Gastroenteritis

Question 1

what is salmonella enterica?

Answer 1

• gram -ve bacillus

Question 2

what is the incubation for salmonella enterica?

Answer 2

12-48 hours

Question 3

symptoms of salmonella enterica infection?

Answer 3

• inflam of ileum, colon, diarrhoea +/- blood
• abdo pain
• vomit
• dehydration

Question 4

treatment of salmonella enterica?

Answer 4

self limiting

BUT if systemic illness, ciprofloxacin

Question 5

investigation for salmonella enterica?

Answer 5

stool culture

Question 6

what is campylobacter and how is it spread?

Answer 6

curved grame -ve

Question 7

symptoms for campylobacter?

Answer 7

• inflam of the colon/rectum
• bloody stool
• abdo pain

Question 8

what triggers guilian barre?

Answer 8

C.jejuni

Question 9

treatment for campylobacter?

Answer 9

self limiting

BUT if systemic, use a macrolide

Question 10

investigation for campylobacter?

Answer 10

stool culture

Question 11

what is c.diff?

Answer 11

gram +ve bacilli, can produce spores

Question 12

how are c.diff infections caused?

Answer 12

often in hospitals, due to antibiotics killing off bacterial flora

Question 13

complications of c.diff?

Answer 13

• pseudomembranous colitis

- bowel perforation

Question 14

diagnosis of c.diff?

Answer 14

• screening for GDH

- if this is positive, test for toxins A and B

Question 15

treatment of c.diff?

Answer 15

less severe = mentronidazole

severe = vancomycin

Question 16

norovirus spread?

Answer 16

• faecal oral
• waterbourne
• shellfish

Question 17

norovirus incubation?

Answer 17

24-48 hours

Question 18

norovirus symptoms?

Answer 18

• nausea
• vomiting
• diarrhoea
• cramp
• myalgia

Question 19

norovirus investigations?

Answer 19

PCR (vomit swab/faeces)

Question 20

roatvirus spread?

Answer 20

person to person, usually in winter

Question 21

roatvirus symptoms?

Answer 21

• diarrhoea, NO BLOOD

- dehydration

Question 22

roatvirus treatment?

Answer 22

rehydration, vaccine is available

Question 23

roatvirus diagnosis?

Answer 23

PCR of faeces

Question 24

what is cholera?

Answer 24

gram -ve bacilli

Question 25

spread of cholera?

Answer 25

- person to person | - from contaminated water

Question 26

incubation of cholera?

Answer 26

1-9 days

Question 27

symptoms of cholera?

Answer 27

- fluid out pour from small intestine, due to exotoxin | - rice water stools

Question 28

treatment of cholera?

Answer 28

fluid and electrolyte replacement

Question 29

investigations for cholera?

Answer 29

culture

Question 30

how is salmonella typhoid/paratyphoid spread?

Answer 30

- person to person | - contaminated food and water

Question 31

salmonella typhoid/paratyphoid incubation?

Answer 31

- 14-21 days

Question 32

salmonella typhoid/paratyphoid symptoms?

Answer 32

- headache - fever - rash on abdo (rose spots) - diarrhoea

Question 33

salmonella typhoid/paratyphoid treatment?

Answer 33

- ciprofloxacin

Question 34

salmonella typhoid/paratyphoid investigations?

Answer 34

blood culture and stool culture

Question 35

what is clostridium perfringens?

Answer 35

gram +ve bacillus

Question 36

how is clostridium perfringens spread?

Answer 36

- part of normal gut flora | - spores survive cooking and produce enterotoxin

Question 37

clostridium perfringens associated with?

Answer 37

inadequately refrigerated and reheated gravy

Question 38

what is bacillus cereus?

Answer 38

gram +ve bacilli

Question 39

how is bacillus cereus spread?

Answer 39

exotoxin ingested as pre formed toxin in food OR spores survive cooking

Question 40

what is bacillus cereus associated with?

Answer 40

refrigerated and reheated rice

Question 41

what is staph aureus?

Answer 41

gram +ve cocci

Question 42

how does staph aureus cause symptoms?

Answer 42

- produces enterotoxin, which acts on vagus nerve and vomiting centre (vomit 1-2 hours after ingestion)

Question 43

how is staph aureus spread?

Answer 43

ingesting something infected

Question 44

staph aureus symptoms?

Answer 44

- vomit - headache - diarrhoea

Question 45

staph aureus investigations?

Answer 45

stool culture

Question 46

what is shigella?

Answer 46

gram -ve bacilli

Question 47

how is shigella spread?

Answer 47

person to person via fomites

Question 48

what are shigella symptoms?

Answer 48

- inflam, pus and blood in stools | - abdo pain

Question 49

treatment of shigella?

Answer 49

symptomatic

Question 50

investigations of shigella?

Answer 50

stool culture

Question 51

how does E.coli cause infection and what does it cause?

Answer 51

produces a verotoxin, which damages RBC and causes HUS

Question 52

what is HUS?

Answer 52

- increases blood urea, red cell haemolysis and thrombocytopenia

Question 53

what is the presentation of HUS?

Answer 53

- abdo pain, fever, pallor, bloody diarrhoea | - 7-10 days after diarrhoea onset

Question 54

how is e.coli spread?

Answer 54

- carried in the gut flora of cattle - usually in uncooked meat/hamburgers - low infecting dose

Question 55

symptoms of e.coli?

Answer 55

- abdo pain | - bloody diarrhoea

Question 56

treatment and investigations for E.coli?

Answer 56

- symptomatic | - check bloods for HUS, especially in

Question 57

what is cryptosporidium?

Answer 57

protozoa

Question 58

how is cryptosporidium spread?

Answer 58

- domestic animals (calves) - person to person - associated with poor water supply/swimming pools

Question 59

what is the mechanism of cryptosporidium?

Answer 59

- cysts are ingested and hatch into trophocytes | - these invade cells of the SI

Question 60

investigations for cryptosporidium?

Answer 60

stool microscopy

Question 61

what is giardia lamblia?

Answer 61

protozoa

Question 62

how is giardia lamblia spread?

Answer 62

- person to person | - associated with contaminated water supplies

Question 63

mechanism of giardia lamblia?

Answer 63

- cysts ingested, hatch into trophocytes | - invase cells of upper SI

Question 64

symptoms of giardia lamblia?

Answer 64

- diarrhoea | - malabsorption syndrome

Question 65

treatment of giardia lamblia?

Answer 65

oral metronidazole

Question 66

investigations for giardia lamblia?

Answer 66

stool microscopy

Question 67

what are enterobius vermicularis?

Answer 67

threadworms

Question 68

spread of enterobius vermicularis?

Answer 68

person to person

Question 69

mechanism of enterobius vermicularis?

Answer 69

- ova hatch in intestine and live in caecum and colon - adult females go on to perianal skin at night and lay eggs, causing perianal itch - scratch and put fingers in mouth

Question 70

symptoms of enterobius vermicularis?

Answer 70

- perianal itch | - worms in stool

Question 71

treatment of enterobius vermicularis?

Answer 71

oral mebendazole

Question 72

what are amoebiasis?

Answer 72

protozoa

Question 73

spread of amoebiasis?

Answer 73

faeco oral

Question 74

symptoms of amoebiasis?

Answer 74

- acute bloody diarrhoea | - can cause abscesses

Question 75

treatment of amoebiasis?

Answer 75

- metronidazole | - remove from the lumen with paromomycin or diloxanide furoate

Question 76

investigations for amoebiasis?

Answer 76

- examine hot stool for ova/cysts | - serology for extra intestinal disease