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Year 3 Infection (JK) > Introduction to infection and diarrhoea > Flashcards

Introduction to infection and diarrhoea Flashcards

1
Q

2 diagnostic features for gastroenteritis

A

more than 3 loose stools a day

accompanying features

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2
Q

2 main causes of dysentery

A

shigella or entamoeba histolytica

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3
Q

Clinical features of dysentery

A

large bowel inflammation and bloody stools

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4
Q

Does gastroenteritis need a microbiological diagnosis?

A

No

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5
Q

What chart can you use to rate the consistencies of stools and what are the numbers in this?

A

Bristol stool chart

1-7

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6
Q

4 main epidemiologies of gastroenteritis

A

contaminated foodstuff
poor storage of produce
travel related infections
person to person spread

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7
Q

Why is salmonella rare in UK?

A

vaccinate hens

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8
Q

Commonest bacterial pathogen in gastroenteritis

A

campylobacter

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9
Q

Commonest pathogen of gastroenteritis?

A

viral

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10
Q

Most common pathogen for food poisoning

A

campylobacter

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11
Q

Pathogen causing most hospital admissions in food poisoning

A

salmonella

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12
Q

Commonest source of food poisoning

A

poultry meat - undercooked

spike in summer with BBQ

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13
Q

4 main defences against enteric infections

A

hygiene
stomach acid
normal flora
immunity

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14
Q

Type of salmonella in HIV

A

invasive non typhoidal

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15
Q

3 categories of diarrhoeal illness

A

non inflammatory/secretory
inflammatory
mixed picture

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16
Q

Example of secretory diarrhoea

A

cholera

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17
Q

Example of inflammatory diarrhoea

A

shigella dysentery

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18
Q

Example of mixed picture diarrhoea

A

C. diff

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19
Q

Effects of secretory toxin

A

increase cAMP and chloride, sodium, potassium and water loss

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20
Q

Travellers diarrhoea cause

A

enterotoxigenic E.coli

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21
Q

Clinical features of secretory diarrhoea

A

frequent watery stool

little abdominal pain

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22
Q

treating secretory diarrhoea

A

rehydration

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23
Q

Pathogenesis of inflammatory diarrhoea

A

inflammatory toxin damage

mucosal destruction

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24
Q

Clinical features of inflammatory diarrhoea

A

pain and fever

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25
Q

2 main pathogens of inflammatory diarrhoea

A

bacterial

amoebic dysentery - parasite

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26
Q

Treating inflammatory diarrhoea

A

antimicrobials may be appropriate

mainstay treatment still rehydration

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27
Q

Duration of diarrhoea - when is it unlikely to be infective gastroenteritis ?

A

longer than 2 weeks

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28
Q

3 ways to assess hydration

A

postural bp
skin turgor
pulse

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29
Q

3 main risks in history for food poisoning

A

dietary
travel
contact

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30
Q

SIRS features of inflammation

A

fever, raised WCC, increase RR, increase HR

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31
Q

Assessing a child for dehydration

A 
sunken eyes and cheeks 
dry tongue and mouth 
sunken fontanelles 
decreased skin turgor 
few or no tears
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32
Q

What type of diarrhoea is fluid and electrolyte loss severe?

A

secretory

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33
Q

In secretory diarrhoea why is the patient hypokalaemic and hyponatraemic?

A

replace salt with hypotonic solution

lose potassium in stool

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34
Q

5 main investigations in infective gastroenteritis

A 
3 stool cultures 
blood culture 
renal function 
blood count - haemolysis and neutrophilia 
abdominal X-ray if distended
35
Q

3 differential diagnoses for diarrhoea

A

IBD
carcinoma
spurious - secondary to constipation

36
Q

2 clues the diarrhoea and fever is occurring with sepsis outwith the gut?

A

lack of abdominal pain/tenderness

no blood or mucus In stools

37
Q

Treating gastroenteritis main treatment and how this can be done

A

rehydration - oral or IV?
ORHT? - salt and sugar solution
iv saline

38
Q

incubation of campylobacter

A

up to 7 days

39
Q

When are stools negative in campylobacter?

A

6 weeks

40
Q

2 post infective sequalae of campylobacter gastroenteritis

A

Guillian barre syndrome

reactive arthritis

41
Q

How to do a routine bacterial culture

A

variety of media and incubation conditions

takes 3 days

42
Q

Is campylobacter associated with sporadic or outbreaks?

