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Gastrointestinal > GI infection and Gastroenteritis > Flashcards

GI infection and Gastroenteritis Flashcards

1
Q

What is the commonest bacterial cause of food poisoning?

A

Campylobacter

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2
Q

What food poisoning pathogens have a short incubation period and why is this?

A

Staph aureus, bacterius cerus

They are pre formed toxins

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3
Q

What is a short incubation time?

A

1 - 6 hours

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4
Q

Describe the presentation of bacillus cerus infection

A
  1. Common after eating rice/pasta
  2. Initially vomitting
  3. Diarrheoa within 1 - 6 hours
    (usually not bloody)
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5
Q

Describe how a campylobactor infection would present?

A

Long incubation time (2 - 14 days following exposure)
Blood diarrhoea
Usually due to eating raw poultry

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6
Q

What antibiotics would you use to treat campylobactor?

A

Ciproflaxin
Erythromycin
(but only in some circumstances - very old/very young)

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7
Q

What is the incubation period of salmonella enteritidis?

A

12 - 48 hours

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8
Q

How do you determine the type of infecting salmonella?

A
  1. Antigen on body, 0 antigen/ serotype (B, C and D most common) allows to follow outbreak
  2. Antigen on tail (serotype) allows you to decide the most likely origin
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9
Q

How do you test for the body antigen in salmonella?

A

Slide agglutination test

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10
Q

Give two serotypes of salmonella

A

Salmonella enteritidis

Salmonella Typhimurium

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11
Q

What are the key features of E Coli 0157?

A

Bloody diarrhea, most often in children under 16 (especially those under 5. Recent contact with farm animals/raw milk.

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12
Q

What is the increased risk with E Coli infection?

A

Release of verotoxins with can then cause Haemolytic uraemia syndrome.

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13
Q

What is HUS?

A

Verotoxins act to cause apoptosis in RBC’s and kidney causing the patient pain fever and bloody diarrhoea

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14
Q

What is a marker for cell damage that will be raised in HUS?

A

lactate dehydrogenase

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15
Q

What tests would you perform on a patient you suspect has HUS?

A 
Stool culture
U & E
FBC
Clotting
Lactate dehydrogenase
Urine dipstick
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16
Q

How do you treat HUS?

A 
Monitioring/ rehydration
 NO antibiotics
NO anti motility
NO NSAIDS
Inform Health protection unit
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17
Q

How does rotavirus present?

A 
Watery diarrhoea (no blood)
Children under 5
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18
Q

How is rota virus spread?

A

Faecal oral

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19
Q

How do you test for rotavirus?

A

PCR on faeces

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20
Q

How do you treat rotavirus?

A

Hydration

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21
Q

How is the rotavirus vaccine given?

A

Orally given live attenuated vaccine given at 2 and 3 months old

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22
Q

How is noro virus spread?

A

faecal oral/droplet

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23
Q

How is noro virus tested for?

A

PCR of faeces

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24
Q

How do you treat norovirus?

A

Rehydration

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25
Q

What toxins does C Diificile produce?

A

Entero/cytotoxins

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26
Q

What does C Difficile produce that makes the infection so difficult to contain?

A

Spores

27
Q

What kind of colitis is found in C Difficile infection?

A

Pseudomembranous colitis

28
Q

How do you test for C Difficile?

A
  1. Sensitive screening test (detects antigen and toxin)
  2. More specific test (done when screening is positive to test for further toxins)
  3. Stool culture
29
Q

What do you do if the screening test in positive but the toxin is negative?

A

Re assess and repeat tests

30
Q

What tests do all stools get tested for?

A

Salmonella, Shigella, Campylobactor, E Coli 0157 and cryptomagalovirus
Anyone over 15 years gets C Diff test also

31
Q

What is acute enteritis?

A

Fever, D &V, abdominal pain

32
Q

What is acute colitis?

A

Fever, pain, bloody diarrhoea

33
Q

What is enters fever like illness?

A

fever, rigors, pain, little diarrhoea

34
Q

What are the most common infectious causes of bloody diarrhoea?

A

Campylobactor, shigella, e coli, amoebiasis

35
Q

Give some non infectious causes for bloody diarrhoea?

A

IBD
Malignancy
Ischaemia

36
Q

What is a further disease that could develop as a result of campylobactor infection?

A

Guillain barre syndrome

37
Q

What tests would you need to diagnose typhoid?

A 
Blood cultures (most important)
Stool and urine cultures
38
Q

How does typhoid present?

A

Traveller (e.g. india)

Mile bacteraemia, enterocolitis

39
Q

How effective is the typhoid vaccine?

A

70% against typhoid but not effective against parathyroid

40
Q

When would you order a stool microscopy?

A

Suspicion of parasites

41
Q

When would you do a stool culture?

A

Salmonella, campylobacter, shigella

42
Q

When would you do a stool toxin?

A

C Difficiile

43
Q

When would you do blood cultures?

A

Salmonella, Typhoid

44
Q

Why would you do a FBC?

A

Asses severity of C Diff infection

45
Q

Why would you do U & E tests?

A

Assess renal function (e.g. from dehydration)

46
Q

When would you want to give antibiotics?

A 
Typhoid
Shigella
E coli (sometimes)
Cholera
C Diff
Giardiasis
Amoediasis
Invasive Salmonella
47
Q

WHat antibiotic would you give to patients with gastroenteritis

A

Ciprofloxacin for 3 - 5 days

48
Q

What is the gram stain of c diff?

A

Gram positive, spore forming, bacillis

49
Q

What antibiotics precipitate C diff?

A

fluoroquinolones, cephalosporins, clindamycins, broad spectrum penicillins
(most begin with C)

50
Q

What other medication can precipitate C diff?

A

PP1
Histamine 2 antagonist
Chemotherapy

51
Q

What are the four C antibiotics?

A

ANTIBITOICS- CEPHALOSPROINS, CLINDAMYCIN, CIPROFLOXACIN [QUINOLONES] , CLARITHROMYCIN [ MACROLIDES]

52
Q

How do you treat pseudomembranous colitis?

A 
Discontinue current antibiotics, PPIs
Avoid opiates and anti peristaltic drugs
Non severe: Metronidazole (10 - 14 dyas)
Severe: Vancomycin
(orally)
53
Q

What is a future drug that could be used to treat C Diff?

A

Fidaxamicin

54
Q

When will fidaxomicin be used?

A

For first relapse within 12 weeks of initial infection

55
Q

What is amoebiasis?

A

Protozoal infection spread by faecal oral route seen in areas of poor sanitation

56
Q

How do you diagnose amoebiasis?

A

Hot stool microscopy

Also serology

57
Q

How do treat amoebiasis?

A

Metronidazole

Removal from lumen using diloxanide furoate or paromomycin

58
Q

What are the symptoms of giardiasis?

A

Foul smelling diarrhoea

mal absorption

59
Q

How is giardiasis spread?

A

By cysts in normal drinking water

60
Q

How is the diagnosis of giardiasis made?

A

Hot stool microscopy

Duodenal aspiration

61
Q

How do you treat giardiasis?

A

Metronidazole

62
Q

What is cryptosporidiosis?

A

A parasite that is one of the main causes of travel related diarrhoea infection. Usually self limiting

63
Q

How do you treat cryptosporidosis?

A

Supportive

Nitizoxamide?

64
Q

How do you diagnose cryptosporidosis?

A

Duodenal aspirate

Stool microscopy

Gastrointestinal (7 decks)

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