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Infection > Infectious Diarrhoea > Flashcards

Infectious Diarrhoea Flashcards

1
Q

Define Diarrhoea?

A

Fluidity and Frequency

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2
Q

Define Gastro-enteritis?

A

Three or more loose stools/day

Accompanying features

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3
Q

Define Dysentry?

A

Large bowel inflammation w/ bloody stools

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4
Q

What causes gastroenteritis ?

A

Contaminated foodstuffs (intensively farmed chicken and campylobacter), poor storage of produce, salmonella or norovirus

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5
Q

What is the commonest bacterial pathogen that causes gastroenteritis?

A

Campylobacter

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6
Q

What pathogen causes the most hospital admissions?

A

Salmonella

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7
Q

What are the best defences against enteric infections?

A

Hygeine, stomach acidity, normal gut flora and immunity

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8
Q

What are clinical features of diarrhoeal illnesses?

A

Secretory toxin mediated secretion (cholera and enterotoxic E.coli (travellers diarrhoea))

Frequent watery stools with little abdominal pain

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9
Q

How do you treat non inflammatory diarrhoea?

A

Rehydration

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10
Q

What is the mechanism behind cholera?

A

Increased cAMP levels = loss of Cl from cells along with Na and K loss

Osmotic effect leads to massive loss of water from gut

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11
Q

What are the clinical features of inflammatory diarrhoea?

A

Inflammatory toxin damage and mucosal destruction

Pain and fever

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12
Q

What is the main treatment of inflammatory diarrhoeal illness?

A

Rehydration therapy and perhaps antimicrobials

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13
Q

What is the typical presentation of gastroenteritis in an infant?

A

Sunken fontanelle, sunken eyes and cheeks, decreased skin turgor, dry mouth/tongue, sunken abdomen

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14
Q

What electrolyte imbalances are seen in gastroenteritis?

A

Hyponatremia due to sodium loss with fluid replacement by hypotonic solutions

Hypokalaemia due to K loss in stools

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15
Q

How much fluid can be lost with secretory diarrhoea?

A

1-7l fluid per day

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16
Q

What investigations should be done if gastroenteritis is suspected?

A

Stool culture, Ag testing, blood culture, renal function, blood count, abdominal x-ray if abdomen distended

17
Q

What are the differentials for infectious diarrhoea?

A

IBD, Spurious diarrhoea, carcinoma, sepsis outwith the gut

18
Q

What are the two most common causative campylobacter organisms ?

A

C. Jejuni and C. Coli

19
Q

What are the characteristics of salmonella gastroenteritis?

A

Symptom onset usually <48 hours after exposure

Diarrhoea lasts less than ten days

20% of patients still have positive stools at 20 weeks post infection

20
Q

What are the two species of salmonella?

A

S. Enterica and S. Bongori

21
Q

What are the most common isolates of salmonella in the UK?

A

Salmonella Enteritidis and Salmonella Typhimurium

22
Q

How is E.Coli spread?

A

Contaminated meat or person-to-person

23
Q

How is E.Coli characterised?

A

Frequent bloody stools

24
Q

What does E.Coli O157 produce?

A

Shiga toxin

25
Q

What can E.Coli O157 cause?

A

Haemolytic-Uraemic syndrome

26
Q

What is HUS characterised by?

A

Renal failure, haemolytic anaemia and thrombocytopenia

27
Q

What is the pathology behind HUS?

A

Shiga toxin is released into blood and stimulates platelet activation

Results in micro-angiopathy

28
Q

When are antibiotics given for gastroenteritis?

A

If patient is immunocompromised, sever sepsis or invasive infection and chronic illness

29
Q

What is clostridiodes difficile diarrhoea ?

A

Mild diarrhoea- sever colitis caused by previous antibiotic treatment

30
Q

How do you treat CDI?

A

Metrondiazole, oral vancomycin, stool transplant, surgery

31
Q

What are the 4 C antibiotics which cause CDI?

A

Cephalosporins, co-amoxiclav, clindamycin and ciprofloxacin

32
Q

How does giardia duodenalis present?

A

Diarrhoea, gas, malabsorption, failure to thrive

33
Q

How is giardia lamblia spread?

A

Direct contact with cattle/dogs/cats or other people

Water or food contaminated with faeces

34
Q

Who is rotavirus common in?

A

Children under 5

Infection (12 decks)

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