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Year 3 > Infectious diarrhoea (I) > Flashcards

Infectious diarrhoea (I) Flashcards

1
Q

How can we define diarrhoea?

A

The passage of:

  • 3+ loose or liquid stools per 24h, and/or
  • stools that are more frequent than what is normal for the individual lasting <14d, and/or
  • stool weight >200g/day
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2
Q

How can we classify diarrhoea based on duration? (3)

A
  • acute (</=14 days)
  • persistent (>14 days)
  • chronic (>4 weeks)
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3
Q

Why does diarrhoea occur?

A

Decreased absorption or increased secretion of fluid and electrolytes, or increase in bowel motility

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4
Q

What viral causes of diarrhoea are there? (3)

A
  • Norovirus
  • Rotavirus
  • Adenovirus
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5
Q

What bacterial causes of diarrhoea are there? (6)

A
  • Campylobacter jejuni (gram -ve curved rod best incubated at 42C) - after exposure to poultry
  • E. coli (gram -ve rod) - traveller’s diarrhoea
  • C. diff (anaerobic gram +ve rod) - Abx and PPI-associated diarrhoea
  • Shigella (gram -ve rod)
  • Salmonella (gram -ve rod)
  • Bacillus cereus - incubation period 6h until vomiting and diarrhoea
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6
Q

What parasitic causes of diarrhoea are there? (3)

A
  • Giardiasis - can cause lactose intolerance
  • Enterobiasis
  • Amebiasis
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7
Q

What are some risk factors for infectious diarrhoea? (4)

A
  • recent travel (traveller’s diarrhoea - E. coli)
  • exposure to outbreak
  • recent hospitalisation (C. diff)
  • medication use
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8
Q

What condition is infectious diarrhoea associated with?

A

Gastroenteritis - may be accompanied by abdominal pain and N/V

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9
Q

What are the main clinical features of infectious diarrhoea? (4)

A
  • sudden onset watery/fatty/bloody stool
  • fever
  • abdominal pain and cramping
  • nausea and vomiting
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10
Q

What is the most common cause of food poisoning from raw meat?

A

Campylobacter jejuni –> bloody diarrhoea

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11
Q

What type of disease can Salmonella cause, and what are the features of this?

A

Typhoid fever:

  • non-bloody, yellow-green ‘pea soup’ diarrhoea
  • fever
  • abdominal pain
  • rose spots over abdomen
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12
Q

How is Salmonella spread? (3)

A
  • eggs
  • poultry
  • contaminated food
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13
Q

How is Bacillus cereus spread? (2)

A
  • rice
  • pasta
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14
Q

When does S. aureus infection cause its symptoms and what are they?

A
  • starts 1-6h after exposure
  • profuse vomiting (only mild diarrhoea)
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15
Q

What is the incubation period and main symptom of norovirus?

A
  • highly infective - incubation period 12-24h
  • projectile vomiting
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16
Q

What is the incubation period and main symptom of Campylobacter? (4)

A
  • incubation period of 1-6 days
  • prodrome - headache, malaise
  • bloody diarrhoea
  • abdominal pain - may mimic appendicitis
17
Q

What is the incubation period and main symptom of E. coli?

A
  • incubation period: 3-4 days
  • commonly after air travel (traveller’s diarrhoea)
  • bloody diarrhoea lasting up to 1 week
18
Q

What is the incubation period for Bacillus cereus?

A

6h –> vomiting and diarrhoea

19
Q

How is Entamoeba histolytica spread?

A

Contaminated water

20
Q

What are the symptoms of Giardiasis? (4)

A

After ongoing diarrhoea and recent travel:

  • abdominal pain
  • bloating/flatulence - can develop lactose intolerance after Giardiasis
  • steatorrhoea
  • lethargy
21
Q

How do we diagnose bacterial infections (infectious diarrhoea)?

A

Stool culture

22
Q

When is a stool culture recommended in a primary care setting for infectious diarrhoea? (6)

A
  • patient systemically unwell and needs hospital admission +/- Abx
  • blood or pus in stool
  • immunocompromised
  • recently received Abx, PPI or been in hospital
  • recent foreign travel
  • public health indication - diarrhoea in high-risk, suspected food poisoning
23
Q

How do we diagnose viral infections (infectious diarrhoea)?

A

PCR

24
Q

What other investigations can be done for infectious diarrhoea? (2)

A
  • U&Es - if severe may show AKI, hypokalaemia and hyponatraemia
  • CRP and ESR for inflammation
25
Q

What supportive treatment do we give for infectious diarrhoea with no systemic signs? (3)

A
  • bed rest
  • fluids
  • electrolyte replacement - oral rehydration therapy (ORT)
26
Q

How do we manage infectious diarrhoea with systemic signs? (3)

A
  • admit
  • IV fluids
  • stool culture
27
Q

What medication can we give for infectious diarrhoea symptoms?

A

Anti-diarrhoeal agents e.g. loperamide

28
Q

What antibiotics can we give for C. diff infectious diarrhoea?

A

Oral vancomycin (+ IV metronidazole if severe)

29
Q

What antibiotics can we give for Campylobacter infectious diarrhoea?

A

Clarithromycin if severe

30
Q

What antibiotics can we give for E. coli infectious diarrhoea?

A

Ciprofloxacin

Year 3 (170 decks)

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