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Paediatrics cabinetchip > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

differentiate enteritis and gastroenteritis

A

enteritis - inflammationm of intestines-> presents with diarrhoea

gastroenteritis - inflam from stomach to intestines
-presents with nausea vomitting and diarrhoea

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2
Q

main concern with gastroenteritis in children 1

A

dehydration

-establish whether they need IV fluids and admission Or can hydrate themselves

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3
Q

differential diagnosis for loose stools children 8

A

Infection gastroenteritis

IBD

Lactose intolerance

coeliac disease

Cystic fibrosis

Diarrhoea toddlers

Irritable bowel syndrome

Medications- ABX

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4
Q

most common type of gastroenteritis -1
-causes -2

A

viral

rotavirus
norovirus

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5
Q

Presentation of viral gastroenteritis caused by adenovirus 1

A

less common

more subacute diarrhoea

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6
Q

bacterial causes of gastroenteritis 6

A

E. coli

campylobacter jejuni

shigella

bacillus cereus

Yersinia enterocolitica

staph aurea toxin

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7
Q

parasitic cause of gastroenteritis 1

A

Giardiasis

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8
Q

How is E. coli spread 3

A

Infected faeces

unWashed salads

Contaminated water

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9
Q

what type of E. coli is a particular concern what does it produce and what is its affect

A

E Coli 0157

-produces Shiga toxin

-shiga toxin destroys blood cells and can lead to haemolytic uraemic syndrome

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10
Q

Important factor when treating E. coli 0157

A

using ABx Increases the risk of HUS and should be avoided

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11
Q

what is a common cause of travellers diarrhoea

A

Campylobacter jejuni

-most common cause of bacterial gastroenteritis worldwide

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12
Q

how is campylobacter spread

A

Raw are improperly cooked poultry

Untreated water

Unpasteurised milk

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13
Q

incubation of campylobacter jujuni and length of syx

A

incubation 2-5 days

syx resolve after 3-6 days

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14
Q

symptoms of campylobacter Jejuni 4

A

abdo cramps

diarrhoea -often w blood

vomiting

fever

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15
Q

when would antibiotics be considered for a campylobacter infection

A

once bacteria isolated adn if:
-patient has severe syx
-or underlying health conditions ie HIV or heart failure

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16
Q

antibiotics for campylobacter Jejuni infection 2

A

azitrhomycin or ciprofloxacin

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17
Q

How is shigella spread 3

A

spread by faeces in
- contaminated drinking water
-contaminated swimming pools
-contaminated food

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18
Q

incubation period and length of symptom symptoms in shigella infection

A

incubation period one to 2 days

Symptoms resolve within a week without treatment

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19
Q

symptoms of shigella infection 3

A

Bloody diarrhoea

Abdo cramps

Fever

20
Q

treatment of severe shigella infection 2

A

ABX
-azitrhomycin
-ciprofloxacin

21
Q

what can shigella produce and what can this lead to

A

Shiga toxin

this can cause haemolytic uraemic syndrome

22
Q

how is salmonella spread 2

A

Eating raw eggs or poultry

Food contaminated with infected faeces of small animals

23
Q

incubation period and length of symptoms and salmonella infection

A

incubatino period is 12 hours to 3

Symptoms resolve within one week

24
Q

symptoms of salmonella infection 3

A

Watery diarrhoea- a associated with mucus or blood

abdo pain

vomitting

25
Q

when can antibiotics be used and salmonella infection

A

Only in severe cases
-guided by stool cultures and sensitivites

26
Q

how is bacillus cereus spread

A

through inadequatley cooked foods
or
grows well on food not immediately refrigerated after cooking
-typical food is fried rice left at room temp

27
Q

what toxin does bacillus cereus produce

A

cereulide

28
Q

whaat symptoms do the toxin of bacillus cereus cause (2) and after what length of time

*when bacillus cereus arrives in the intestines, what symptoms can occur

A

abdo cramps

vomiting

-within 5 hours of ingestion

*produces different toxins-> caues watery diarrhoea
-occur around 8 hours after digestion

29
Q

typical course of bacillus cereus infection

A

vommintng after 5 hours

diarrhoea after 8 hours

resolution after 24hours

30
Q

how does yersinia enterocolitica spread 1

A

pigs key carriers
-earting raw or undercooked pork

spread trhough contaminaitno with the urine or faeces of other mamals like rats and rabbits

31
Q

presenation of yersinia enterocolitica in a child 4

A

watery or bloody diarrhoea

fever

abdo pain

LYMPHADENOPATHY

32
Q

presenation of yersinia enterocolitica in older children and adults

A

right sided abdo pain
-due to MESENTERIC LYMPHADENITIS

-gives impression of appendicitis

33
Q

course of yersinia enterocolitica infection

A

incubation 4-7days

-can last longer than other gastroenteirits
-3 weeks or more

34
Q

when are abx used for yersinia enterocolitica

A

only in severe cases
-guided by stool cultures and sensitivities

35
Q

what can staph aureus produce with regards to gastroenteritis

-what can be contaminated

A

prodcues enterotoxins

-grows on foods luke eggs diary and meat

36
Q

what happens when staph aures toxins (enterotoxins) are ingested

-whats the syxx 5

A

causes small intestine inflam

-diarrhoea
-perfuse vomitting
-abdo pain
-fever
-abdo cramps

37
Q

course of staph aures toxins (enterotoxins) infection

A

syx within hours of ingestion
-settle within 12-24 hours

38
Q

important point to note regarding staph arues related gastroenteritis

A

not the bacteria causing the enteritis but hte staphylococcus enterotoxin

39
Q

overview of giardisis contamination route

A

lives in the small intestines of mammals. These mammals may be pets, farmyard animals or humans. It releases cysts in the stools of infected mammals. The cysts contaminate food or water and are eaten, infecting a new host. This is called faecal-oral transmission.

40
Q

presenatino of giardisis

A

may be asymptomatic or cause chronic diarrhoea

41
Q

diagnosis of giardis and treatment

A

made by stool microscopy

-treatment with metrodiazole

42
Q

prinicples of gastroenteritis managemnt 3

A

when patient develops syx- isolated
-barrier nursing
-infection control

stay of school until 48hours AFTER syx fully resolve

faecal microscopy, culture and senstivities to establish causative organism and ABx senstivities\

-once oral intake tolerated-> light diet slowly reintroducted

43
Q

fluid management in gastroenteritis 3

A

ensure they remain hydraged whilst waiting for diarrhoea and comiting to settle

-attempt fluid challege
-give small amoount of fluid ervery 5-10 minutes
-ensure they can tolerate
-use diaorlayte if tolerated

-if child fails fluid challenge may require IV fluids

44
Q

when shoudl antidiarrheal medication and metoclopramide be particulary avoid in gastroenteritis 3

A

e coli 0157

shigella

bloody diarrhoea

high fever

*ANTIDIARRHEAL AND ANTIEMETICS ARE GENERALLY NOT RECOMMENED FOR GASTROENTERITIS MANAGEMENT

45
Q

post gastroenteritis complications 4

A

lactose intolerance

irritable bowel syndrome

reactive arthitis

guillain-barre syndrome

46
Q

clinical signs of dehydration in a child 8

A

dry mucous membranes

suken fontanelle

depressed level of consciousness

sunken eyes

tachypneao,tachycaridc, prolonged CRT

decreased skin turgor

wight loss

oliguria

47
Q

how to assess for decreased skin turgor

A

(pinch some skin over chest/ abdo, if it does not return
almost immediately then skin turgor abnormal)

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