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Phase 4 > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

Name some bacterial that cause dysentery:

A

Shigella Dysenteriae

Campylobacter Jejuni

Hemorrhagic E.Coli

Yersina Enterocolitia

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2
Q

How is norovirus diagnosed?

A

PCR of stool

- reverse transcriptase

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3
Q

What is an important factor of norovirus with regard to further transmission/ being infective?

A

Even once the patient is asymptomatic, they still shed the virus in the stool.

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4
Q

What diet is often recommended for people with gastroenteritis?

A

BRAT

  • Banna
  • Rice
  • Applejuice
  • Toast
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5
Q

Name three main ways a person can get Salmonella poisoning? Name some complications of salmonella poisoning:

A

Undercooked Chicken or eggs (salmonella is heat sensitive)

Faecal oral transmission

Animals - reptiles

Complications:

  • bacteraemia
  • osteomyelitis
  • septic arthritis
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6
Q

List some risk factors for C.Diff infection:

A

Recent hospital admission
Recent use of antibiotics
>65 years
Immunosuppressed

Cephalosporins
Clindamycin
Ciprofloxacin
Co-amoxiclav

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7
Q

What investigations should be done in suspected C. Diff?

A

Stool culture

Immunoassay for Glutamate dehydrogenase which is a common antigen seen on all strains of C.Diff.

Toxin immunoassay

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8
Q

What is the management for C.Diff?

A

Isolation

Hygiene practice

Protective clothing

Moderate: Metronidazole PO

Severe: Vancomycin PO

Non responders: HIgh dose vancomycin + metronidazole IV.

Recurrence: Vancomycin + faecal transplant`

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9
Q

If someone has an infectious cause of diarrhea that is persistent and non bloody - what are possible organisms? and how would you test for them?

A

Giardia

Cryptosporidium

Ova samples over 3 separate days

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10
Q

If someone has an infectious cause of diarrhea that is persistent and bloody - what are possible organisms? and how would you test for them?

A

Entamoeba Histolytica

  • severe abdominal pain
  • fever

Ova Samples over 3 separate days

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11
Q

What bacterial infection can mimic the symptoms of appendicitis, inducing mesenteric lymphadenopathy?

A

Yersinia Enterocolitica

Symptoms can last up to 3 weeks

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12
Q

How is campylobacter and Shigella infections treated if severe?

A

ciprofloxacin

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13
Q

How does bacillus cereus present symptomatically?

A

produces a toxin called cereulide;
within 5 hours of ingestion it produces:
- cramping abdominal pain + profuse vomiting

~8 hours later as it reaches intestines it produces severe diarrhoea.

symptoms usually resolve after 24 hours.

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14
Q

How is Giardiasis treated?

A

Metronidazole

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15
Q

When should anti - diarrhoea medication be avoided?

A

In bloody diarrhoea and fever

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16
Q

What are some differentials for chronic diarrhea?

A

Giardia

UC

Crohn’s

Celiac disease

IBS

laxative use

Hyperthyroidism

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17
Q

What are some non-infective causes of diarrhoea?

A

IBD

Bowel cancer

Thyrotoxicosis

Laxative use

Chronic pancreatitis

Celiac disease

Ischemic bowel

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18
Q

What are the symptom of enteric fever?

A

Systemic upset

Relative Bradycardia

Abdominal pain

Constipation** characteristic finding

Rose spots

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19
Q

What are some complications of enteric fever?

A

Osteomyelitis

G.I perforation

Meningitis

20
Q

What investigations should be done into diarrhoea?

A

Bloods:

  • FBC
  • U&Es
  • CRP
  • LFTs
  • tTG/ Anti -EMAs/ Anti DGP

Orifices:

  • Stool cultures
  • C.Diff toxin
  • faecal elastase
  • Ova/ cysts
  • calprotectin

Xray:
- AXR

E

S:

  • flexible sigmoidoscope
  • colonoscopy
21
Q

What are some Different pathogens for watery diarrhea?

A

Toxigenic E.Coli

Cholera Vibrio

Clostridium perfringens

Bacillus Cereus

Garidais infection

Norovirus

Rotavirus

22
Q

What are some differentials for watery diarrhea?

