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INTERNAL MED 3+ conditions > Food Poisoning/Acute Infectious Diarrhoea > Flashcards

Food Poisoning/Acute Infectious Diarrhoea Flashcards

1
Q

Define acute infectious diarrhoea

A

Ingestion of food/water contaminated with bacteria, viruses, parasites or chemicals

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2
Q

Typically food poisoning is…..

A
  • Mild

- Self-limiting

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3
Q

3 biggest causes of acute infectious diarrhoea in the UK

A
  1. Campylobactor
  2. Clostridium perfringens
  3. Norovirus
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4
Q

3 biggest causes of food poisoning globally

A
  1. Shigella
  2. Salmonella
  3. Campylobacter
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5
Q

Common cause of food poisoning in developed countries

A

STEC - Shiga toxin producing E.coli

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6
Q

Common cause of food poisoning in developing countries

A

Entamoeba histolytica

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7
Q

Seasonal peaks - food poisoning - generally peaks in…

A

Summer

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8
Q

Describe the mechanism of enterotoxins

A
  • Influence secretory mechanisms of the mucosa of the SI
  • LI = invasive and destructive - inflammation
  • SI or LI = non-inflammatory, no invasion
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9
Q

Mechanism of subtypes of food poisoning causing vomiting

A

Toxins act on the CNS

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10
Q

Bacteria causing botulism

A

Clostridium botulinum

- Inhibits ACh release in nerve endings

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11
Q

Food poisoning - small bowel pathogen

A

Watery diarrhoea

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12
Q

Food poisoning - large bowel pathogen

A

Inflammatory diarrhoea - fever, bloody mucoid stool (invasion of mucosa)

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13
Q

Non-infectious causes of diarrhoea

A
  • ADR
  • Food allergies
  • IBD
  • Thyrotoxicosis
  • Carcinoid syndrome (paraneoplasm)
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14
Q

3 subtypes of diarrhoea

A
  • Acute watery (several hours - days)
  • Acute bloody
  • Persistent (14+ days)
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15
Q

2 subtypes of dehydration

A
  • No dehydration
  • Some dehydration - 2+ signs - thirst, restlessness, irritable, decreased skin elasticity, sunken eyes
  • Severe dehydration
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16
Q

Dehydration is less likely with ….. diarrhoea

A
  • Inflammatory diarrhoea

smaller stool volume

17
Q

Other, more rare systemic symptoms of infectious diarrhoea

A
  • Skin macules
  • Reactive arthritis
  • Neurological - diplopiea, decreased muscle tone, slurred speech
18
Q

Investigations for infectious diarrhoea

A
  • Stool microscopy
  • Stool culture
  • Stool O and P (ova and parasite)
  • FBC
  • Serum creatinine and electrolytes
19
Q

Risk factors for infectious diarrhoea

A
  • Old/children
  • Pregnant
  • Chronic disease
  • Recent travel history
  • Immunocompromised
  • Contact history
  • Consumption of uncooked meat/seafood
  • Use of antacids
20
Q

DDX for infectious diarrhoea

A
  • Acute viral syndromes
  • Crohn’s disease
  • Ulcerative colitis
  • Food allergies/intolerance
  • IBS
  • Microscopic colitis
  • Acute appendicitis
  • Cholecystitis
  • Pancreatitis
21
Q

Management/treatment for infectious diarrhoea

A
  • Oral rehydratio nfluids
  • Symptom control
  • Electrolyte replacement

*** antiemetics are not indicated for infectious diarrhoea

22
Q

Mild moderate diarrhoea treatment

A
  1. Oral rehydration
  2. Antiperistaltics (opiate derivatives) - for watery diarrhoea
  3. Antidiarrhoeals (Aluminium hydroxide, Bismuth subsalicylate, Loperamide)
23
Q

Aluminium hydroxide is an….

A

Absorbent

24
Q

Bismuth is a….

A

Antisecretory

25
Q

Severe diarrhoea - more than 3 days

A
  • IV hydration
  • Empirical antibiotics
    = Ciprofloxacin
    = Erythromycin
    = Metronidazole
26
Q

Antibiotics should only be given for non-bloody diarrhoea after….

A

A microbiological diagnosis

27
Q

Treatment for suspected botulism

A

Antitoxin from Clostridium botulinum

Supportive care

28
Q

Food poisoning mortality rate

A

<0.1%

29
Q

Complications of food poisoning

A
  • Botulism-induced respiratory failure/paralysis
  • Haemolytic uraemic syndrome
  • IBS
  • Guillain-Barre syndrome
  • Reactive arthritis
30
Q

What is haemolytic uraemic syndrome

A
  • Microangiopathic haemolytic anaemia
  • Acute renal failure
  • Thrombocytopenia
31
Q

What is Guillain-Barre syndrome

A
  • Acute, autoimmune polyradiculoneuropathy

INTERNAL MED 3+ conditions (18 decks)

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