Food Posining _علاء خطار Flashcards

1
Q

What is food born illness?

A

Illness resulting from eating food contaminated with organism or their toxin.

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2
Q

what’re the risk factors of the food poising ?

A

1-Travel to developing countries or cities with poor services.

2-Improper food preparation , storage or handling

3-Weakened immune system, pregnancy, very young age

3-Underlying gastrointestinal disorders

4-Patients taking antacids, H-2 blockers, and proton pump inhibitors

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3
Q

what’re the symptoms of the food poising ?

A
1-Nausea
2-Vomiting
3-Stomach cramps
4-Diarrhea
5-Fever
6-Headache

CAN be fatal - RARE!

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4
Q

what’s Differential diagnosis of acute diarrhoea and vomiting in food poising?

A

1-Infectious causes

2-Infectious causes

infectious causes include

1-Gastroenteritis
(also known as infectious diarrhea, is inflammation of the gastrointestinal tract—the stomach and small intestine. Symptoms may include diarrhea, vomiting and abdominal pain.)

2-C. difficile infection
(is bacteria that can infect the bowel and cause diarrhoea. The infection most commonly affects people who have recently been treated with antibiotics. It can spread easily to others)

3-Acute diverticulitis

4-Sepsis 
Sepsis is a potentially life-threatening condition caused by the body's response to an infection
Sepsis Symptoms
Fever and chills.
Very low body temperature.
Peeing less than normal.
Rapid pulse.
Rapid breathing.
Nausea and vomiting.
Diarrhea.

5-Pelvic inflammatory disease
an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis.

6-Meningococcaemia
is an infection of the blood. Meningococcal meningitis and meningococcaemia are caused by the bacterium Neisseria meningitidis (N. meningitidis), which is known as the meningococcus and infects humans only.

7-Pneumonia (especially ‘atypical disease’

8-Malaria

1- Gastrointestinal

Inflammatory bowel disease
Bowel malignancy
Overflow from constipation •
Enteral tube feeding

2- Metabolic: 
Diabetic ketoacidosis 
Thyrotoxicosis 
Uraemia 
Neuroendocrine tumours releasing   

3- Drugs and toxins:

NSAIDs
Cytotoxic agents
Antibiotics
Proton pump inhibitors
Dinoflagellates 
Plant toxins 
Heavy metals 
Ciguatera fish poisoning
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5
Q

Differential diagnosis of acute diarrhoea and vomiting for the infectious cause ?

A
1-Gastroenteritis
2-C. difficile infection 
3-Acute diverticulitis 
4-Sepsis 
5-Pelvic inflammatory disease 
6-Meningococcaemia 
7-Pneumonia (especially ‘atypical disease’
8-Malaria
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6
Q

Differential diagnosis of acute diarrhoea and vomiting for the non infectious cause ?

A

1- Gastrointestinal

Inflammatory bowel disease
Bowel malignancy
Overflow from constipation •
Enteral tube feeding

2- Metabolic: 
Diabetic ketoacidosis 
Thyrotoxicosis 
Uraemia 
Neuroendocrine tumours releasing   

3- Drugs and toxins:

NSAIDs
Cytotoxic agents
Antibiotics
Proton pump inhibitors
Dinoflagellates 
Plant toxins 
Heavy metals 
Ciguatera fish poisoning
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7
Q

what the cause of the food poising ?

A

toxin may short released or take longer time to release

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8
Q

which types cause signs and symptoms within (1-6)h?

A

1-Bacillus cereus (preformed enterotoxin)

2- Staphylococcus aureus

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9
Q

what’s the source of the bacillus cereus & staph aureus?

A

_Bacillus cereus sources are cooked rice/fried rice and red meats.
Causes sudden onset of severe nausea and vomiting. Diarrhea may be present.

_ Staphylococcus aureus source is Unrefrigerated meats, potato and egg salads.
Causes sudden onset of severe nausea and vomiting. Abdominal cramps and fever may be present.

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10
Q

what the possible cause of eating improper cooked rice ?

A

Bacillus cereus Causes sudden onset of severe nausea and vomiting. Diarrhea may be present.

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11
Q

what the possible cause of eating improper cooked rice ?

A

Staphylococcus aureus Causes sudden onset of severe nausea and vomiting. Abdominal cramps and fever may be present.

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12
Q

which types cause signs and symptoms within 8–16 hours?

A

so it’s Medium incubation period (8–16 hours)

the cause is :

1-Bacillus cereus (toxin)
from the Meat, stew gravy, vanilla sauce
مرق اللحم وصلصة الفانيليا

Causes watery diarrhea, abdominal cramps, nausea.

