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Gastroenteritis Flashcards

(51 cards)

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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?

Study These Flashcards
A

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

22
Q

What does shiga toxin do?

Study These Flashcards
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?

Study These Flashcards
A

Type 1 and type 2

Type 2 more potent

24
Q

What is the mechanism of action of e.coli?

Study These Flashcards
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
How do shiga toxins enter the bloodsteam?
Via damaged intestinal epithelium and cause the death of vascular endothlial cells by the same mechanism
26
What accompaies endothelial cell lysis?
Platelet adhesion and aggregation, cytokine secretion, vascular constriction contributing to fibrin deposition and clot formation within the capillary lumen
27
How does e.coli cause HUS?
Microangiopathy propagates distally as the toxins are carried to the kidneys, causin the critical syndrome of haematuria dn renal failure
28
What is the presentation of HUS?
``` Abdo pain Fever Pallor Petevhiae Oliguria Blood diarrhoea High WCC Low PLT Low Hb Red cell fragments High LDH ```
29
What should be avoided in HUS?
Abtibiotics as it may precipitates HUS No anti-motility agents No NSAIDS
30
What is associated with enteropathogenic e.coli?
Attaching and effacing lesions, no toxin, not invasive Non breastfed childre Can be asymptomatic
31
What is assoacited with enterotoxigenic e.coii?
Produces heat labile and heat stable toxin Heat stable toxin similar to cholera Travel related
32
What is associated with enteroinvasive e.coli?
Watery diarrhoea, rare dysentry Demonstrates invasion Sereny test
33
What is associated with enteroaggregative e.coli?
Travellers diarrhoea | Cytogenic, secretogenic and proinflammatory
34
What is the incubation period for campylobacter?
16-48 hours
35
Where is campylobacter found?
Food hygiene issues (poultry), raw milk
36
What is the incubation period for salmonella enteriditis?
12-48 hours
37
Where is salmonella found?
Poultry, meat, raw egg | Animal gut, multiplies in food
38
Where are o antigens found?
Part of LPS
39
Where are H antigens found?
In the flagellum
40
What is the incubation period of listeria?
9-48 hours | Causes fever, muscle aches and diarrhoea
41
Who does it affect?
Particular pregnant women as it can be passed to the foetus
42
Where can listeria be found?
Unpasturised milk products and in the fridge
43
What type of bacteria is listeria?
Gram positive rod
44
How is rotavirus passed?
Person to person Faecal-oral Usually in the winter
45
Who does rotavirus tend to affect?
Kids under 3
46
What are the complications of rotavirus?
Can cause post infection malabsorption which leads to more diarrhoea Repeat infections Can cause outbreaks Always hydrate
47
What type of vaccine is the rotavirus vaccine?
Oral Live attenuated Excreted in faeces
48
What is the nickname for norovirus?
Winter vomiting disease | Affects all ages
49
How is norovirus spread?
``` Highly infectious Faecal/oral Droplet Environmetn survivial on fomites for days or weeks Low infectious dose ```
50
What are the symptoms of norovirus?
Diarrhoea and vomiting - sudden and explosive
51
What is the incubation period for norovirus?
Less than 24 hours | Usually self limiting

GI (42 decks)

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