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Infection > Infectious Diarrhoea > Flashcards

Infectious Diarrhoea Flashcards

1
Q

What are 4 ways which gastro-enteritis can spread?

A

Contamination of foodstuffs
Poor storage of produce
Travel-related infections
Person-person spread

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2
Q

How is contamination of foodstuffs linked to spread of G-E?

A

Intensely farmed chicken tends to facilitate campylobacter spread

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3
Q

How is poor storage of produce linked to spread of G-E?

A

Bacterial proliferation at room temperature

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4
Q

How does person-to-person spread affect G-E spread?

A

Norovirus passed on

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5
Q

How many people visit the GP every year because of GI infection?

A

2% of the population

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6
Q

What is the most common cause of G-E?

A

Viral

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7
Q

What is the most common bacterial pathogen causing G-E?

A

Campylobacter

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8
Q

Which pathogen causes the most G-E hospital admissions every year?

A

Salmonella

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9
Q

What are some defences against enteric infections?

A

Hygiene
Stomach acidity
Normal gut flora
Immunity

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10
Q

What might compromise stomach acidity?

A

Antacids

Infection

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11
Q

How might normal gut flora be compromised?

A

Clostridium Difficile Diarrhoea

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12
Q

How may immunity be compromised?

A

HIV

Salmonella

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13
Q

Give an example of a non-inflammatory G-E.

A

Cholera

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14
Q

Give an example of an inflammatory G-E.

A

Shigella dysentery

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15
Q

What G-E organism could give a mixed picture?

A

C. Difficile

Toxins which increase secretion as well as inflammation

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16
Q

How does non-inflammatory present?

A

No fever
Little to no abdominal pain
Frequent watery diarrhoea

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17
Q

What is the effect of cholera?

A

Increases cAMP secretion
Increases Chloride secretion
These both cause massive loss of fluid from the gut

18
Q

Describe enterotoxigenic e-coli?

A

Common cause of traveller’s diarrhoea
Frequent watery diarrhoea
Secretory toxin

19
Q

How is inflammatory G-E characterised?

A 
Frequent watery stool
Inflammatory toxin damage
Mucosal destruction
Pain
Fever
20
Q

What is the main stay of treatment for diarrhoea?

A

Rehydration

21
Q

What are some signs of G-E in infants?

A

Dry mouth
Decreased skin turgor
Few or no tears
Sunken eyes, cheeks, abdomen, fontanelle

22
Q

What are some useful investigations for diarrhoea?

A

Stool culture
Blood culture
Renal function
Blood Count (Neutrophilia, haemolysis)

23
Q

What is a possible differential diagnosis for diarrhoea?

A

IBD
Spurious diarrhoea
Carcinoma

24
Q

Can sepsis occur outside the gut with fever and diarrhoea?

A

Yes

25
Q

Describe the onset of salmonella G-E.

A

Symptoms usually onset within 48 hours of exposure

Diarrhoea usually lasts <10 days

26
Q

What are some features of e.coli 0157?

A

Usually from meat or person-to-person spread
Produces shiga toxin
Can cause haemolytic-uraemic syndrome (HUS)

27
Q

What are some characteristics of HUS?

A

Renal failure
Haemolytic anaemia
Thrombocytopaenia

28
Q

Are antibiotics indicated in e.coli 0157?

A

No

29
Q

What are some causes of occasional food poisoning outbreaks?

A 
Staph Aureus
Baccilus cereus (re-fried rice)
Clostridium Prefringes (Undercooked meat)
30
Q

What bacteria is often found in undercooked meat?

A

Clostridium perfringens

31
Q

When should antibiotics be given in G-E?

A

Indicated in G-E for immunocompromised, severe sepsis, invasive infection or chronic illness

32
Q

When are antibiotics not indicated in G-E?

A

Healthy patient with non-invasive infection

33
Q

How is clostridiodes difficile diarrhoea treated?

A 
Metronidazole
Oral vancomycin
Fidaxomicin (expensive)
Stool transplant
Maybe surgery
34
Q

What are the 4 Cs antibiotics?

A

Cephalosporins
Co-Amoxiclav
Clindamycin
Ciproflaxin

35
Q

How can we prevent spread of clostridiodes?

A 
Reduce broad spectrum antibiotics
Avoid 4Cs
Isolate symptomatic patients
Wash hands between patients
Cleaning environment
36
Q

How is CDI managed?

A

Stop precipitating antibiotic if possible

Oral vancomycin

37
Q

How does giardia duodenalis present?

A

Diarrhoea
Gas
Malabsorption
Failure to thrive

38
Q

How does cryptosporidium present?

A

Diarrhoea
Nausea
Vomiting
Abdominal pain

39
Q

How is cryptosporidium parvum spread?

A

Infected animals/faeces contaminate water/food

40
Q

How is norovirus diagnosed?

A

PCR

Infection (10 decks)

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