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Gastrointestinal > Infectious Diarrhoea > Flashcards

Infectious Diarrhoea Flashcards

1
Q

Vomiting is a more common symptom than nausea in patients with gastroenteritis. T/F?

A

False - the opposite is true

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2
Q

What are some of the non-intestinal manifestations of gastroenteritis?

A

Botulism

Gullain-Barre syndrome

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3
Q

If vomiting is the predominant symptom of gastroenteritis then what aetiologies does this suggest?

A

S.aureus
B.cereus
Norovirus

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4
Q

What diarrhoeal symptoms are particularly associated with infection of the small intestine?

A 
Large volume of watery stool
Not usually blood in the stool
Cramps
Bloating
Wind
Weight loss
Rarely there is fever
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5
Q

What diarrhoeal symptoms are particularly associated with infection of the large intestine?

A

Small volume of stool
frequent stool passage which is often painful
associated with fever and blood in the stool

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6
Q

What is tenesmus?

A

Urgent desire to defecate and a feeling of incomplete defecation

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7
Q

Which bacteria commonly cause gastroenteritis?

A 
Campylobacter
Salmonella
Shigella
E.coli 0157
Clostridium difficile
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8
Q

Which viruses commonly cause gastroenteritis?

A

Norovirus
Sapovirus
Rota virus
Adenoviruses

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9
Q

Which parasites commonly cause gastroenteritis?

A 
Cryptosporidium
Giardia
Entamoeba histolytica
Cyclospora
Isospora
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10
Q

What factors in a patients history are particularly important in cases of gastroenteritis?

A 
Food history
Onset and nature of symptoms
Residence and travel
Occupation
Pets
Hobbies
Recent hospitalisation
Recent antibiotic use
Comorbidities
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11
Q

Stool cultures can be used to investigate gastroenteritis but have a low rate of positive results. Why is this?

A

Many causes of diarrhoea are actually viral

Many bacteria which cause gastroenteritis can only survive in very specific environments

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12
Q

Diarrhoeal disease is self-limiting. T/F?

A

True

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13
Q

What technique is used to look for ova and cysts if parasitic causes of gastroenteritis are suspected?

A

Microscopy

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14
Q

How might viruses be identified when investigating gastroenteritis?

A

PCR

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15
Q

Why might endoscopy and biopsy be used in investigation of gastroenteritis?

A

To look for alternative non-infective causes of diarrhoea if other tests are negative

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16
Q

How is the dehydration which accompanies diarrhoea treated?

A

Oral rehydration salts or (if severe diarrhoea) IV fluids

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17
Q

Why do oral rehydration salts contain glucose and salt?

A

Because, despite the diarrhoea the sodium/glucose transporters are often still functioning and so using glucose and sodium in the oral rehydration salts helps to increase the absorption of water

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18
Q

Antibiotics should only be used in specific incidences when a patient has gastroenteritis. What are these?

A

Sepsis
Significant co-morbidities
Causal agents such as c.difficile

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19
Q

What types of antibiotics are most commonly used in the treatment of gastroenteritis?

A

Quiolones

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20
Q

Symptomatic treatment is used in gastroenteritis. T/F?

A

False

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21
Q

What kind of food is campylobacter most commonly found?

A

Uncooked poultry

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22
Q

Campylobacter has a high infectious dose of around…?

A

9000 organisms

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23
Q

Campylobacter is sensitive to stomach acidity. T/F?

A

True

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24
Q

Campylobacter has a short incubation period of around…?

A

3 days

25
Q

What are the symptoms of campylobacter symptoms?

A 
Frequent, high volume and bloody diarrhoea
Abdominal pain
Nausea
Fever
(Vomiting is not common)
26
Q

Campylobacter infections are self-limiting and usually disappear within how many days?

A

7 days

27
Q

Campylobacter has a high rate of resistance to antibiotics. T/F?

A

True

28
Q

What are the potential late complications of campylobacter infection?

A

Reactive arthritis

Gullain-barre syndrome

29
Q

How does salmonella spread?

A

Commonly found in poultry

Spreads person to person

30
Q

What kind of pets put people at a higher risk of salmonella infection?

A

Reptiles such as snakes

31
Q

Salmonella has a high infectious dose of around…?

A

10,000 organisms

32
Q

Salmonella is sensitive to stomach acidity. T/F?

A

True

33
Q

Within how many hours of ingestion of salmonella do patients become unwell?

A

72 hours

34
Q

What symptoms does salmonella infection usually cause?

A

Diarrhoea
Nausea
Abdominal Cramps
Fever

35
Q

Because salmonella is invasive it can, in rare cases, cause bacteraemia. This can cause secondary infectious such as…?

A

Endocarditis
Osteomyelitis
Mycotic aneurysms

36
Q

Salmonella infection is a self-limiting disease and lasts around how many days…?

A

10 days

37
Q

There can be asymptomatic shedding of salmonella for up to how many weeks?

A

5 Weeks

38
Q

In what foodstuffs is E.coli 0157 present?

A

Mince
Spinach
Bean sprouts

39
Q

E.coli 0157 can be spread person to person. T/F?

A

True

40
Q

E.coli 0157 produces shiva toxin. What are its effects?

A

Eneterocyte death

Enters the systemic circulation

41
Q

What is the incubation period of E.coli 0157?

A

3-4 days

42
Q

What symptoms result from E.coli 0157 infection?

A

Bloody diarrhoea and abdominal tenderness

43
Q

Haemolytic uraemia syndrome is a very serious complication of the effects of the shiva toxin. What does this involve?

A

Microangiopathic haemolytic anaemia
Acute renal failure
Thrombocytopaenia

44
Q

What percentage of patients with haemolytic uraemia syndrome will require dialysis?

A

50%

45
Q

If a person infected with E.coli 0157 develops haemolytic uraemia syndrome how many days after the onset of diarrhoea will the syndrome present?

A

5-10 days

46
Q

There is an associated between haemolytic uraemia syndrome and antibiotic use. T/F?

A

True

47
Q

Describe the pathogenesis of C.difficile infection?

A

Normally when c.difficile is ingested the healthy bowel will provide resistance to it. But when there is a reduction in colon resistance (normally due to age or antibiotic use) this causes colonisation and toxin production

48
Q

What symptoms result for c.difficile infection?

A

Loose stool and colic
Fever
Leukocytosis
Protein losing enteropathy

49
Q

Infection by which bacterium causes pseudomembranous colitis?

A

C.difficile

50
Q

How has the incidence of c.difficle in Scotland been reduced?

A

More careful use of antibiotics

51
Q

What techniques are used to identify c.difficile infection?

A

ELISA assays and then tests for toxin presence if these are positive

52
Q

How is c.difficile infection treated?

A

Stopping causative antibiotics
Using metronidazole or vancomycin
Facial transplant to recolonise with normal flora

53
Q

What is the most common viral cause of gastroenteritis?

A

Norovirus

54
Q

What is the route of transmission for norovirus?

A

Facael oral route

55
Q

What is the infectious dose of norovirus?

A

10-100 viruses

56
Q

What is the infectious dose of E.coli 0157?

A

10 organisms

57
Q

Norovirus is very stable in the environment - it can survive alcohol gel, bleach and temperatures of up to…?

A

60 degrees Celsius

58
Q

How long does norovirus diarrhoea last?

A

24-28 hours

59
Q

There is long lasting immunity to norovirus. T/F?

A

False

Gastrointestinal (22 decks)

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