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Clinical Pathology > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

what is the perfect environment for organisms to grow in- dry or moist sites

A

moist

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2
Q

what are the main beneficial effects of commensal flora of the gut.

A

metabolism, colonisation resistance, antibody induction

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3
Q

examples of 2 obligate anaerobes

A

clostridia, bifidobacteria

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4
Q

what pathogens are vitamins B12 and k secreted by

A

commensal eneteric bacteria

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5
Q

examples of 2 facultative anaerobes

A

enterobacteriacea and enterococci.

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6
Q

what are the most common bacterial causes of diahorrhea

A

salmonela, shinglla, E coli, Campylobacter, vibrio cholera, clostridium difficile, staph auerus, bacillus cerues

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7
Q

what are the most common parasitic causes of diarrhoea

A

Parasitic- Entamoeba hist, Giardia lamblia, cyrptospodium

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8
Q

what are the most common viral causes of diarrhoea

A

Viral- norovirus- rotavirus

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9
Q

what are the presenting complaint symptoms of gastroenetriritis

A
  • Acute onset
  • Vomiting AND/OR diarrhoea (frequency, mucous, blood).
  • Abdominal pain
  • Systemic-fever
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10
Q

complications of gastroenteritis

A

dehydration, renal failure, Haemolytic urea syndrome, toxic mega colon, salmonella, GBS (Guillain-Barre Syndrome)

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11
Q

common investigations in gastroenteritis

A

• Bloods – FBC, U&E, CRP, blood cultures- what is causing the infection
• AXR (abdominal X-ray) – if severe
• Stool
– Ova, parasites and cysts ‘OCP’
– Microscopy, culture and sensitivity ‘MC&S’
– Clostridium difficile toxin ‘CDT’
– Viral PCR- difficult to interpret due to 100’s of normal gut flora(coliforms)

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12
Q

what is the most common cause of viral gastroenteritis

A

norovirus

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13
Q

what are the symptoms of viral gastroenteritis

A

diahorrhea and projectile vomitting.

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14
Q

treatment of viral gastroenteritis

A

drinks water to avoid dehydration, stay away from work and good hygiene.

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15
Q

how to prevent viral gastroenetitis

A

rotovirus vaccine

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16
Q

how is cryptospordium transferred to humans

A

water bourne/ food bourne

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17
Q

symptoms of cryptospordium parasitic gastroenteritis

A

watery diahorrhea.

18
Q

what chemical are the oocytes of cryptosporidium resistant to

A

chlorine

19
Q

2 ways in which bacteria can cause gastroenteritis

A 
produce toxin (eneterotoxin
bacteria itself (adherence)
20
Q

enterotoxin (bacteria producing toxin) organism which causes gastroenteritis

A 
–	Vibrio cholerae
–	Escherichia coil (entertoxigenic – ETEC, verotoxigenic - VTEC)
–	Clostridium perfringens
–	Staphylococcus aureus
–	Bacillus cereus
–	Clostridium difficile
21
Q

bacterial which causes gastroenerteritis itself. (adherence)

A

– Shigella sonnei / flexneri
– Escherichia coil (entertoadherent – EAEC)
– Campylobacter jejuni
– Salmonellae

22
Q

what is the name of the toxin produced by E.coli

A

shiga toxin

23
Q

what is the source of E coli

A

cattle

24
Q

symptoms associated with E coli infection

A

HUS (haemolytic uraemic syndrome)

25
Q

pathogenesis of E coli

A

toxin activates G protein leading to increased cAMP, activates ion channels, chloride ions leave and water follows.
killing bacteria can result in release of more toxin and making the disease worse

26
Q

where is salmonella transmitted from

A

abroad from food or drink.

27
Q

4 types of salmonella causing organisms

A

S. typhi, S. paratyphi, S. enteritidis, S. typhimurium

28
Q

what is the difference between typhoid and paratyphoid salmonella

A

typhoid- affects cells outside the GI tract

Parathyphoid- stays within the Gl tract

29
Q

supporative management of gastroenteritis

A

avoid antibiotics- salmonella and E. coli

antibiotics- prolonged camplyobacter and very young/old.

30
Q

how much time after antibiotic treatment does antibiotic associated diahorrhea occur

A

months after treatment

31
Q

what causes antibiotic associated diahorrehea.

A

disruption to gut flora

  1. Change in metabolism (carbohydrates / bile acids), leads to osmotic change and diarrhoea.
  2. Overgrowth of pathogenic organisms
32
Q

most common cause of antibiotic associated diahorrehea.

A

C.diff

33
Q

severe symptoms of antibiotic associated diahorrehea.

A

pseudomembranous colitis

- Toxic mega colon, perforation, shock

34
Q

high risk antibiotics for antibiotic associated diahorrehea form C. diff

A

cephlosporin and clindamycin

35
Q

medium risk antibiotics for antibiotic associated diahorrehea C. diff.

A

ampicillin, amoxicillin, co-triazole, macrolides, fluroquinolones

36
Q

low risk antibiotics for ntibiotic associated diahorrehea C. diff.

A

aminoglycosides, metronidazole, anti pseudomonal penicillin, B lactamase inhibitor, tetracycline, rifampicin, vancomycin.

37
Q

control mechanism for C diff

A

early warning system
reduce risk of transmission
early isolation/cohorting of patients with diarrhoea
• Environmental cleaning, chlorine
• Hand hygiene soap & water
• Examine/optimise/reduce overall antibiotic use
• Limit high risk agents in high risk patients
• Feedback CDI & antibiotic data on a regular basis

38
Q

tretament for C diff antibiotic associated diarrhoea

A

oral metronidazole / oral vancomycin

new drug- oral fidaxomicin

39
Q

potential risk of antibiotic treatment for C diff antibiotic associated diarrhoea

A

increased risk of vancomycin resistant enterococci selection

• Potential for emergence of resistance to vancomycin / metronidazole in C. difficile.

40
Q

do patients relapse with antibiotic treatment for C diff antibiotic associated diarrhoea

A

yes

41
Q

so patients relapse with Faecal transplant for antibiotic treatment for C diff antibiotic associated diarrhoea

A

no

42
Q

define faecal transplant

A

• Family faeces used orally or rectally- increases gut flora diversity similar to donor.

Clinical Pathology (45 decks)

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