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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
What toxin is produced in bacillus cereus?
Cereulide - while growing on food
26
What does cereulide toxin cause?
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
What is the typical patient with bacillus cereus?
Eating leftover fried race left at room temperature Recovery within 24 hours Vomiting within 5 hours Diarrhoea after 8 hours
28
What is yersinia enterocolitica?
Gram negative bacillus
29
What is a common source of yersinia enterocolitica?
**PIGS** Raw or undercooked pork Contamination with urine or faeces of other mammals e.g. rats and rabbits
30
What are the signs of yersinia enterococolitica infection?
Watery or bloody diarrhoea Abdominal pain Fever **Lymphadenopathy**
31
How long is the incubation period of yersinia and how long do symptoms last?
4-7 days incubation period Symptoms last 3 weeks or more
32
Why can yersinia infection be harder to diagnose in older children or adults?
Mesenteric lymphadenitis Causing right sided abdominal pain Appendicitis impression
33
When are antibiotics given for yersinia?
Severe cases Guided by **stool culture **and **sensitivities**
34
What toxins does staph aureus produce?
Enterotoxins When growing on food e.g. eggs, dairy and meat
35
What causes symptoms with staph aureus infection?
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
What is giardia lamblia?
Microscopic parasite Lives in small intestines of mammals e.g. pets, farmyard animals or humans
37
How does giardia lamblia spread?
**Faeco-oral transmission** Parasite releases cysts in stools of infected mammals Cysts contaminate food or water, infecting new host
38
What does giardia lead to?
May not cause any symptoms or Chronic diarrhoea
39
How is giardia managed?
Stool microscopy Treat with **metronidazole**
40
How do you prevent spread of gastroenteritis?
**Good hygiene** Barrier nursing Rigorous infection control to stop spread **Off school for 48 hours after symptoms resolve**
41
What is fluid challenge used for?
Ensure patient can tolerate the fluids If they can tolerate fluids and hydrated can be managed at home
42
What rehydration solutions can be used?
Dioralyte
43
If fluid challenge fails what must be done?
IV fluids
44
When are antidiarrhoeals particularly avoided?
Escherichia coli 0157 Shigella infections Bloody diarrhoea or high fever
45
What are some possible post gastroenteritis complications?
Lactose intolerance IBS Reactive arthritis Guillain-Barré syndrome

Year 4 - Paediatrics (150 decks)

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