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Y4: Infectious Disease > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

What is gastroenteritis?

A
  • Diarrhoea (+ vomiting)
  • Due to enteric infection: viruses, bacteria or parasites
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2
Q

Define acute diarrhoea?

A

>=3 episodes of watery stool/day for <14 days

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3
Q

Define dysentery?

A

Infectious gastroenteritis with bloody diarrhoea

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4
Q

Define persistent diarrhoea?

A

Acutely starting diarrhoea lasting > 14 days

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5
Q

Define travellers diarrhoea?

A

Starting during, or shortly after, foreign travel

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6
Q

Define food poisoning?

A

Disease cuased by consumption of food/water

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7
Q

Common viral causes of gastroenteritis?

A
  • Norovirus
  • Rotavirus
  • Astrovirus
  • Adenovirus
  • Sapovirus
  • CMV
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8
Q

Common bacterial causes of gastroenteritis?

A
  • Shigella
  • Salmonella
  • E. coli
  • S. aureus
  • C. difficle
  • C. perfringens
  • Campylobacter
  • Listeria
  • Vibrio cholerae
  • Bacillus cereus
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9
Q

Parasites which commonly cause gastroenteritis?

A
  • Giardia
  • Cryptosporidium
  • Entamoeba histolytica
  • Trichinella
  • Trichuriasis
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10
Q

Describe Norovirus?

A
  • 1d incubation
  • Epidemic gastroenteritis
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11
Q

Describe Rotavirus?

A
  • 1-3d incubation
  • Most children affected by 5
  • Live vaccine available
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12
Q

Describe astrovirus?

A
  • 5d incubation
  • Less severe than norovirus
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13
Q

Describe Adenovirus?

A
  • 3-10d incubation
  • Enteric adenovirus
  • Mainly children
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14
Q

describe CMV?

A
  • Asymptomatic
  • If immunosupressed:
    • Colitis, hepatitis, pneumonia
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15
Q

Which pathogens cause diarrhoea with and without blood?

A
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16
Q

What is a majory cause of traveller’s diarrhoea?

A

Enterotoxigenic E. coli

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17
Q

How can traveller’s diarrhoea be prevented?

A
  • Boil water
  • Cook thoroughly
  • Peel fruit and vegetables
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18
Q

Presentation of traveller’s diarrhoea?

A
  • During first week of travel
  • Enterotoxigenic e. coli
    • Watery diarrhoea, cramps, nausea
  • Giardia lamblia
    • Bloating, belching
  • Campylobacter and shigella
    • Colitic symptoms, cramps
19
Q

Treatment for traveller’s diarrhoea?

A
  • Oral rehydration
  • Antimotility agents
    • Loperamide, bismuth salicylates
  • Antibiotics (usually not indicated)
20
Q

Describe a home-made oral rehydration recipe?

A
  • 6 teaspoons of sugar
  • Half teaspoon of salt
  • 1L of clean drinking water
21
Q

Contraindications for antimotility agents?

A
  • Severe pain
  • Bloody diarrhoea
    • ** May indicate invasive colitis
22
Q

Describe Norovirus?

A
  • Single-stranded RNA virus
  • Transmitted by contact with someone infected, environment or food
  • Presents 12-48hrs after exposure, lasts 24-72hrs
  • Vomiting, watery diarrhoea, cramps, nausea.
23
Q

Describe the diagnosis and treatment of norovirus?

A
  • Diagnosis
    • Clinical, stool sample reverse transcriptase PCR
  • Treatment
    • Supportive
    • Anti-motility agents
    • Usually self-limiting
24
Q

Describe Rotavirus?

A
  • Double stranded RNA, wheel-like appearance
  • Most common cause of gastroenteritis in children
  • Watery diarrhoea and vomiting, fever, abdo pain
25
Q

Describe the diagnosis and treatment of Rotavirus?

A
  • Diagnosis
    • Clinical
    • Antigen in stool
  • Treatment
    • Supportive
    • Live vaccine (antigen seen in stool after)
26
Q

Describe Enterotoxigenic E. coli?