2-2. Clostridium perfringens
sources from Dry or precooked meats and poultry
اللحوم والدواجن الجافة أو المطبوخة مسبقًا

Causes watery diarrhea, nausea, abdominal cramps.

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13
Q

what the possible cause of eating Meat, stew gravy, vanilla sauce?

A

Bacillus cereus (toxin)
from the Meat, stew gravy, vanilla sauce
مرق اللحم وصلصة الفانيليا

Causes watery diarrhea, abdominal cramps, nausea.

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14
Q

what the possible cause of from Dry or precooked meats ?

A

Clostridium perfringens
sources from Dry or precooked meats and poultry
اللحوم والدواجن الجافة أو المطبوخة مسبقًا

Causes watery diarrhea, nausea, abdominal cramps.

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15
Q

which types cause signs and symptoms >16 hours?

A

Long incubation period (>16 hours)

A- Toxin-producing organisms

1- Clostridium botulinum:
2-Enterohemorrhagic E. coli
3-Enterotoxigenic E. coli
4-Vibrio cholerae

B- Invasive organisms
1- Campylobacter jejuni
2. Salmonella
3. Shigella
4. Vibrio parahaemolyticus
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16
Q

what’re the clinical features of the infection with the Clostridium botulinum?

A

source is : canned foods.

mechanism by : long period toxin >16h

causes : vomiting, diarrhea, blurred vision, diplopia, dysphagia, and descending muscle weakness

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17
Q

what’re the clinical features of the infection with the Enterohemorrhagic E. coli?

A

source is : undercooked beef, especially hamburger, unpasteurized milk, raw fruits and vegetables, and contaminated water.

mechanism by : long period toxin >16h

causes : Causes severe diarrhea that is often bloody, abdominal pain, vomiting. More common in children <4 years of age.

مهمه هيموراجك تسوي bloody diarrhia

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18
Q

what’re the clinical features of the infection with the Enterotoxigenic E. coli?

A

source is : foods or water contaminated by human feces.

mechanism by : long period toxin >16h

causes : Causes watery diarrhea, abdominal cramps, and vomiting.

19
Q

what’re the clinical features of the infection with the Vibrio cholerae?

A

source is : contaminated water, fish, and shellfish, especially food sold by street vendors
لمياه الملوثة والأسماك والمحار ، وخاصة الطعام الذي يبيعه الباعة الجائلين

mechanism by : long period toxin >16h

causes : profuse watery diarrhea and vomiting which can lead to severe dehydration and death within hours.

20
Q

what’re the clinical features of the infection with the Campylobacter jejuni?

A

source is : raw and undercooked poultry, unpasteurized milk, contaminated meats

mechanism by : invasive organism

causes : diarrhea (may be bloody), cramps, vomiting, and fever

21
Q

what’re the clinical features of the infection with the Salmonella typhi?

A

source is : contaminated eggs, poultry, unpasteurized milk or juice, cheese, contaminated raw fruits and vegetables

mechanism by : invasive organism

causes : diarrhea, fever, abdominal cramps, vomiting.

22
Q

what’re the clinical features of the infection with the Vibrio parahaemolyticus ?

A

source is : undercooked and raw seafood

mechanism by : invasive organism

causes : nausea vomiting, diarrhea, and abdominal pain.

23
Q

H ow to diagnosis the food positing ?

A

Food poisoning most often presents as gastroenteritis
Most cases of gastroenteritis have a viral etiology.
Suspect bacterial food poisoning when multiple persons become ill after eating the same meal, with fever and blood or mucus in stool.
Timing and presentation can aid in establishing an etiology

signs of dehydration, including evaluating skin turgor and mucous membranes, and observing for hypotension or orthostatic changes.
abdominal distension with tenderness, Auscultation may demonstrate increased bowel sound in obstruction or decreased bowel sounds with an ileus

Culture of stool and sensitivity,

general stool examination

Blood morphology, culture and white blood cell count if diarrhea is severe

24
Q

How to distinguish wether the food poising is viral or bacterial ?

A

Suspect bacterial food poisoning when

  • multiple persons become ill after eating the same meal, -fever
  • blood or mucus in stool.
25
Q

what’re the investigation of the Gastointeritis ?

A

1-Culture of stool and sensitivity,

2-general stool examination : for leukocytes, and Hemoccult testing; consider ova and parasites if history of foreign travel or symptoms lasting longer than 2 weeks.

3-Blood morphology, culture and white blood cell count if diarrhea is severe, temperature (38.5°C), persistently bloody stools, severe abdominal pain, or if patient is immunocompromised, elderly, or very young

26
Q

when we take the blood sample ?

