Diarrhoea in transplant patient

Question 1

Significance of bloody diarrhoea in immunosuppressed patient

Answer 1

Does not restrict diagnosis to common pathogens for bloody diarrhoea - tissue damage and invasion can be seen with broader spec of opportunistic pathogens

Question 2

Offer what test to anyone presenting with gastroenteritis

Answer 2

HIV

Question 3

How to diagnose colitis

Answer 3

Flexible sigmoidoscopy with biopsy

Question 4

Risks for developing Candidaemia

Answer 4

Broad spec abx

esp immunocompromised

Question 5

Pan-fungal test for systemic fungal infection

Answer 5

Serum fungal antigen test (beta-D-glucan test; BDG)

Question 6

Common source of infection for candidaemia

Answer 6

Blood lines

also gut flora translocation following damage to gut lining

Question 7

Chickenpox rash

Answer 7

Itchy
Vesicular
Involves mouth and conjunctivae

Question 8

Management of glandular fever/mononucleosis

Answer 8

Self-limiting in immunocompetent patients
Rest
If LFTs deranged, avoid paracetamol

Question 9

Bacteria causing diarrhoea

Answer 9

Campylobacter sp
Shigella sp
non-typhi Salmonella
E coli O157
C difficile

Question 10

Viral causes of diarrhoea

Answer 10

Rotavirus

Noravirus

Question 11

Parasitic causes of diarrhoea

Answer 11

Entamoeba histolytica
Cryptosporidium
Giardia lamblia