A

Gastroenteritis infection

Coeliac disease

IBS

Crohn’s

Laxative use

Serotonin Syndrome

Over flow diarrhea
- constipation

23
Q

How is cholera tested for?

A

Dipstick testing - picks up serovars 0139 in stool

Darkfield microscopy of stool

24
Q

What fluids should be given to patients with Cholera and Why?
additionally, what substance can be given to children which can shorten duration?

A

WHO Hypo-osmolar formulation
- contains 75Na and 20 K+ (high amount)
Added with water.

If IV is needed:
Hartman’s/ Ringer’s lactate
- because patient’s have usually lost a lot of K+

Zinc lessens severity and time

25
Q

What is a potentially fatal type of Clostridium perfringens?

A

Beta toxin from C. Perfringens Type C

Causes:
Clostridium Necrolysis enterocolitis

26
Q

If antibiotics are to be given for Cholera what should be used?

A

Ciprofloxacin

27
Q

What are the symptoms of enteric fever/ typhoid fever?

A 
Fever 
headache 
Myalgia 
Relative Bradycardia 
Constipation
Diarrhoea (in children)

Rose spots
Splenomegaly
Cough
Epistaxis

28
Q

What are some of the complications of Enteric fever?

A

Septic shock

Bowel perforation

Meningitis

Cholecystitis

29
Q

What is the management for Enteric fever?

A

Antipyretics

IV fluids

Ciprofloxacin + Ceftriaxone
if non responding:
- Azithromycin

30
Q

How is enteric fever investigated?

A

Blood cultures

Stool samples

Bloods:

  • leucopenia
  • Dehydration
  • deranged LFTs
31
Q

What are the signs of peritonism?

A

Involuntary guarding

Rigid abdomen

Fever

Tachycardia

Ileus

32
Q

Which of the gastroenteritis diseases is most associated with guillain barre syndrome?

A

Campylobacter jejuni

33
Q

Why should antimotility drugs not be given to Shigella infections?

A

Risk of toxic megacolon

34
Q

What investigations should be done into C.Diff?

A

Bloods:

  • FBC
  • CRP
  • U&Es
  • Blood cultures

Orifices:

  • Stool cultures
  • Immunoassay for C.Diff toxin A and B
  • Immunoassay for glutamate dehydrogenase

X-rays:
- ABX - toxic megacolon

35
Q

What are the complications of C.Diff?

A

Ileus

Toxic Megacolon

Perforation

Pseudomembranous

36
Q

What are the diarrhoeas associated with traveling?

A 
E.Coli - Enterotoxigenic 
Salmonella typhi/ paratyphi 
Entamoeba HIstolytica 
Giardia Lamblia
Strongyloides Stercoralis
37
Q

How does Entamoeba histolytica present?

A

1-4 weeks intubation

Dysentery
Excessive wind 
Tenemus 
RUQ pain 
Swinging fevers

*treat with metronidazole

38
Q

Which two infections are likely to early onset vomiting, followed by diarrhoea?

A

Staph Aureus

Bacillus Cereus

39
Q

What infection is associated with soft cheese and refridged items?

A

Listeria monocytogenes

40
Q

How does yersinia Enterocolitica present?

A

Fever
Diarrhoea
Mesenteric adenitis
Erythema nodosum

41
Q

Which Gastroenteritis infections present with fever?

A

One’s that are invasive as they stimulate the innate immune system
- part from E.Coli 0157

42
Q

Contrast Invasive and non-invasive gastroenteritis?

A

Non- invasive

  • No fever
  • Toxin mediated
  • No leukocyte in stool
  • Confined to lumen
43
Q

How does the Shiga toxin cause its pathology?

A

Binds to 60S ribosomes inducing cellular death

44
Q

What severe infection can cause paralysis?

A

Clostridium Botulism
causes D&V

this is followed by:

  • cranial nerve palsies
  • ascending weakness

Needs ventilator support and anti-toxins

High mortality

45
Q

Which invasive gastroenteritis does not cause a fever?

A

E.Coli 0157

46
Q

Complication of dysentery?

A

Sepsis

Severe dehydration
- AKI

Electrolyte abnormalities

  • hypokalemia
  • Metabolic acidosis
47
Q

What are the symptoms of HUS following Ecoli 0157 infection?

A

Pallor - anaemia
Jaundice
Septic picture

Phase 4 (49 decks)

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