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GI > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

Can cause family/community outbreaks, cruise ships

A

Norovirus

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2
Q

Who does norovirus tend to affect?

A

Older children, adults

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3
Q

Faecal/oral, waterborne, shellfish

A

Norovirus

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4
Q

Abrupt nausea, vomitting, diarrhoea, cramps, myalgia

24-48 hour incubation

A

Norovirus

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5
Q

When will norovirus resolve?

A

24-48 hours

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6
Q

Onset 1-6 hours after exposure
Diarrhoea, abdominal pain, afebrile
No blood or pus in faeces

A

Toxin mediated food poisoning (e.g. staph aureus, clostridium perfringens, bacillus cereus)

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7
Q

Fever, D&V, abdominal pain

A

Acute enteritis

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8
Q

Fever, pain, bloody diarrhoea

A

Acute colitis

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9
Q

Enteric fever like illness

A

Fever, rigors and pain but LITTLE diarrhoea

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10
Q

Infections that cause bloody diarrhoea

A

Camplyobacter
Shigella
E.coli O157
Amoebiasis

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11
Q

Food/water, poultry

Most common cause of bacterial infection

A

Camplyobacter

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12
Q

2-5 day incubation

Illness lasts 5-14 days

A

Camplyobacter

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13
Q

Associated with Guillain-Barre

A

Campylobacter

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14
Q

How does camplyobacter present?

A

Colitic syndrome - fever, pain, bloody diarrhoea

May mimic appendicitis

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15
Q

GI bleed

A

E. coli

CMV

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16
Q

Malabsorptive diarrhoea with bloating

A

Microsporidium

Giardia lamblia

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17
Q

Indian subcontinent, SE Asia, Far East, Middle East, Africa etc

A

Typhoid

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18
Q

What is key to diagnosis of typhoid?

A

Blood cultures

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19
Q

Test for salmonella

A

Stool culture

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20
Q

Test for Campylobacter

A

Stool culture

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21
Q

Test for Shigella

A

Stool culture

22
Q

Test for C. difficile

A

Stool toxin (culture not routinely done!!)

23
Q

Test for E. coli O157?

A

Cytotoxin

24
Q

Test for salmonella

A

Blood culture

25
Q

Test for Norovirus

A

PCR

26
Q

How to assess severity of CDI?

A
  • Suspicion of Pseudomembranous colitis (PMC) or toxic megacolon or ileus or colonic dilatation in CT/AXR >6cm
  • WCC >15 cells/mm3
  • Creatinine >1.5 x baseline
27
Q

Complications of bacterial enteritis?

A

Severe dehydration and renal failure
Acute colitis, toxic dilatation
Post infective irritable bowel (very common)
Transient secondary lactose intolerance

28
Q

Antimotility agents

A

Opiates, loperamide

avoid if dysentery symptoms

29
Q

Anti-secretory agents

A

Chlropromazine

Bismuth subsalycilate

30
Q

Empirical therapy

A

Ciprofloxacin 500mg BD for 3-5 days

31
Q

Abx predisposing to C.diff infection

A

Cephalosproins
Clindamycin
Ciprofloxacin
Clarithromycin

32
Q

Treatment for pseudomembranous colitis

A

Metronidazole (non-severe)
Vancomycin (severe)
Give both orally!!

Give metronidazole –> should improve 3-5 days, if not then start metronidazole!

33
Q

Abx for shigellosis

A

Ciprofloxacin (quinolone)

34
Q

Abx for campylobacter

A

Macrolide (azithromycin etc)

35
Q

Community acquired/traveller’s diarrhoea

A 
Salmonella
Shigella
Campylobacter
E. coli
C. diff
36
Q

Nosocomial diarrhoea

A

C. diff

37
Q

Persistant diarrhoea > 7 days

A

Giardia

Cryptosporidium

38
Q

Treatment for traveller’s diarrhoea?

A

Ciprofloxacin and anti-diarrhoeals

39
Q

Diagnosis of amoebiasis?

A

Examination of hot stool for ova and cysts

40
Q

Treatment of amoebiasis?

A

Metronidazole

-remove from lumen by using diloxanide furoate or paromomycin

41
Q

Associated with liver abscess?

A

Amoebiasis

42
Q

Diarrhoea and malabsorption, often explosive

A

Giardiasis

43
Q

Infection spread by cysts found in normal drinking water

Diagnosis= examination of hot stools for ova and cysts (more accurately by duodenal aspiration)

A

Giardiasis

44
Q

Treatment for giardiasis

A

Metronidazole

45
Q

How does amoebiasis present?

A

Acute bloody diarrhoea

46
Q

What do you HAVE to do if extra-intestinal amoebiasis?

A

SEROLGY

47
Q

Diagnosis of intestinal amoebiasis

A

Stool M&C

48
Q

Probable cause of protracted diarrhoeal symtpoms

A

Giardiasis

49
Q

Probable cause of protracted diarrhoeal symtpoms

A

Giardiasis

50
Q

Cryptosporidosis treatment

A

Usually supportive

GI (11 decks)

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