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Infection & Immunology > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

Define Gastroenteritis?

A

Acute inflammation of the lining of the GI tract, manifested by nausea, vomiting, diarrhoea and abdominal discomfort

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2
Q

What is the aetiology of Gastroenteritis?

A

Caused by viruses, bacteria, protozoa or toxins containted in contamined food or water (faecal-oral route)

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3
Q

What are the viral causes of Gastroenteritis?

A 
Rotavirus
Adenovirus
Astrovirus 
Calcivirus
Norwalk Virus
Small round structures viruses
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4
Q

What are the bacterial causes of Gastroenteritis?

A 
Campylobacter jejuni
Escherichia coli (particularly O157)
Salmonella 
Shigella 
Vibrio Cholerae 
Listeria 
Yersinia Enterocolitica
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5
Q

What are the protozoal causes of Gastroenteritis?

A

Entamoeba histolytica
Cryptosporidium aureus
Giardia Lamblia

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6
Q

What toxins can result in Gastroenteritis?

A 
Staphylococcus aureus 
Clostridium Botulinum 
Clostridium Perfringens 
Bacillus cereus
Mushrooms
Heavy metals
Seafood
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7
Q

What commonly contamined foods can cause Gastroenteritis?

A 
Improperly cooked meat 
Old rice 
Eggs and poultry
Milk and cheeses 
Canned food
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8
Q

What is the epidemiology of Gastroenteritis?

A

COMMON

Serious cause of morbidity and mortality in the developing world

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9
Q

What are the presenting symptoms of Gastroenteritis?

A

Sudden onset nausea, vomiting, anorexia
Diarrhoea (bloody or watery)
Abdominal Pain or discomfort
Fever and malaise

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10
Q

What’s important to ask about for Gastroenteritis?

A

Enquire about recent travel, antibiotic use and recent food intake (how the food was cooked, sourced and whether anyone else is ill)

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11
Q

What is the time of onset of Gastroenteritis?

A 
Toxins = early (1-24 hrs)
Bacterial/viral/protozoal = 12+ hrs
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12
Q

What are some of the other effects of toxins in Gastroenteritis?

A

Botulinum causes paralysis

Mushrooms can cause fits, renal or liver failure

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13
Q

What are the signs of Gastroenteritis on physical examinatiom?

A

Diffuse abnormal tenderness
Abdominal distension
Bowel sounds are often increased

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14
Q

What are the signs of severe Gastroenteritis on physical examination?

A

Pyrexia
Dehydration
Hypotension
Peripheral shutdown

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15
Q

What’s important to remember with diarrhoeal conditions?

A

They can lead to dehydration so assess and address the patient’s hydration status immediately

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16
Q

What bloods would you do for Gastroenteritis?

A

FBC
Blood Culture (identify bacteraemia)
U&Es (dehydration)

17
Q

Why do we investigate stools for Gastroenteritis?

A

Faecal microscopy and analysis for toxins (particularly for the toxin causing pseudomembranous colitis (C. diificile toxin))

18
Q

Why do we do an AXR or US for Gastroenteritis?

A

Exclude other causes of abdominal pain (e.g. bowel perforation)

19
Q

Why do we do a Sigmoidoscopy for Gastroenteritis?

A

Usually unnecessary unless inflammatory bowel disease needs to be excluded

20
Q

What is the management plan for Gastroenteritis?

A

Bed rest
Fluid and electrolyte replacement with oral rehydration solution (contains glucose and salt)[
IV rehydration may be necessary in those with severe vomiting
Most infections are self-limiting (so will go away with time)
Antibiotic treatment is only used if severe or if infective agent has been identified

21
Q

What do you do if botulism is present for Gastroenteritis (due to Clostridium botulinum)?

A

Treat with botulinum antitoxin (IM) and manage in ITU

22
Q

What’s important about Gastroenteritis?

A

This is often a notifiable disease and is an important public health issue

23
Q

What are the possible complications of Gastroenteritis?

A

Dehydration
Electrolyte imbalance
Prerenal failure (due to dehydration)
Secondary lactose intolerance (particularly in infants)
Sepsis and shock
Haemolytic uraemic syndrome (associated with toxins from E.coli O157)
Guillain-Barre Syndrome may occur weeks after recovery from Campylobacter Gastroenteritis

24
Q

What can botulism lead to?

A

Respiratory muscle weakness or paralysis

25
Q

What is the prognosis for patients with Gastroenteritis?

A

Good prognosis because most cases are self-limiting

Infection & Immunology (40 decks)

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