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GI > diarrhoeal diseases PH > Flashcards

diarrhoeal diseases PH Flashcards

1
Q

what is the definition of diarrhoea?

A

3 or more watery stools a day (but remember need to take into account what is the normal for the pt as well)

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2
Q

what is the bristol stool chart?

A

groups stools into seven types from type 1 to type 7

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3
Q

what is type 7 stool?

A

watery, no solid pieces, entirely liquid

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4
Q

what is type 1 stool?

A

separate hard lumps like nuts that are hard to pass

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5
Q

what type of stool is like a sausage or snake and is smooth and soft?

A

type 4

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6
Q

what are the non-infective causes of diarrhoea?

A 
neoplasm
hormonal 
inflammatory
radiation
irritable bowel 
chemical
anatomical
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7
Q

give an example of an anatomical cause of diarrhoea?

A

short gut syndrome either from birth or due to surgery eg for mesenteric ischaemia

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8
Q

what are the hormones that can cause diarrhoea?

A

adrenaline
serotonin
thyroxine

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9
Q

why does radiation cause diarrhoea?

A

due to the inflammation of the bowel caused by the radiation

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10
Q

how can the infective causes of diarrhoea be classified?

A

bloody (dysentery)

non-bloody

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11
Q

what could be a reservoir of infection?

A

environment, human, animal

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12
Q

what are the 3 broad types of transmission of infection?

A

direct
indirect
airborne

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13
Q

what are the methods of transmission within the direct group?

A

direct contact eg for STIs

faeco-oral route

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14
Q

what are the methods of transmission within indirect transmission?

A

vehicle borne - ie needle or transfusion products

vector borne - eg malaria and Dengue fever

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15
Q

is legionella and airborne disease and can it be passed from human to human?

A

yes airborne

no - can’t be passed from human to human

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16
Q

what organisms could be causing frequent diarrhoea, flatulence, nausea and abdominal discomfort in a student returning from a backpacking holiday in south asia?

A 
giardia - protozoa
E. coli
Enteric fever (Salmonella typhi and paratyphi)
Cholera 
viral gastroenteritis eg norovirus and rotavirus
Campylobacter
Entamoeba histolytica 
Cryptosporidium hominis
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17
Q

which pathogen is common in nurseries?

A

rotavirus

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18
Q

which pathogens cause illness from petting zoos?

A

Campylobacter
Salmonella
E. coli O157

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19
Q

what bacterium is responsible for HUS

A

E. coli O157

20
Q

What can the E. coli O157 toxin lead to?

A 
acute kidney failure 
liver dysfunction
haemolysis of blood cells 
bloody diarrhoea 
HUS
21
Q

what pathogen is common in care homes?

A

norovirus

22
Q

give the symptoms of norovirus

A 
vomiting 
diarrhoea 
nausea
cramps 
headache 
fever 
chills 
myalgia
23
Q

how long do the symptoms in norovirus last?

A

1-3 days

24
Q

where is norovirus found?

A
  • Hospitals
  • Care Homes
  • Schools
  • Cruise ships
  • Families
25
Q

what should you tell a food handler who has diarrhoea?

A

keep out of work for days, they need to come back to the doctor to assess their fitness to practice before going back to work

26
Q

is food poisoning a notifiable disease?

A

yes - as this means that the source could be found and the infection and spread controlled

27
Q

an elderly pt who has diarrhoea while recovering from surgery is likely to have what pathogen?

A

C. diff

28
Q

what can low volume bloody stools be caused by?

A

Shigella

29
Q

what are the characteristics of the bacterium C. diff?

A

produces spores - which are difficult to eradicate
people can carry C. diff
C. diff is an environmental pathogen eg found in soil

30
Q

what causes psudomembranous colitis in C. diff infection?

A

the C. diff toxin

31
Q

how is C. diff spread?

A

faeco-oral route

spores in the environment

32
Q

what does the acronym SIGHT stand for?

A 
Suspect C diff as a cause of diarrhoea
Isolate the case
Gloves and aprons must be worn
Hand washing with soap and water
Test stool for toxin - request this on the form as this test is not routinely done
33
Q

How is C. diff managed?

A

infection control procedures
control antibiotic use especially the broad spectrum ones such as ampicillin, amoxicillin and cephalosporins
surveillance and case finding
any pt with diarrhoea should be isolated, enteric precautions taken, stool samples tested, environmental cleaning and treat C.diff with metronidazole or vancomycin

34
Q

how is C. diff infection investigated?

A

test stool samples
culture stool samples to identify the strain
biopsies taken at sigmoidoscopy

35
Q

Do you need to treat asymptomatic carriers of C. diff?

A

no

36
Q

what may be causing altered bowel motions, increased frequency and mucous and symptoms for 6 months, weight loss and night sweats?

A

bowel cancer, most likely to be colorectal cancer

37
Q

what is the second largest killer of children worldwide?

A

diarrhoea!

38
Q

what is the first largest killer of children world-wide?

A

resp tract infections

39
Q

what is the number 1 treatment for diarrhoea in developing countries?

A

rehydration

40
Q

Which parts of the world have a high infant mortality for diarrhoeal diseases?

A

south asia

africa

41
Q

Give examples of causative organisms for diarrhoea in children

A 
E. coli
Shigella
Campylobacter
Salmonella
Cryptosporidium
Rotavirus
42
Q

How are diarrhoeal diseases prevented as part of the global WHO-UNICEF prevention package?

A 
vaccinations 
breastfeeding 
vitamin A supplementation 
promote hand washing with soap
improved water supply quantity and quality
sanitation promotion in communities
43
Q

How are diarrhoeal diseases treated as part of the global WHO-UNICEF treatment package?

A

Fluid Replacement to prevent dehydration

Zinc treatment

44
Q

what are some control measures that can be taken to prevent spread of diarrhoea?

A
  • Hand-washing with soap
  • Ensure availability of safe drinking water
  • Safe disposal of human waste
  • Breastfeeding of infants & young children
  • Safe handling and processing of food
  • Control of flies/vectors
  • Case management including exclusion
  • Vaccination
45
Q

who are the 4 at risk groups fro diarrhoea?

A

A – Persons of doubtful personal hygiene or with
unsatisfactory hygiene facilities at home, work or
school
B – Children who attend pre school or nursery
C – People whose work involves preparing or serving
unwrapped/uncooked food
D – HCW/Social care staff working with vulnerable
people

GI (15 decks)

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