Gastroenteritis

Question 1

What is gastroenteritis?

Answer 1

inflammation of the gastrointestinal tract

Question 2

What is infectious gastroenteritis?

Answer 2

gastroenteritis caused by pathogens; most commonly viruses

Question 3

Is infectious gastroenteritis common?

Answer 3

yes

Question 4

What are the viral causes of gastroenteritis?

Answer 4

1. Norovirus
2. Rotavirus
3. Adenovirus
4. Astrovirus
5. Calicivirus

Question 5

What are the bacterial causes of gastroenteritis?

Answer 5

1. Campylobacter jejuni
2. Escherichia coli (particularly 0157)
3. Salmonella
4. Shigella
5. Vibrio cholerae
6. Listeria
7. Yersinia enterocolitica

Question 6

What are the protozoa causes of gastroenteritis?

Answer 6

1. Entamoeba histolytica
2. Cryptosporidium parvum
3. Giardia lamblia

Question 7

How does viral gastroenteritis present?

Answer 7

1. usually nonbloody watery diarrhea and vomiting

2. abdominal pain, cramps, and fever are also commonly associated

Question 8

What age group is norovirus common in?

Answer 8

most common all ages

Question 9

What age group is rotavirus common in?

Answer 9

primarily young children <5 years

Question 10

What age group is entertic adenovirus common in?

Answer 10

• young children

- long period of diarrhoea (>12days)

Question 11

What age group is astrovirus common in?

Answer 11

young children <2years, considered to be milder

Question 12

What age is cytomegalovirus common in?

Answer 12

immunosuppressed – colitis with ulceration

Question 13

What are symptoms of gastroenteritis?

Answer 13

1. Sudden-onset diarrhoea (>3 movements/day)
2. Blood or mucus in the stool
3. Faecal urgency
4. Nausea/ Vomiting
5. Fever + malaise.
6. Abdominal pain or cramps

Question 14

What are associated symptoms of gastroenteritis?

Answer 14

1. Headache
2. Myalgia
3. Bloating
4. Flatulence
5. Weight loss
6. Malabsorption

Question 15

What is dysentery?

Answer 15

bloody diarrhoea

Question 16

How do you remember the organisms for dysentry?

Answer 16

CHESS

Question 17

What organisms cause dysentery?

Answer 17

1. Campylobacter / c.diff
2. Haemorrhagic E.coli
3. Shigella
4. Salmonella

Question 18

What organisms cause secretory diarrhoea?

Answer 18

1. Campylobacter / c.diff
2. Staph aureus
3. Virbrio cholera
4. E.coli
5. Salmonella
6. Bacillus cereus

Question 19

What is C,Diff associated with?

Answer 19

Use of antibiotics, PPI, antiperistaltic drugs

Question 20

What is staph aurus associated with?

Answer 20

contaminated food, 1-6 hours after eating, short lived

Question 21

What is vibrio cholera associayed with?

Answer 21

rice water diarrhoea, contaminated water/undercooked seafood, shock

Question 22

What is E.coli associated with?

Answer 22

recent travel, contaminated foods

Question 23

What is bacillus cereus associated with?

Answer 23

1. reheated rice

2. can cause cerebral abscess

Question 24

What is salmonella associated with?

Answer 24

1. eggs, poultry
2. may present with constipation
3. multiplies in Payer’s patches of the intestine

Question 25

What is campylobacter associated with?

Answer 25

1. recent travel 2. uncooked poultry 3. associated with Guillain-barre syndrome

Question 26

What is haemorrhagic E.coli associated with?

Answer 26

1. contaminated foods | 2. bloody diarrhoea followed by haemolytic uraemic syndrome (EHEC 0157:H7)

Question 27

What is entamobea histolytica associated with?

Answer 27

contaminated water, tropical places, MSM

Question 28

What is shigella associated with?

Answer 28

person-to-person contact, poor sanitation, MSM

Question 29

What are the 5 bacterial infections most commonly associated with reactive arthritis?

Answer 29

1. Chlamydia (most common) 2. Salmonella 3. Shigella 4. Yersinia 5. Campylobacter (+group A strep) - these bacteria usually cause gastrointestinal or genitourinary infections.

Question 30

What are the findings on Examination of gastroenteritis?

Answer 30

1. Mucous membranes, skin turgor, cap refill, low urine output can lead dehydration? 2. HR, BP lo2 shock? 3. Temperature

Question 31

What bloods are done?

Answer 31

FBC, ESR/CRP, U&Es - deranged (low K in severe D&V)

Question 32

What is done in Stool MCandS?

Answer 32

1. Bacterial pathogens 2. Ova cysts (eggs) 3. Parasites

Question 33

What is the Mx if no systemic signs?

Answer 33

1. Supportive therapy 2. Bed rest, fluids and electrolyte replacement with oral rehydration solution 3. No stool culture needed

Question 34

What are signs of systemic illness?

Answer 34

1. >39C or dehydration | 2. Visible blood or >2wks

Question 35

How do you manage gastroenteritis with systemic illness?

Answer 35

1. Admit and give oral fluids (IV rehydration for severe vomiting) 2. Antibiotics if infective organism identified 3. Direct faecal smear, then culture

Question 36

Are antibiotics given?

Answer 36

not routienly

Question 37

What are indication for emperical antibitoics?

Answer 37

``` 1. Suspected shigella infection 2. Suspected enteric fever 3. High-grade fever or sepsis 4. High-risk groups ```

Question 38

When is antibiotic therapy contraindicated?

Answer 38

enterohemorrhagic E. coli - may increase the risk of or worsen HUS.

Question 39

What antibtioics would you give in severe campylobacter?

Answer 39

Clarithromycin

Question 40

What antibiotics are given in severe amoebic dysentry?

Answer 40

metronidazole + diloxanide

Question 41

What antibiotics are given in serve giardiasis?

Answer 41

Tinidazole