Gastroenteritis

Question 1

What is gastroenteritis?

Answer 1

Acute inflammation of the lining of the GI tract, manifested by N+V, diarrhoea + abdominal discomfort.

Question 2

Give 3 epidemiological facts about gastroenteritis

Answer 2

COMMON
20% UK develop yearly
Serious cause of morbidity + mortality in developing world

Question 3

What are 4 causes of gastroenteritis?

Answer 3

Viruses
Bacteria
Protozoa
Toxins in contaminated food or water (faecal-oral route)

Question 4

List 3 viral causes of gastroenteritis

Answer 4

Rotavirus
Adenovirus
Norovirus

Question 5

List 4 bacterial causes of gastroenteritis

Answer 5

Campylobacter jejuni
Escherichia coli (esp. O157)
Salmonella
Shigella

Question 6

List 3 protazoal causes of gastroenteritis

Answer 6

Entamoeba histolytica
Cryptosporidium parvum
Giardia lamblia

Question 7

List 3 sources of toxins that may cause gastroenteritis

Answer 7

Staphylococcus aureus
Clostridium perfringens
Bacillus cereus

Question 8

List 3 commonly contaminated foods that may cause gastroenteritis

Answer 8

Improperly cooked meat
Old/ reheated rice
Eggs + poultry

Question 9

List 3 risk factors for gastroenteritis

Answer 9

Poor personal hygiene + lack of sanitation
Immunosuppression
Achlorhydria

Question 10

List 4 symptoms of gastroenteritis

Answer 10

N+V
DIARRHOEA (bloody or watery)
Abdominal pain/ discomfort
Fever + malaise

Question 11

List 3 signs of gastroenteritis on examination

Answer 11

Diffuse abdominal tenderness
Abdominal distension
Bowel sounds are often INCREASED

Question 12

What should you ask the patient about in suspected gastroenteritis?

Answer 12

Recent travel
Abx use
Recent food intake (how food was cooked, sourced + if anyone else is ill)

Question 13

What is the difference in onset of symptoms between types of gastroenteritis?

Answer 13

Toxins = early (1-24 hours)

Bacterial/ viral/ protozoal = 12+ hours

Question 14

List 4 signs seen in In SEVERE gastroenteritis

Answer 14

Pyrexia
Dehydration
Hypotension
Peripheral shutdown

Question 15

What are the bloods tested in suspected gastroenteritis?

Answer 15

FBC
Blood culture (identify bacteraemia)
U+Es (dehydration)

Question 16

Why is a stool sample taken in suspected gastroenteritis?

Answer 16

Faecal microscopy + analysis for toxins (e.g. C. difficile toxin)

Question 17

Why is an AXR or US performed in suspected gastroenteritis?

Answer 17

To exclude other causes of abdominal pain (e.g. bowel perforation)

Question 18

When is a sigmoidoscopy performed in suspected gastroenteritis?

Answer 18

If IBD needs to be excluded

Question 19

What does management of gastroenteritis involve?

Answer 19

Most cases are self-limiting
Bed rest
Fluid + electrolyte replacement with oral rehydration solution (glucose + salt)
IV rehydration in those with severe vomiting

Question 20

When are antibiotics indicated in gastroenteritis?

Answer 20

If case is due to a known bacterial or protozoal cause

Question 21

List 6 complications of gastroenteritis

Answer 21

Dehydration  
Electrolyte imbalance  
Reactive complications e.g. arthritis
Secondary lactose intolerance 
Haemolytic uraemic syndrome
Guillain-Barre Syndrome after CMV

Question 22

Describe the prognosis of gastroenteritis

Answer 22

Good prognosis as most cases are self-limiting