody antibiotics lol

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8
Q

what 2 things can’t you take if on metronidazole

A

Alcoholol

Oramorph

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9
Q

what med must you stop if you get C.diff

(other than the bloody antibiotic)

A

PPI

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10
Q

how is C.diff treated

A

Normal -> PO metronidazole

severe -> IV metronidazole & PO vanc

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11
Q

what in the GI tract provides defense to pathogens

A

Lymphoid tissue (peyers patches & appendix)

Stomach acid

Large amounts of bacteria already in colon (hard for new ones to fit)

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12
Q

how may GI pathogens work

3 ways

A

Localised infection & inflammation

Toxin production

Syetemic infection +/- bacteriema

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13
Q

how do these common GI pathogens work:

  1. chlorea, noravirus, rotavirus
  2. campylobacter, entamoeba histoloyca
  3. c.diff, E.coli, staph A
A
  1. local infection
  2. systemic infection
  3. toxin production
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14
Q

what bacteria can come from this…

  1. animal poo & farming
  2. travelers diarrhoea
  3. contamined animal products
  4. contamined chicken
  5. water in developing countries
A
  1. E.coli 0157
  2. enterotoxigenic e.coli
  3. salmondella
  4. campylobacter
  5. chlorea
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15
Q

what types of e.coli are realted to…

  1. travelers
  2. farming & animal poo
  3. heamolytic ureameia syndrome (HUS)
A
  1. enterotoxigenic

2 & 3. E.coli 0157

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16
Q

e.coli 0157 can cause haemolytic aneamia, what is the triad

A

Anaemia

Thromnocytopenia

AKI

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17
Q
A
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18
Q
A
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19
Q

where is C.diff normally present in gut flora

A

in kids

not obvs in adults

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20
Q

how is c.diff spread

A

fecal oral

airborne (spores ingestion)

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21
Q

can you have c.diff in your gi tract and be fine

A

yeah

it can lie dormant and only cause issues if on antibiotics

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22
Q

rice-water stools

mad secreatary diarrhoea

what causes this

A

chlorea

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23
Q

what can cause post-infective IBS

A

salmonella

24
Q

what diarrhoea causing viruses & protozoa come from…

  1. young kids (<5yo)
  2. contamined water
  3. hospitals, curise ships & care homes (highly contagious)
A
  1. rotavirus
  2. giardia lamblia (protozoa)
  3. noravirus
25
Q
A
26
Q

what protozoas can cause diarrhoea

A

Giardia lamblia

Entamoeba histoyica -> dysentery & liver cysts

27
Q

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

A

Camplyobacter & salmonella

cause these one cause systemic infection and bacteremia

28
Q

when are stool cultures useful

A

to isolate bacterial pathogens

camplyobacter and samlonella need this done even tho they may spred to blood, although that is rare

29
Q

when are these diarrhea investigations useful…

  1. blood culture
  2. stool culture
  3. stool microscopy
  4. viral PCR & antigen testing
A
  1. camplyobacter or samlonella
  2. bacteria causes
  3. protozoa causees
  4. viral causes
30
Q

does alcohol gel kill C. diff sprores

A

no way

need soapy water

31
Q

if a pt gets C.diff, what happens ASAP

A

Put into isolation

only allowed out if diarrhoea free for 48hrs

32
Q

how long does a pt with C.diff need to be in isolation

A

48hours with no diarhroea

33
Q

whats essentially the main way to manage diarrhoea

A

fluid control

sodium & glucose rehydration

34
Q

if a pt who has had severe diarrhoea becomes hypotensive, what is the first thing you do

A

lift their legs up

has the same effect as a 500ml fluid challenge lol

35
Q

like all infectins, what must you always ask in the history

A

has anyone at home/work been feelign the same

36
Q

protozoa causing diarrgoea…

  1. forein travel & contamined food with shit
  2. contamined water, greasy stool, treated with metronidazole
A
  1. entameba histolyica
  2. giralambia histolyica
37
Q

if you get HUS from E.coli 0157, how is it traeted

are antiboitcs used?

A

Fluids & monitor kidney function

No antiboitics

38
Q

what is the commonest bacteria cause of diarrhoea

A

camplyobacter

39
Q

camplyobacter

  1. what antiboitics can be used to treat
  2. complications
  3. shape of rods
A
  1. Clarithromycin or eyrthoromycin
  2. GBS & reactive arthritis
  3. seagul shaped rods
40
Q

if you have HIV and get diarrhoea, whats the likley cause

A

cryptosporidium

41
Q

diarrhoea + rose spots

treated with ceftriaxone

whats this

A

Typhoid fever

42
Q

what causes of diarrhoea have the shorted and longest incubatoin time

A

shortest -> bacillis cerus & staph A

longest -> protozoa causes

43
Q

what causes these gastroenteritis presentatins…

  1. prolonged, watery, maybe been to SE asia, bloating
  2. very watery & profuse, hypoglycemia
  3. bloody, vomitng & abdo pain
  4. vomiting quickly after eating
  5. flu-like prodrome
  6. from rice
A
  1. giradiasis
  2. chlorea
  3. shigella
  4. staph A
  5. camplyobacter
  6. bacillis cerus
44
Q

what are the main 2 symptoms of gasteroenteritis

A

vomiting & diarrhoea

dont need both

45
Q

what cause of diarrhoea ofetn has a low BG

A

Chlorea

46
Q
A
47
Q

vomiting after having some reheated rice is a cause of

A

bacillus cerus

48
Q

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

A

Overflow diarrhoea

49
Q

what is the critiera to have diarrhoea

A

>3 loose or watery stools per day

50
Q

diarrhoea from heavy straining is called

A

spurious diarrhoea

51
Q

what chart do you always use for anything poo related

A

bristol stool chart

52
Q

what investigation can you do for C.diff

A

fleixible sigmoidosocopy

53
Q

does e.coli ferment lactose

A

yeah lol

unlike salmonella apparently

54
Q

what diarrhoea causing bacteria can cause osteomyleitis in kids with SCD

A

salmonella

55
Q

what type of toxin does E.coli 0157 release

A

shiga-like toxin

56
Q

rice-water stools is caused by

A

vibrio cholerae

Oh no- Infections (13 decks)

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