Gastritis Flashcards
What is C.diff?
C. difficile can exist in normal gut flora and acts as an opportunistic pathogen that is able to reproduce and become the dominant species in the gut of someone who has had disruption of their gut flora
What can a C.diff infection result in?
pseudomembranous colitis which can lead to toxic megacolon and colonic perforation
How do you manage C.diff?
- ORAL vancomycin, metronidazole or fidaoxmicin
- Stop diuretics and ACEi (reduced rx of dehydration and AKI)
How do you test for C.diff?
- Stool sample - testing for C. diff toxin
* FBC and serum creatinine
What is the main management for diarrhoea?
- Oral rehydration (dioralyte) or ORS.
- Give IV fluids if vomiting.
What indicates that a patient needs a stool culture after >3 days hospitalisation?
- > 65yrs
- Comorbid disease
- Neutropenia
- HIV infection
What is he most common cause of diarrhoea?
Campylobacter
What are the signs of Campylobacter infection?
Abdominal pain, diarrhoea (may be bloody), malaise, vomiting
How do you treat campylobacter?
Supportive
- Clarithromycin if severe
Who are STEC and VTEC most common in?
Children <5yrs
What can STEC cause?
HUS and TTP
What does salmonella cause?
- Watery and sometimes bloody diarrhoea
- Abdominal pain
- Headache
- Nausea
- Vomiting
- Fever
What is enteric fever?
Salmonella typhi/parathyphi
What are the key points about enteric fever?
- Fever and abdominal pain
- Constipation more common that diarrhoea
What can shigella cause?
- Bloody diarrhoea
- Fever
What can cause chronic diarrhoea?
- Giardia lamblia
- Ameobiasis
- Schistosomiasis
What tests would you do for chronic diarrhoea?
> 4 weeks • FBC, U+Es, LFTs, TFTs • Blood cultures • Malaria films • HIV test • Stool culture and microscopy including acid fast staining • Flexible sigmoidoscopy with biopsies
What are the features of giardia?
- Present in upper small bowel
- Lethargy, bloating, abdominal pain
- Non-bloody diarrhoea
- Malabsorption
- Empiric trial of therapy may be indicated with metronidazole/tinidazole
What are the features of amoebiasis?
- Bloody diarrhoea, abscesses, amoebomas
- Stool microscopy: hot stool and antigen test
- Amoebic serology
- Treatment = metronidazole and luminal cysticide
- Abscesses may require drainage
What are the features of schistosomiasis?
Severe disease follows years of mildly symptomatic infections
What are the two types of dysentery?
- Shigella dysentery
- Amoebic dysentery
When to norovirus symptoms begin and how long do they last?
- Symptoms begin 24-48hrs after infection
- Can last for 12-60hrs
