Gatstroenteritis inc. HUS

Question 1

What are the 2 mechanisms for bacteria to produce symptoms?

Answer 1

Invade bowel wall

produce toxin

Question 2

What is the most common bacterial cause of gastroeneritis?

Answer 2

Campylobacter

serious in very young and old

Question 3

What other bacteria can cause gastroenteritis?

Answer 3

Salmonella

E. coli 0157

Question 4

What bacteria have a short incubation period of 1-6 hours? Why is this?

Answer 4

Staph aureus
Bacillus cereus
Preformed toxin in food leads to rapid absorption

Question 5

What bacteria have a medium incubation period of 12-48 hours? Why is this?

Answer 5

Salmonella
Cl perfringens
invasion of bowel wall and toxin produced in gut

Question 6

What bacteria have a long incubation period of 2-14 days? Why is this?

Answer 6

Campylobacter
E coli 0157
invasion of bowel wall and toxin produced in gut

Question 7

Where is campylobacter most commonly spread from?

Answer 7

poultry and raw milk

Question 8

Where is salmonella enteritidis most commonly spread from?

Answer 8

poultry, meat and raw egg

Question 9

How are salmonellae typed?

Answer 9

O-antigen on body

Antigen on tail

Question 10

How is E coli 0157 spread?

Answer 10

person-person

from food-person

Question 11

Who are at risk of E coli 0157 complications

Answer 11

children and elderly

Question 12

How does HUS present?

Answer 12

Abdo pain
fever 
pallor 
petechiae
oliguria
bloody diarrhoea in 90% cases

Question 13

What is used to diagnose HUS?

Answer 13

LDH >1.5 x normal

Question 14

What causes HUS?

Answer 14

verotoxin produced by E coli (not just 0157) leads to renal cell anc RBC death as well as other cells deaths

Question 15

If a patient has HUS what should not be given?

Answer 15

Antibiotics
anti-motility agents
NSAIDs

Question 16

Where can E coli 0157 be contracted from?

Answer 16

Contact with farm animals
Private drinking water
Burgers
unpasteurised dairy product

Question 17

If a patient has Ecoli 0157 or HUS what has to be done?

Answer 17

Contact Health Protection Unit

Question 18

What do bacteria need t multiply?

Answer 18

Time, temperature, food source, moisture

Question 19

How does acute enteritis present?

Answer 19

fever
D&V
abdominal pain

Question 20

How does acute colitis present?

Answer 20

fever
pain
bloody diarrhoea

Question 21

How does enteric fever like illness present? Typhoid presents like this

Answer 21

fever 
rigors 
abdo pain
constipation but possible short history of diarrhoea
tired 
muscle pains

Question 22

What infections can cause bloody diarrhoea?

Answer 22

Campylobacter
Shigella
E coli 0157
amoebiasis

Question 23

What is Guillain-Barre syndrome?

Answer 23

Post infectious sequalea of neurological symptoms

Question 24

How is enteric fever like illness (typhoid) diagnosed?

Answer 24

Blood culture (key)
stool and urine cultures

Question 25

What does HUS consist of?

Answer 25

haemolytic anaemia
acute kidney failure
low platelet count (thrombocytopenia)

Question 26

What is used to determine the severity of a CDI?

Answer 26

Suspicion of pseudomembranous colitis or toxic megacolon or ileus or colonis dilation
WCC
Creatinine

Question 27

How is gastroenteritis treated?

Answer 27

oral rehydration #1
IV fluids 
anti-spasmodics?
Anti-motility? (loperamide, opiates)
antibiotics?

Question 28

How is C diff described?

Answer 28

Anaerobic gram-positive spore forming bacillus

Question 29

How is pseudomembranous colitis treated?

Answer 29

non-severe - metronidazole

severe - vancomycin