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Infection > Infectious Diarrhoea > Flashcards

Infectious Diarrhoea Flashcards

1
Q

What is the definition of gastroenteritis?

A

Clinical diagnosis of stools three or more daily with associated symptoms like fever and abdominal pain.

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2
Q

What is the name of the chart used to categorise the consistency of stools?

A

Bristol Stool Chart

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3
Q

What are four methods of getting gastro enteritis?

A

Person to person spread
Contaminated food that isn’t cooked properly
Leaving food out at the wrong temperature
Travel related infections

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4
Q

What are the most common causes of gastroenteritis?

A

Viruses are the most common cause

Campylobacter is the most common bacterial cause

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5
Q

What are four defences against enteric infections?

A

Good hygiene
Acid in stomach-so if on antacids more likely to get an infection
Immune system-if immunocompromised more likely to get an infection
Normal gut flora

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6
Q

What are two types of secretory (non inflammatory) diarrhoea?

A

Cholera-caused by the toxins that are secreted by the cholera virus that increase cAMP and chloride secretion which affects the osmotic gradient and they get a large volume of fluid loss.
Traveller’s diarrhoea- enterotoxigenic E. Coli
They get frequent watery diarrhoea and little abdominal pain. Often present with hypovolaemic shock.

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7
Q

What are the features of inflammatory diarrhoea?

A

Inflammatory toxin damage and mucosal destruction.
Get pain and fever.
Bacterial and amoebic dysentery.

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8
Q

What are some signs of dehydration in a child?

A 
Sunken fontanelles
Sunken eyes
Skin turgor
Sunken abdomen
Dry mouth and eyes
Few/no tears
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9
Q

What investigations should be done in a patient with diarrhoea?

A 
Stool culture
Molecular and antigen testing
Full blood count (WBC, and haemolysis)
Blood cultures
Renal Function
Abdominal X-Ray/CT if the abdomen is distended as higher risk of perforation if dilatation of bowel (>9cm at caecum)
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10
Q

What is the treatment of gastro enteritis?

A

IV saline

Oral rehydration with glucose/salt solution

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11
Q

What are two main Campylobacter species?

A

C. Jejuni

C. Coli

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12
Q

What is a Campylobacter species that causes extra intestinal infections?

A

C. Fetus

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13
Q

What is the incubation period for Campylobacter and how long does it take to clear the system?

A

7 days

Takes 6 weeks to clear from the system

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14
Q

What are some sources of campylobacter infection?

A

Birds (raw chicken)
Young animals-sheep or cattle
Drinking contaminated water
Visiting Africa/foreign travel

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15
Q

What are some post infection complications from Campylobacter infections?

A

Arthritis

Guillain Barre Syndrome

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16
Q

What is the incubation period for Salmonella and how long does it take to clear the system?

A

10 day incubation period

20 week clearance time

17
Q

What is a post infection complication from Salmonella infection?

A

IBS

18
Q

What are two non typhoidal species of Salmonella>

A

S. enterica

S. bongori

19
Q

Describe the bacteria salmonella

A

Gram negative anaerobic bacilli

20
Q

What do the Salmonella Typhoid species cause in the body?

A

Enteric fever, not gastroenteritis

21
Q

What are two salmonella typhoid species?

A

S, typhi

S. paratyphi

22
Q

What is haemolytic uraemia?

A

Haemolytic anaemia
Renal Failure
Thrombocytopenia

23
Q

How can E. coli cause haemolytic uraemia?

A

E. coli produces the Shig toxin (similar to the one produced by shigella spp) that gets into the bloodstream and causes HUS (bacteria itself doesn’t get into the blood)

24
Q

What are five symptoms of HUS?

A 
Lethargy
Seizures
Abdominal pain
Bloody Diarrhoea
Fever
25
Q

When are antibiotics indicated in gastroenteritis?

A

Sepsis or invasive infection
Immunocompromised
Chronic Illness (malignancy)

26
Q

What are the possible treatments for C. Diff infection?

A 
metronidazole
oral vancomycin
Fidaxomicin (new and expensive)
Stool transplants
surgery may be required
27
Q

What are the four ‘C’ antibiotics that commonly precipitate C. diff infection?

A

Cephalosporin
Co-amoxiclav
Ciprofloxacin
Clindamycin

28
Q

How are parasites in stools diagnosed?

A

Send away a stool culture and ask for parasites, cysts and ova.

29
Q

What is an example of a protozoa causing gastroenteritis?

A

Giardia duodenalis

30
Q

How is Giardia spread?

A

Via animals and other people

Via infected food or water

31
Q

What are the symptoms of giardia and how is it treated?

A 
Diarrhoea
Failure to thrive
Gas
Malabsorption
Treat with metronidazole
32
Q

What is the typical presentation of rotavirus?

A

Children under five in the winter getting ill

Diagnosed via stool antigen

33
Q

How is norovirus diagnosed?

A

PCR

34
Q

What is the presentation of Entamoeba histolytica?

A 
amoebic dysentery (instestinal amoebiasis)
Invasive extraintestinal amoebiasis (liver/pleuropulmonary/brain abscess) – months/years later – usually no bowel symptoms
35
Q

How is Entamoeba histolytica diagnosed?

A

Hot stool and serology. Trophosites and cysts seen in sample

36
Q

How is Entamoeba histolytica treated?

A

Metronidazole and luminal agent

Infection (10 decks)

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