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Year 4 - Paediatrics > Gastro - Gastroenteritis > Flashcards

Gastro - Gastroenteritis Flashcards

1
Q

What is the most common cause of gastroenteritis?

A

Viral cause

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2
Q

What initial management is there for gastroenteritis?

A

Treat dehydration- IV fluids
Consider anti-emetics e.g. ondansetron, can be given IV if bringing everything up

Very easily spread, so must be isolated

Antibiotics are not recommended

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3
Q

What are the differentials for diarrhoea in children?

A

Infection - gastroenteritis
IBD
IBS
Lactose intolerance
Coeliac disease
Cystic fibrosis
Toddler’s diarrhoea
Some antibiotics

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4
Q

What does steatorrhea indicate?

A

Greasy stool with excessive fat content

Problem with fat digestions e.g. due to pancreatic insufficiency

Cystic fibrosis

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5
Q

What are some common causes of viral gastroenteritis?

A

Rotavirus
Norovirus

Adenovirus- less common and more subacute

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6
Q

Why should antibiotics be avoided in gastroenteritis?

A

Escherichia coli 0157 produces Shiga toxin

Shiga toxin destroys RBCs and leads to haemolytic uraemic syndrome

Antibiotic risk increases risk of HUS

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7
Q

How is E.coli spread?

A

Feaco-oral route
Unwashed salads
Contaminated water

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8
Q

What are the signs and symptoms of E.coli infection?

A

Abdominal cramps
Bloody diarrhoea
Vomiting

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9
Q

What is the most common bacterial cause of gastroenteritis?

A

Campylobacter jejuni

Common cause of travellers diarrhoea

Gram negative with a spiral shape

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10
Q

How is Campylobacter Jejuni spread?

A

Raw or improperly cooked poultry
Untreated water
Unpasteurised milk

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11
Q

How long is the incubation period in C.jejuni?

A

2-5 days

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12
Q

What are the symptoms of C. jejuni and how long do they take to resolve?

A

Abdominal cramps
Diarrhoea, often with blood
Vomiting
Fever

3-6 days to resolve

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13
Q

When are antibiotics considered for campylobacter jejuni?

A

After isolating organism
Severe symptoms
HIV
Heart failure

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14
Q

What antibiotics are used for campylobacter jejuni?

A

Azithromycin
Ciprofloxacin

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15
Q

How is shigella spread?

A

Feaco-oral route
Contaminated drinking water
Swimming pools
Food

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16
Q

What is the incubation period of shigella and how does long does it take to resolve?

A

1-2 days incubation

Resolve within 1 week

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17
Q

What are the symptoms of shigella?

A

Bloody diarrhoea
Abdominal cramps
Fever

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18
Q

How is shigella treated?

A

No treatment needed unless severe

Can produce Shiga toxin and cause HUS

Azithromycin or ciprofloxacin

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19
Q

How is salmonella spread?

A

Raw eggs
Raw poultry
Food contaminated with infected faeces of small animals

20
Q

What is the incubation period for salmonella and how long does it take to resolve?

A

12 hours to 3 days incubation period

Within 1 week

21
Q

What are the symptoms of salmonella?

A

Watery diarrhoea associated with mucus or blood
Abdominal pain
Vomiting

22
Q

How is salmonella treated?

A

Supportive

Antibiotics only in severe cases, guided by stool culture and sensitivities

23
Q

What is bacillus cereus?

A

Gramp positive bacillus

24
Q

What is a typical cause of bacillus cereus infection?

A

Food not refrigerated after cooking
Fried rice left out at room temperature

25
Q

What toxin is produced in bacillus cereus?

A

Cereulide - while growing on food

26
Q

What does cereulide toxin cause?

A

Abdominal cramping Vomiting
Within 5 hours of ingestion

When it arrives in the intestines, produces different toxins causing
Watery diarrhoea
More than 8 hours after ingestion

Typically resolves within 24 hours

27
Q

What is the typical patient with bacillus cereus?

A

Eating leftover fried race left at room temperature

Recovery within 24 hours

Vomiting within 5 hours
Diarrhoea after 8 hours

28
Q

What is yersinia enterocolitica?

A

Gram negative bacillus

29
Q

What is a common source of yersinia enterocolitica?

A

PIGS
Raw or undercooked pork
Contamination with urine or faeces of other mammals e.g. rats and rabbits

30
Q

What are the signs of yersinia enterococolitica infection?

A

Watery or bloody diarrhoea
Abdominal pain
Fever
Lymphadenopathy

31
Q

How long is the incubation period of yersinia and how long do symptoms last?

A

4-7 days incubation period

Symptoms last 3 weeks or more

32
Q

Why can yersinia infection be harder to diagnose in older children or adults?

A

Mesenteric lymphadenitis

Causing right sided abdominal pain

Appendicitis impression

33
Q

When are antibiotics given for yersinia?

A

Severe cases

Guided by **stool culture **and sensitivities

34
Q

What toxins does staph aureus produce?

A

Enterotoxins

When growing on food e.g. eggs, dairy and meat

35
Q

What causes symptoms with staph aureus infection?

A

Toxin ingestion, causes intestine inflammation

Diarrhoea
Perfuse vomiting
Abdominal cramps
Fever

Starts within hours of ingestion, settles within 12-24 hours

The enterotoxin causes the symptoms not the bacteria

36
Q

What is giardia lamblia?

A

Microscopic parasite

Lives in small intestines of mammals e.g. pets, farmyard animals or humans

37
Q

How does giardia lamblia spread?

A

Faeco-oral transmission
Parasite releases cysts in stools of infected mammals

Cysts contaminate food or water, infecting new host

38
Q

What does giardia lead to?

A

May not cause any symptoms

or

Chronic diarrhoea

39
Q

How is giardia managed?

A

Stool microscopy

Treat with metronidazole

40
Q

How do you prevent spread of gastroenteritis?

A

Good hygiene
Barrier nursing
Rigorous infection control to stop spread
Off school for 48 hours after symptoms resolve

41
Q

What is fluid challenge used for?

A

Ensure patient can tolerate the fluids

If they can tolerate fluids and hydrated can be managed at home

42
Q

What rehydration solutions can be used?

A

Dioralyte

43
Q

If fluid challenge fails what must be done?

A

IV fluids

44
Q

When are antidiarrhoeals particularly avoided?

A

Escherichia coli 0157
Shigella infections
Bloody diarrhoea or high fever

45
Q

What are some possible post gastroenteritis complications?

A

Lactose intolerance
IBS
Reactive arthritis
Guillain-Barré syndrome

Year 4 - Paediatrics (25 decks)

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