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GI > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

What are the common bugs to cause gastroenteritis?

A 
Campylobacter
Salmonella
E. Coli 0157
C. diff
Listeria
Shigella
Norovius
Rotavirus
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2
Q

What are GI infection risk factors?

A 
Malnutrition deficiency
Closed/ semi-closed communities
Exposure to contaminated food/water/travel 
Winter congregating /summer floods 
Age less than 5, not breastfeeding
Older age 
Acid suppresion
Immunosuppresion
Microbiome
Genetics
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3
Q

What is inoculum size?

A

The amount of bug that is needed to establish an infection

pH affects required dose

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4
Q

What is diarrhoea?

A

More than 3 unformed stools a day with no other cause

Stool holds shape in contained, departure from normal bowel habit

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5
Q

What is dysentry?

A

Inflammation of the intestine, particularly the colon causing diarrhoea associated with blood and mucus
Generally associated with fever, abdo pain and rectal tenesmus

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6
Q

What bacteria can mimic appendicitis?

A

Yersinia enterocolitca as it envades meseneric nodes

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7
Q

What is gastroenteritis?

A

An illness caused by eating food contaminated with micro-organisms, toxins, poisons
Usually have GI symptoms
Tends to be in small bowel
Cholera causes large volume diarrhoea (rice water)

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8
Q

What history should be taken for gastroenteritis?

A

Diarrhoea frequency, blood, mucous, time course
Other symptoms
Epidemiology (travel, contacts, human and animal)
Food history (time, type, storage, reheating, washing)
Contacts
Age of patients
Comorbidities
Medication history

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9
Q

What is likely to cause travelers diarrhoea?

A

E. Coli

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10
Q

What is exposure to raw seafood likley to cause?

A

Noncholera vibrio

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11
Q

What is exposure to daycare likley to give you?

A

Rotavirus

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12
Q

What is anal-reecptive sex likely to give you?

A

Shigella, campylobacter, salmonella

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13
Q

What is the incubation period of bacillus cerus?

A

1-6 hours

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14
Q

What can you get bacillus cerus from?

A

Heat resistent spores, starchy foods (reheated rice)

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15
Q

What type of bacteria is bacillus cereus?

A

Gram positive bacillus

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16
Q

What is the incubation period of staph aureus?

A

1-6 hours

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17
Q

What can you get a staph aureus infection from?

A

Foods left at room temp

Milk /meat/ fish

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18
Q

What are the clinical features and incubation period, duration and source of campylobacter?

A

Acute watery diarrhoea, fever, dyseneric
I = 2-5 days
D = 5-14 days
Food, water, chickens

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19
Q

What are the clinical features and incubation period, duration and source of shigella?

A

Acute watery diarrhoea, fever, dysenteric, toxigenic
I = 1-2 days
D = 2-7 days
Water, person to person

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20
Q

What are the clinical features and incubation period, duration and source of E.Coli 0157?

A

Watery, blood diarrhoea, foodbourne, toxigenic, associated with HUS
I = 2-5 days
D = 5-10 days
Uncooked beef, water, person to person

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21
Q

How long does a lab diagnosis take?

A

48 hours
1- selection from normal bowel flora
2 - enrichement for small numbers
3 - genetic methods

22
Q

What does shiga toxin do?

A

It binds to receptors found on renal cells, RBC and others
Inhibits protein synthesis
Causes cell death

23
Q

What are the different types of shiga toxin?

A

Type 1 and type 2

Type 2 more potent

24
Q

What is the mechanism of action of e.coli?

A

Competes with bacterial bowel flora and adheres to the intestinal epithelial cells to elaborate shiga toxin
Toxin adheres to absorptive enterocytes on the luminal surface of the small and large intestines to enter the cell and irreversibly inhibit protein synthesis resultin the death of the cell

25
Q

How do shiga toxins enter the bloodsteam?

A

Via damaged intestinal epithelium and cause the death of vascular endothlial cells by the same mechanism

26
Q

What accompaies endothelial cell lysis?

A

Platelet adhesion and aggregation, cytokine secretion, vascular constriction contributing to fibrin deposition and clot formation within the capillary lumen

27
Q

How does e.coli cause HUS?

A

Microangiopathy propagates distally as the toxins are carried to the kidneys, causin the critical syndrome of haematuria dn renal failure

28
Q

What is the presentation of HUS?

A 
Abdo pain
Fever
Pallor
Petevhiae
Oliguria 
Blood diarrhoea
High WCC
Low PLT
Low Hb
Red cell fragments 
High LDH
29
Q

What should be avoided in HUS?

A

Abtibiotics as it may precipitates HUS
No anti-motility agents
No NSAIDS

30
Q

What is associated with enteropathogenic e.coli?

A

Attaching and effacing lesions, no toxin, not invasive
Non breastfed childre
Can be asymptomatic

31
Q

What is assoacited with enterotoxigenic e.coii?

A

Produces heat labile and heat stable toxin
Heat stable toxin similar to cholera
Travel related

32
Q

What is associated with enteroinvasive e.coli?

A

Watery diarrhoea, rare dysentry
Demonstrates invasion
Sereny test

33
Q

What is associated with enteroaggregative e.coli?

A

Travellers diarrhoea

Cytogenic, secretogenic and proinflammatory

34
Q

What is the incubation period for campylobacter?

A

16-48 hours

35
Q

Where is campylobacter found?

A

Food hygiene issues (poultry), raw milk

36
Q

What is the incubation period for salmonella enteriditis?

A

12-48 hours

37
Q

Where is salmonella found?

A

Poultry, meat, raw egg

Animal gut, multiplies in food

38
Q

Where are o antigens found?

A

Part of LPS

39
Q

Where are H antigens found?

A

In the flagellum

40
Q

What is the incubation period of listeria?

A

9-48 hours

Causes fever, muscle aches and diarrhoea

41
Q

Who does it affect?

A

Particular pregnant women as it can be passed to the foetus

42
Q

Where can listeria be found?

A

Unpasturised milk products and in the fridge

43
Q

What type of bacteria is listeria?

A

Gram positive rod

44
Q

How is rotavirus passed?

A

Person to person
Faecal-oral
Usually in the winter

45
Q

Who does rotavirus tend to affect?

A

Kids under 3

46
Q

What are the complications of rotavirus?

A

Can cause post infection malabsorption which leads to more diarrhoea
Repeat infections
Can cause outbreaks
Always hydrate

47
Q

What type of vaccine is the rotavirus vaccine?

A

Oral
Live attenuated
Excreted in faeces

48
Q

What is the nickname for norovirus?

A

Winter vomiting disease

Affects all ages

49
Q

How is norovirus spread?

A 
Highly infectious 
Faecal/oral 
Droplet 
Environmetn survivial on fomites for days or weeks
Low infectious dose
50
Q

What are the symptoms of norovirus?

A

Diarrhoea and vomiting - sudden and explosive

51
Q

What is the incubation period for norovirus?

A

Less than 24 hours

Usually self limiting

GI (42 decks)

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