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Gastroenterology (Own) > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

What is gastroenteritis?

A

This is inflammation of the stomach or intestines which inhibits nutrient absorption and excessive water and electrolyte loss

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2
Q

What can gastroenteritis be caused by?

A

Bacteria, virus, parasites or poisoning by microbial toxins

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3
Q

What is the most common cause of gastroenteritis?

A

Infection

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4
Q

How do patients present with food poisoning?

A

Fever
Abdominal pain
Diarrhoea
PR bleeding in some cases

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5
Q

what can cause toxin mediated food poisoning?

A

staph. aureus, bacillus cereus or enterotoxigenic E. Coli

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6
Q

Is there blood or pus in the faeces of a patient with toxin mediated food poisoning?

A

No - usually not

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7
Q

What can Arizonan turtles cause?

A

Salmonella

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8
Q

Give examples of resivoirs for salmonella

A

reptiles, eggs and undercooked poultry

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9
Q

What are the causes of non-infectious diarrhoea?

A 
Fish toxins
Endocrine disorders
Withdrawl
Diverticulitis
Ischemic gut
Numerous drugs
GI bleed
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10
Q

What symptoms are caused by the norovirus?

A

Abrupt nausea, vomiting, diarrhoea, cramps, myalgia

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11
Q

what is myalgia?

A

Pain in a muscle or a group of muscles

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12
Q

What are the presenting complains in a patient with acute enteritis?

A

fever, diarrhoea, vomiting and abdominal pain

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13
Q

What are the presenting complains in a patient with acute colitis?

A

fever, pain, bloody diarrhoea

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14
Q

What are the presenting complains in a patient with enteric fever?

A

fever, rigors and pain - perhaps a little diarrhoea

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15
Q

what does bloody diarrhoea suggest?

A

Infection - usually colonic inflammation

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16
Q

what kind of bacteria can cause bloody diarrhoea?

A

Campylobacter, shigella spp or E. coli

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17
Q

what can campylobacter mimic?

A

appendicitis

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18
Q

name an important complication to remember of campylobacter

A

Guillain-Barre syndrome

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19
Q

what can be used to treat campylobacter?

A

if severe treat with clarithromycin and azithromycin

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20
Q

what is Guillain-Barre syndrome?

A

Autoimmune response - leads to tingling of the feet and progressive paralysis of the legs, arms then rest of the body

21
Q

what are the symptoms of enteric fever like illness?

A

fever, systemic illness, abdominal pain and constipation - may have short history of diarrhoea

22
Q

Give an example of an enteric fever?

A

typhoid fever

23
Q

how does typhoid fever present?

A

Asymptomatic, mild, bacteraemia, enterocolitis

24
Q

How is typhoid fever diagnosed?

A

blood, stool and urine cultures

25
Q

What is used to treat typhoid fever?

A

Usually azithromycin - in Asia there is a resistance to chloramphenicol and ciprofloxacin

26
Q

what is important when taking a drug history?

A

To find out if they have been on recent antibiotics or PPIs

27
Q

what investigations can be ordered for gastroenteritis?

A 
Stool microscopy
Stool culture
Stool toxin - for C diff
Blood cultures - Salmonella
PCR
FBC
AXR
28
Q

what are the severity markers for CDI?

A

Suspicion of pseudomembranous colitis/toxic megacolon/colonic dilatation
increased WCC
Increased Creatinine
CDI symptoms despite 2 treatments

29
Q

What are the complications of bacterial enteritis intestinal?

A

Severe dehydration and renal failure
Acute colitis, toxic dilatation
Post infective irritable bowel
Transient secondary lactase intolerance

30
Q

What are the complications of bacterial enteritis extra-intestinal?

A 
Bacteriaemia leading to sepsis 
metastatic infection: meningitis, aortitis, Ostyeomyelitis, endocarditis
Reactive arthritis
Meningism
Neurological 
Haemolytic uraemic syndrome
31
Q

what are the objectives of antibiotic treatment?

A

treat invasive disease
reduce severity of symptoms
eradicate faecal excretion

32
Q

what is the treatment for gastroenteritis?

A

Oral rehydration - IV fluids
Anti-spasmodics
Anti-motility (short term)

33
Q

what are risk factors for gastroenteritis?

A

age
immunosuppression
PPI use
Hospitalisation

34
Q

Key factors to the treatment of C. Difficile?

A

treat according to severity
reduce acute complications
reduce likelihood of recurrence

35
Q

which patients are more at risk of C. Diff?

A 
Elderly
Antibiotic treatment
Prolonged hospitalisation
Defective immune response to toxin A
Gastric acid suppression
36
Q

what are the drivers for C. Difficile infections?

A 
Broad spectrum antibiotic therapy
certain antibiotic types
long duration of therapy
total amount of antibiotic use
vulnerable groups
37
Q

How should patients with vomiting and diarrhoea be managed?

A

oral rehydration

38
Q

what should be avoided in patients with vomiting and diarrhoea?

A

anti-motility agents

39
Q

what can cause travel related diarrhoea?

A

amoebiasis
giardiasis
cryptosporidiosis

40
Q

how should traveller’s diarrhoea be treated?

A

treat symptomatically
ciprofloxacin
short term anti-diarrhoeals

41
Q

what is amoebiasis?

A

Protozoal infection spread by faeco-oral route or by an ill or asymptomatic carrier

42
Q

how can amoebiasis be diagnosed?

A

examination of hot stool for ova and cycsts

Amoebic serology

43
Q

what may occur during amoebiasis?

A

an amoebic liver abscess may form

44
Q

how does giardiasis spread?

A

by cysts found in normal drinking water

45
Q

how is giardiasis diagnosed?

A

examination of stools for ova and cysts

duodenal aspiration

46
Q

How is giardiasis treated?

A

Metronidazole

47
Q

how is Cryptosporidiosis

transmitted?

A

water, food, contact with animals - highly infectious

48
Q

how is Cryptosporidiosis

diagnosed?

A

duodenal aspirate

49
Q

How is Cryptosporidiosis

treated?

A

supportive - nitizoxamide can be used

Gastroenterology (Own) (18 decks)

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