A

sporadic

43
Q

Time of symptom onset of salmonella gastroenteritis

A

48 hours or more

44
Q

What percent of people still have positive stools for salmonella after 20 weeks?

A

20%

45
Q

association with chronic salmonella gastroenteritis?

A

gallstones

46
Q

What is a common post infectious condition after slamonella gastroenteritis?

A

IBS

47
Q

What is the basis of how salmonella is cultured?

A

lactose non fermenter

48
Q

Tests following the lactose non fermenter tests of salmonella

A

antigen and biochemical tests

49
Q

What species are most salmonella genetically serotypes of?

A

salmonella enterica

50
Q

How are salmonella strains named?

A

after place of isolation

51
Q

2 commonest salmonella isolates in UK

A

enteritidis

typhimurium

52
Q

What do salmonella typhi and paratyphi cause and not cause?

A

cause paratyphoid and typhoid fever

do not cause gastroenteritis

53
Q

How is Ecoli O157 spread?

A

contaminated meat

low inoculum person to person spread

54
Q

What toxin does Ecoli produce?

A

(verocyto)toxin

55
Q

Clinical symptom of Ecoli O157

A

frequent bloody stool

56
Q

Does Ecoli O157 or the toxin get into the blood?

A

toxin

57
Q

What can Ecoli O157 toxin cause?

A

Haemolytic uraemic syndrome

58
Q

3 ways HUS is characterised

A

renal failure
haemolytic anaemia
thrombocytopenia

59
Q

Thrombocytopenia

A

low platelet count

60
Q

Treatment of Ecoli O157

A

supportive - not antibiotics

61
Q

Where has there been outbreaks of shigella sonnei?

A

nurseries

62
Q

What Ecoli strain is the only one easily distinguishable?

A

Ecoli O157

63
Q

3 pathogens of food poisoning outbreaks

A

staph aureus
bacillus cereus
clostridium perfingens

64
Q

5 occasions when antibiotics are used in gastroenteritis

A 
immunocompromised 
severe sepsis or invasive infection 
valvular heart disease 
chronic illness 
diabetes
65
Q

The 4 C antibiotics in c diff

A

ciprofloxacin
co-amoxiclav
cephalosporin
clindamycin

66
Q

Range of severity of c diff

A

mild diarrhoea –> pseudomembranous colitis

67
Q

What 2 toxins does c diff make and which drives inflammation?

A

enterotoxin - A

cytotoxin - B - inflammation

68
Q

5 treatments of c diff

A 
metronidazole 
oral Vancomycin 
fidaxomicin
stool transplants 
surgery? - also stop precipitating antibiotics
69
Q

4 ways to prevent c diff infection

A

reduce use of broad spectrum antibiotics
avoid 4C antibiotics
antimicrobial management team and local policy
hand washing

70
Q

2 parasites

A

protozoa

helminths

71
Q

How are parasite infections diagnosed?

A

microscopy - parasites, cysts, ova

72
Q

Vegetative form and cyst form of giardia lamlia found how?

A

duodenal biopsy
string test
Stool microscopy for cysts

73
Q

Treatment of giardia lamlia

A

metronidazole

74
Q

Where are most UK parasites found?

A

contaminated water

75
Q

What does entamoeba histolytica cause?

A

amoebic dysentery

76
Q

What is found in a symptomatic and asymptomatic patient with amoebic dysentery

A

symptomatic - vegetative form - hot stool

asymptomatic - cysts

77
Q

Long term complication of amoebic dysentery

A

amoebic liver abscess - Anchovy pus

78
Q

Treatment of amoebic dysentery

A

metronidazole

79
Q

Viral diarrhoea in children under 5 pathogen

A

rotavirus

80
Q

How is viral diarrhoea diagnosed?

A

antigen detection

81
Q

What vaccine for viral diarrhoea is available?

A

rotavirus

82
Q

Norovirus is a common cause of what? where is it found?

A

oubreaks of winter vomiting disease

cruise ships, hospital, community

83
Q

Diagnoses of norovirus

A

PCR

84
Q

Is norovirus infectious?

A

yes very only need 18 particles
often close wards
strict infection control

Year 3 Infection (JK) (12 decks)

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