Diarrhoea, gastroenteritis & C.diff

Question 1

what antibiotics commonly cause C.diff

Answer 1

the Cs

Clindamycin

Ceftriaxone

Cipro

Cephalo

Co-amox

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

Question 2

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

Answer 2

Enterotoxin

Cytotoxin

Question 3

whats the 1st thing you do for C.diff

Answer 3

stop the bloody antibiotic lol

Question 4

how may cdiff present

Answer 4

watery diarrhoea (10-15 tiems a day)

abdo pain

loss of appetite

fever & tachy

high WCC

Question 5

what the main test do you do for C.doff

Answer 5

check for C. diff toxin from stool sample

cause it spreds via toxin production

(not the anitgen)

Question 6

what can untreated c.diff lead to

Answer 6

Toxic megacolon

Pseuodomonas colitis

Bowel perf

Question 7

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

Answer 7

cause evryone is on bloody antibiotics lol

Question 8

what 2 things can’t you take if on metronidazole

Answer 8

Alcoholol

Oramorph

Question 9

what med must you stop if you get C.diff

(other than the bloody antibiotic)

Answer 9

PPI

Question 10

how is C.diff treated

Answer 10

Normal -> PO metronidazole

severe -> IV metronidazole & PO vanc

Question 11

what in the GI tract provides defense to pathogens

Answer 11

Lymphoid tissue (peyers patches & appendix)

Stomach acid

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

Question 12

how may GI pathogens work

3 ways

Answer 12

Localised infection & inflammation

Toxin production

Syetemic infection +/- bacteriema

Question 13

how do these common GI pathogens work:

1. chlorea, noravirus, rotavirus
2. campylobacter, entamoeba histoloyca
3. c.diff, E.coli, staph A

Answer 13

1. local infection
2. systemic infection
3. toxin production

Question 14

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

Answer 14

1. E.coli 0157
2. enterotoxigenic e.coli
3. salmondella
4. campylobacter
5. chlorea

Question 15

what types of e.coli are realted to…

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

Answer 15

1. enterotoxigenic

2 & 3. E.coli 0157

Question 16

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

Answer 16

Anaemia

Thromnocytopenia

AKI

Question 19

where is C.diff normally present in gut flora

Answer 19

in kids

not obvs in adults

Question 20

how is c.diff spread

Answer 20

fecal oral

airborne (spores ingestion)

Question 21

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

Answer 21

yeah

it can lie dormant and only cause issues if on antibiotics

Question 22

rice-water stools

mad secreatary diarrhoea

what causes this

Answer 22

chlorea

Question 23

what can cause post-infective IBS

Answer 23

salmonella

Question 24

what diarrhoea causing viruses & protozoa come from…

1. young kids (<5yo)
2. contamined water
3. hospitals, curise ships & care homes (highly contagious)

Answer 24

1. rotavirus
2. giardia lamblia (protozoa)
3. noravirus

Question 26

what protozoas can cause diarrhoea

Answer 26

Giardia lamblia Entamoeba histoyica -\> dysentery & liver cysts

Question 27

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

Answer 27

Camplyobacter & salmonella cause these one cause systemic infection and bacteremia

Question 28

when are stool cultures useful

Answer 28

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

Question 29

when are these diarrhea investigations useful... 1. blood culture 2. stool culture 3. stool microscopy 4. viral PCR & antigen testing

Answer 29

1. camplyobacter or samlonella 2. bacteria causes 3. protozoa causees 4. viral causes

Question 30

does alcohol gel kill C. diff sprores

Answer 30

no way need soapy water

Question 31

if a pt gets C.diff, what happens ASAP

Answer 31

Put into isolation only allowed out if diarrhoea free for 48hrs

Question 32

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

Answer 32

48hours with no diarhroea

Question 33

whats essentially the main way to manage diarrhoea

Answer 33

fluid control sodium & glucose rehydration

Question 34

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

Answer 34

lift their legs up has the same effect as a 500ml fluid challenge lol

Question 35

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

Answer 35

has anyone at home/work been feelign the same

Question 36

protozoa causing diarrgoea... 1. forein travel & contamined food with shit 2. contamined water, greasy stool, treated with metronidazole

Answer 36

1. entameba histolyica 2. giralambia histolyica

Question 37

if you get HUS from E.coli 0157, how is it traeted are antiboitcs used?

Answer 37

Fluids & monitor kidney function No antiboitics

Question 38

what is the commonest bacteria cause of diarrhoea

Answer 38

camplyobacter

Question 39

**camplyobacter** 1. what antiboitics can be used to treat 2. complications 3. shape of rods

Answer 39

1. Clarithromycin or eyrthoromycin 2. GBS & reactive arthritis 3. seagul shaped rods

Question 40

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

Answer 40

cryptosporidium

Question 41

diarrhoea + rose spots treated with ceftriaxone whats this

Answer 41

Typhoid fever

Question 42

what causes of diarrhoea have the shorted and longest incubatoin time

Answer 42

shortest -\> bacillis cerus & staph A longest -\> protozoa causes

Question 43

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

Answer 43

1. giradiasis 2. chlorea 3. shigella 4. staph A 5. camplyobacter 6. bacillis cerus

Question 44

what are the main 2 symptoms of gasteroenteritis

Answer 44

vomiting & diarrhoea dont need both

Question 45

what cause of diarrhoea ofetn has a low BG

Answer 45

Chlorea

Question 47

vomiting after having some reheated rice is a cause of

Answer 47

bacillus cerus

Question 48

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

Answer 48

Overflow diarrhoea

Question 49

what is the critiera to have diarrhoea

Answer 49

\>3 loose or watery stools per day

Question 50

diarrhoea from heavy straining is called

Answer 50

spurious diarrhoea

Question 51

what chart do you always use for anything poo related

Answer 51

bristol stool chart

Question 52

what investigation can you do for C.diff

Answer 52

fleixible sigmoidosocopy

Question 53

does e.coli ferment lactose

Answer 53

yeah lol unlike salmonella apparently

Question 54

what diarrhoea causing bacteria can cause osteomyleitis in kids with SCD

Answer 54

salmonella

Question 55

what type of toxin does E.coli 0157 release

Answer 55

shiga-like toxin

Question 56

rice-water stools is caused by

Answer 56

vibrio cholerae