Infective Diarrhoea

Question 1

Persisting diarrhoea few months post travel to India (or Russia) - watery, green frothy diarrhoea + cysts (white). Affects small bowel

Answer 1

Giardiasis

Question 2

Flask shaped ulcers, greasy consistency, affects colon, periodic acid shift positive trophocyte in ulcer slough off.

Answer 2

Amoebiasis

Question 3

Most common traveller’s diarrhoea

Answer 3

ETEC
Enterotoxic travellers E.Coli

Another more severe form: EHEC, haemolytic E Coli - associated with HUS. Haemolytic uraemia syndrome -renal injury

Question 4

Rose coloured spots on abdomen,
10%are asymptomatic carriers (linked to gallstones )
Fever, malaise aches, CONSTIPATION, diarrhoea.
Associated with bowel perforation

Answer 4

Salmonella typhi/ paratyphi/ typhoid fever

Typhoid Mary is fat female forty (leper colony :(

Question 5

Spiral shapes G negative rods. With ascending paralysis (GBS). Mexico

Answer 5

Campylobacter jejuni

Question 6

Dysentery causes/ bloody dysentery

Answer 6

Salmonella enteritis (chicken)
EColi EHEC
Campylobacter
Shigella 
Yerssinia

Question 7

Most common people returning with diarrhoea

Answer 7

People travelling to see family overseas

Question 8

Preformed toxins, symptoms within hours. Fried rice

Answer 8

Bacillus cereus + staph aureus

Question 9

Clostridium difficile rx and cause and risks

Answer 9

Post ABx - broad spectrum. Ampicillin, ceftriaxone, clindamycin.

1. Metronidazole
2. Oral vancomycin
3. Faecal transplant

TOXIC mega colon

Question 10

Clostridium botulism

• source
• complication

Answer 10

Canned food

Flaccid paralysis

Question 11

Listeria monocytogenes

Answer 11

Unpasteurised milk

Question 12

Groundwater diarrhoea

Answer 12

Giardia

Question 13

Sex + HIV + bloody diarrhoea , MWHSWM
Peritonism
Can treat with Ciproflixacin

Answer 13

Shigella only 10 can causes

Question 14

Ovum and HIV

Answer 14

Cryptosporidium

Question 15

Right iliac fossa pain, (mesenteric adenitis) dx by exclusion, pork !

Answer 15

Yersinia

Question 16

Rice water stool

Answer 16

Vibrio cholera - G -be Comma. Notifiable disease
2 enterotoxins act in channels and cause severe dehydration , loss of 1L per hour.
2-5 days

Question 17

Haemolytic Uraemic syndrome and Diarrhoea

Answer 17

Diarrhoea and haematuria= EHEC

ABx counterproductive

Question 18

Most common cause of Infective diarrhoea

Answer 18

Norovirus
Rotavirus (kids)

Diarrhoea, vomiting

Question 19

Campylobacter
Salmonella
Associations

Answer 19

Chicken milk

Chicken eggs meat

Question 20

Clostridium perfringens

Answer 20

Meat , pain and fever

Question 21

Types of EColi

Answer 21

Toxic - travellers, watery
Pathogenic - children
Haemolytic - HUS
Invasive - sim to shigella

Question 22

Diarrhoea vomiting + HYPOTENSION
Meat, preformed toxins
6 hour onset

Answer 22

Staph aureus