Week 9 - GI Disease 2 Flashcards
What are the most common causes of acute gastroenteritis?
50% Norovirus
20% Campylobacter
Rest - Salmonella, Shigella, C.Diff
What is likely cause of diarrhoea with blood?
Shigella
Campylobacter
Enterovirus
Ecoli 0157
What is the likely cause of diarrhoea with crampy abdo pain?
Campylobacter
Diarrhoea + systemic features (fever, headache, myalgia)?
Shigella
How long does it take for acute gastroenteritis to resolve?
24-96 hours
What investigations should you do for gastroenteritis?
Usually resolves before investigations warranted
Can do Stool MC&S, AXR (exclude toxic megacolon)
If >2w - colonoscopy / flexi sig to exclude IBD
How can you manage Ps with acute gastroenteritis?
Encourage oral fluids
IV fluids
Anti-emetics
Poss empirical Abx
Why should you not give anti diarrhoea meds in Ps with acute gastroenteritis?
Is the body’s way of trying to get rid of infection - preventing that with anti-diarrhoeals may prolong the infection
What can you give for Campylobacter infection?
If >1w or deteriorating / pregnancy / IC - give Ciprofloxacin
What syndrome can you sometimes get after a campylobacter infection?
Guillain-Barre
Very rare and serious condition that affects the nerves.
It mainly affects the feet, hands and limbs, causing problems such as numbness, weakness and pain. Immune system has gone haywire and started attacking the nerves.
The main treatments are:
intravenous immunoglobulin (IVIG) – a treatment made from donated blood that helps bring your immune system under control
plasma exchange (plasmapheresis) – an alternative to IVIG where a machine is used to filter your blood to remove the harmful substances that are attacking your nerves
treatments to reduce symptoms such as painkillers
treatments to support body functions, such as a machine to help with breathing and/or a feeding tube
Most people need to stay in hospital for a few weeks to a few months.
Can you give Abx for shigella?
Only if Shigella shigae or shigella dysenteriae
Which bacterial infection can mimic Crohn’s?
Yersinia enterocolitica - Ps present with acute onset diarrhoea, and a scan suggests some thickening of the terminal ileum - think Crohns but culture to make sure not Yersinia.
Which bacterial infection can cause hemorrhagic colitis and HUS?
Ecoli 0157
What type of bacteria is C Diff?
Gram positive, spore-forming, anaerobic bacillus
What is a potential SE of C Diff infection?
Pseudomembranous colitis
What treatment is given for C Diff?
Metronidazole
Vancomycin
Fidaxomicin
What is the commonest non-bacterial cause of V&D?
Norovirus
What is the treatment for norovirus?
Supportive - fluids, anti-emetics, anti-diarrhoeals
Where can TB cause GI problems?
Ileocaecal
Peritoneum = peritonitis
Exudative ascites with lymphocytosis
Positive for acid fast bacilli
Raised adenosine deaminase
With imaging showing bowel wall thickening can suggest what?
How would you treat?
TB
Rx - as for pulmonary TB
Which bacteria are acid fast bacilli?
Mycobacteria - most common = TB and leprosy
How can you get amoebiasis?
Usually ingestion of faecally contaminated food or water
What infection can present similarly to UC with proctocolitis and rarely can cause toxic megacolon?
Amoebic dysentery
Which amoeba causes amoebic dysentry?
How is this diagnosed?
Entamoeba histolytica
Diagnosed via ELISA with stool sample or serology
How is dysentry treated?
Metronidazole
Abscess drainage if needed
Which parasite can cause small bowel malabsorption?
Giardia
Which parasite can cause amoebic dysentery and liver abscesses?
Entamoeba histolytica
Which parasite can cause IDA?
Hookworm
Which parasite can cause hydatic cysts?
Tapeworm - hydatid disease - linked to sheep - get flukes that cause cysts in liver and other organs 🤮