A
  • if diarrhea is severe,
  • temperature (38.5°C)
  • , persistently bloody stools, severe abdominal pain, or if -patient is immunocompromised
  • elderly, or very young
27
Q

what we need to look for when we do general stool exam?

A

_ for leukocytes, and Hemoccult

_ if parasitic consider ova and parasites if history of foreign travel or symptoms lasting longer than 2 weeks.

(Some of the most common symptoms and signs of intestinal parasites include: Digestive problems, including unexplained constipation, diarrhea, or persistent gas. Skin issues, including unexplained rashes, eczema, hives, and itching. Muscle and joint pain, weight loss )

28
Q

what’re the treatment of the Gastointeritis ?

A

the symptoms go away in 2-3 days
1-Rehydration by oral or paraentral

2-Antibiotic

29
Q

when we use the antiobiotic in Gastointeritis ?

A

_ sever cases ( fever, blood in stool , dehydratedor

_specific isolated micro-organism.(means if we define the bacteria in the culture )

_ Immuno-compromised pt.

30
Q

how to prevent agnist the Gastointeritis ?

A

A- When preparing food at home :
Clean with Wash hands, cutting boards and surfaces before food preparation and after
Wash fresh produce thoroughly before eating.
Separate : Keep raw meat, poultry, fish, and their juices away from other food.
Cook: Thoroughly cook meat to the specific temperature:
Chill : Refrigerate leftovers within 2 hours in clean, covered

B- When traveling to underdeveloped cities :

    • Eat only foods that are freshly prepared.
    • Avoid food washed in nonpotable water, such as salads.
  • – Other risky foods include raw or undercooked meat and seafood, unpeeled raw fruits and vegetables
31
Q

what’s the shigellosis ?

A

it’s Bacillary dysentery caused by Shigellae are Gram-negative rods, that invade the colonic mucosa.

32
Q

what’re the groups of shigella?

A

_dysenteriae cause Sever and may be fulminating and cause death within 48 hours.

_Flexneri Moderate

_ boydii

_sonnei mild

33
Q

way of transmission of the shigellosis ?

A

1-Feco-oral way of transmission. No hand washing

2-Spread may occur via contaminated food , in over crowding and poor sanitation

34
Q

what’s the clinical feature of shigellosis ?

A

1-Nausea and Vomiting, high grade fever*, Lower -abdominal pain & tenderness

2- dehydration.

3-* Dysentery. Bloody Dh + Tensmus

35
Q

what’re the intestinal and extraintestinal complication ?

A
intestinal complication are 
------------------------------------------
mucosal ulceration, 
rectal bleeding, 
dehydration; 
fatality may be 10-15% . 

1-Hemolytic uremic syndrome
(acute kidney failure, hemolytic anemia and thrombocytopenia )

2- Reiter Syndrome
Reiter’s syndrome, also known as reactive arthritis, is the classic triad of conjunctivitis, urethritis, and arthritis occurring after an infection, particularly those in the urogenital or gastrointestinal tract

36
Q

which types cause the bloody diarrhea ?

A

Campylobacter,
Salmonella ,
Shigella,
E-coli food poisoning heamorragic only

37
Q

what’s the differential diagnosis of shigellosis ?

A

1-Acute food poisoning
(Campylobacter, Salmonella , Shigella, E-coli foodpoisoning)

2-Entamoeba histolytica

3- Inflammatory bowel disease

4–Ulcerative colitis , Crohn’s disease
Ischemic colitis

5-Diverticulitis

6-Colorectal cancer

7-CMV - with AIDS or immune compromise

38
Q

all virus don’t cause the bloody diarrhea?

A

no only HIV cause the bloody diarrhea

39
Q

How to diagnosis the shiglosis ?

A
  1. G.S.E & Cultures of stool samples
  2. Blood tests , WBC increased with neutrophile
  3. Electrolyte level as K, Na, cl
  4. PCR
40
Q

what’re the treatments of the shigllosis ?

A

1-Rehydration by oral or intravenous fluids.

2-antispasmodic to suppresses muscle spasms.

3-antipyretic

+++++Ovoid antidiarrheal ( toxic megacolon, septicemia)

4-Antibiotics such as:
norfloxacin, ciprofloxacin, or furazolidone

41
Q

can we go antidiarheal drugs ?

A

no beacuse it’s cause toxic megacolon, septicemia

42
Q
  • when give antibiotic for pt with shiglosis ?
A

_very young, very old,

-when the disease is severe,

_high risk of spreading the disease to others

43
Q

how to prevent the shigllosis ?

A

_washing hands

  • drinking only treated or boiled water,
  • eating WELL cocked food , Never eat unpeeled fruits.
  • swimming only in healthy pools
  • proper sewege disposale