A
  • Gram negative anaerobe
  • Heat-stable/heat-labile toxin stimulates water efflux into gut lumen
  • Watery diarrhoea, cramps
  • Important cause of travellers diarrhoea
27
Q

Describe the diagnosis and treatment of Enterotoxigenic e. coli?

A
  • Diagnosis
    • Clinical
    • Indentification of toxin in stool culture
  • Treatment
    • Supportive
    • Same treatment as traveller’s diarrhoea
28
Q

Describe Clostridium perfringens (type A)?

A
  • Gram positive anaerobe
  • Produces enterotoxin, spores survive cooking and germinate during unrefridgerated storage
  • Sudden-onset diarrhoea, cramps, last <24 hrs
29
Q

Describe Cholera?

A
  • Gram netative aerobic, coma shaped
  • Flagellated so mobile
  • Faecally contaminated water
  • Types 01 and 0139 cause disease
30
Q

Describe the diagnosis of Cholera?

A
  • Clinical
    • Watery, rice-water stool, vomiting, dehydration, metabolic acidosis
  • Identification of 01 or 0139 in stool
  • Rapid dipstick testing
  • Culture
31
Q

Describe the treatment of Cholera?

A
  • Oral rehydration salts
    • Requires clean water
  • IV fluids if dehydrated
    • Ringer’s lactate / 0.9% NaCl
  • Doxycycline if severe dehydration
  • Zinc shortens illness in children
32
Q

Describe the prevention of cholera?

A
  • Clean water
  • Oral cholera vaccine
33
Q

Name the types of shigella?

A
  • Boydii
  • Sonnei
  • Flexneri
  • Dysenteriae
34
Q

Describe shigella gastroenteritis?

A
  • Gram negative anaerobe
  • Watery/bloody diarrhoea, pain, tenesmus, fever
  • Complications: bacteraemia, reactive arthritis, HUS
35
Q

Describe the diagnosis and treatment of shigella gastroenteritis?

A
  • Diagnosis
    • Stool culture
    • PCR/enzyme immunoassay
  • Treatment
    • Supportive
    • Nutrition: green bananas, zinc, vitamin A
    • Anitbiotics if systemically unwell
    • Avoid antidiarrhoeals => toxic dilatation
36
Q

Describe gastroenteritis from enterohaemorrhagic / shiga-toxin producing E. coli (STEC)?

A
  • Gram negative anaerobe
  • Produces veratoxins
  • Diarrhoea, haemorrhagic colitis, HUS
37
Q

Describe the treatment of STEC?

A
  • Diagnosis
    • Stool culture
    • PCR/enzyme immunoassay for shiga-toxin
  • Treatment
    • Supportive
    • NO ANTIBIOTICS => increased risk of HUS
38
Q

Describe gastroenteritis caused by campylobacter?

A
  • Gram negative, spiral shaped rod
  • Bloddy diarrhoea, pain, fever, headache
  • Complications: bacteraemia, hepatitis, pancreatitis, miscarriage, Guillain-barre
39
Q

Describe the diagnosis and treatment of campylobacter gastroenteritis?

A
  • Diagnosis
    • Stool culture
    • PCR/enzyme immunoassay
  • Treatment
    • Supportive
    • Antibiotics only for invasive cases
40
Q

Describe Salmonella enterocolitis?

A
  • Gram negative anaerobe, motile bacilli
  • Diarrhoea, cramps, fever
  • Invasive infection => sepsis, meningitis, osteomyelitis
41
Q

Describe the diagnosis and treatment for salmonella enterocolitis?

A
  • Diagnosis
    • Stool culture
    • PCR
  • Treatment
    • Supportive
    • Antibiotics only for severe disease
42
Q

Describe Yersinia enterocolitica?

A
  • Gram negative rod
  • Diarrhoea, fever, pain (appendicitis mimic)
  • Erythema nodosum, reactive arthritis
43
Q

Describe the diagnosis and treatment of Yersinia enterocolitica?

A
  • Diagnosis
    • Stool culture
    • Agglutination titres
  • Treatment
    • Antibiotics in severe disease
44
Q
A

Y4: Infectious Disease (18 decks)

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