Gastrointestinal infections (needs updated with new lecture)

Question 1

What is the definition of diarrhoea?

Answer 1

3 of more loose stools in 24 hours

Unformed stool - doesnt hold shape

Question 2

What chart do you use to analyse poo?

Answer 2

Bristol stool chart

Type 1- separate hard lumps (hard to pass)
Type 7 - entirely liquid/watery

Question 3

What is food poisoning?

Answer 3

illness caused by eating food contaminated with micro organisms, toxins, poisons etc

(bacteria, viruses, parasites)

Question 4

What symptoms do people usually have if they have food poisoning?

Answer 4

Diarrhoea, abdo pain, vomiting

Question 5

What organisms cause short (1-6) hours of food poisoning?

Answer 5

Staph aureus - cream cakes

Bacillus cereus - rice

Question 6

Describe scombroid posisoning?

Answer 6

Dark meat (tinned tuna)
Instant reaction
Massive hypersensitivity reaction

Question 7

What organisms cause medium (12-48) hours of food poisoning?

Answer 7

Salmonella / C.Perfringens

Question 8

What organisms cause long (2-14) days of food poisoning?

Answer 8

Campylobacter

E.Coli

Question 9

What is the most common organism to cause food poisoning?

Answer 9

Campylobacter - usually self limiting

Question 10

What organisms can cause outbreaks?

Answer 10

Salmonella

E.Coli 0157

Question 11

Describe Staph. Aureus as an organism of food poisoning?

Answer 11

1-6 hour incubation
Associated with cream cakes (dairy)

Acts on com centre in brain
Vomiting/abdo pain

Question 12

Describe Bacillus cereus as an organism of food poisoning?

Answer 12

1-6 hour incubation
Rice

Heat resistant spores
Starchy foods
Profuse vomiting

Question 13

Describe campylobacter - what food can cause it?

Answer 13

Poultry and raw milk

Question 14

What symptoms might you get with campylobacter?

Answer 14

Abdo pain

Bloody bowel

Question 15

Describe what foods might cause salmonella?

Answer 15

Poultry, meat, raw eggs

Question 16

What symptoms might you get with salmonella?

Answer 16

D+V
Blood
Fever

Question 17

Describe serogrouping of salmonellae?

Answer 17

Groups B,C and D are most common locally

Can help pinpoint the source of infection
Useful of detecting outbreaks/contact tracing

Question 18

What does enterohaemorrhagic E.Coli produce (E.Coli 0157)?

Answer 18

One of more cytokines

Shia-like toxins are the new name for verotoxins

Question 19

Describe what foods you might get E.Coli from?

Answer 19

Beef, raw milk, water

has a low infectious dose

Question 20

How is E.coli spread?

Answer 20

Person to person - direct and indirect

animal contract

Question 21

What symptoms might you see in E.COli 0157?

Answer 21

Blood diarrhoea

Question 22

What is the incubation period for E.Coli 0157?

Answer 22

2-14 days

Question 23

What do the shiva-like/verotoxins that enterohaemorrhagic E.Coli produce do?

Answer 23

Bind to receptors found on renal cells, RBC and others - inhibit protein synthesis, cause cell death

Question 24

What might be a complication of E.Coli 0157?

Answer 24

Haemolytic Uraemia Syndrome (HUS)

Question 25

Describe the presentation of HUS?

Answer 25

Abdo pain Fever Pallor Blood diarrhoea High WBC Low platelets Low HB

Question 26

What investigations might you do for HUS?

Answer 26

Stool sample Bloods NO ANTIITOICS NO ANTI-MOTILITY NO NSAIDS

Question 27

What things might cause clinical suspicion of E.Coli 0157?

Answer 27

Private drinking water Burgers Unpasteurised dairy products Contract with suspected/confirmed cases

Question 28

What cases must you notify the health protection unit?

Answer 28

E.Coli 0157 | HPU

Question 29

Describe rotavirus - who gets it how does it spread?

Answer 29

Commonest cause of D and V in <3yrs Most have it before 5 Person-person Faecal oral

Question 30

What are the symptoms and how long does rotavirus last?

Answer 30

``` Diarrhoea - NO BLOOD Vomiting Mod fever Self limiting Lasts a week ```

Question 31

What does rotavirus affect and thus cause dehydration?

Answer 31

Affects absorption and secretion in the bowel

Question 32

What might be a complication in children of rotavirus?

Answer 32

Post infection malabsorption which can lead to more diarrhoea

Question 33

How do you diagnose rotavirus?

Answer 33

PCR of faeces

Question 34

How do you treat rotavirus?

Answer 34

Hydration - oral is poss

Question 35

What vaccine is available for rotavirus?

Answer 35

Oral live attenuated vaccine 2 doses at age 2 and 3 months

Question 36

Describe norovirus - who gets it and how is it spread?

Answer 36

All ages can get it HIGHLY INFECTIOUS Faecal oral/droplets Person to person (or on contaminated food/water)

Question 37

What are the symptoms of norovirus?

Answer 37

Usually asymptomatic for 2 days | Abrupt and sudden explosive D+V (can lead to widespread contamination)

Question 38

How long does norovirus usually last for?

Answer 38

2-4 days

Question 39

How do you diagnose norovirus?

Answer 39

PCR on stool or vomit

Question 40

How do you treat norovirus?

Answer 40

Hydration | ward closure/isolation