23 - Gastroenteritis

Question 1

Gastroenteritis - PC

Answer 1

acute onset
Vomiting
Diarrhoea
Abdominal pain
Systemic effects - fever

Question 2

Gastroenteritis - complications

Answer 2

Dehydration
Renal failure
HUS
Toxic Megacolon
GBS - guillian-barre syndrome
Salmonella

Question 3

Gastroenteritis - investigations

Answer 3

Bloods - FBC, U&E, CRP, blood cultures
AXR - if severe
Stool

Question 4

Viral Gastroenteritis - norovirus

Answer 4

Norwalk-like virus

SRSV (small round structured virus)

Question 5

Gastroenteritis - aerosols

Answer 5

Projectile vomiting + diarrhoea
Lasts 24-48 hours
Letting illness take its course + drink lots of water

Question 6

Parasitic Gastroenteritis - names of causative agents

Answer 6

Cryptosporidium
Giardia
Entamoeba

Question 7

Cryptosporidium infection

Answer 7

Waterbourne disease - pools, drinking water, animals

Oocyst resistance to chlorine disinfectants

Question 8

EHEC/VTEC

Answer 8

Enterohaemorrhagic

Colitis/HUS

Question 9

ETEC

Answer 9

Enterotoxigenic

Traveller’s diarrhoea

Question 10

EAggEC

Answer 10

Enteroaggregative

Travellers’ diarrhoea

Question 11

EIEC

Answer 11

Enteroinvasive dysentery like

Question 12

EPEC

Answer 12

Enteropathogenic

Childhood diarrhoea

Question 13

E.Coli facts

Answer 13

Shiga toxin virulence factor
Cattle major source
10-15% develop haemolytic uraemic syndrome (HUS)

Question 14

Gastroenteritis - treatments

Answer 14

Avoid antibiotics except in young and very old. Campylobacter - prolonged or severe symptoms

Question 15

Antibiotics and high risk of CDI

Answer 15

Cephalosporins

Clindamycin

Question 16

CDI therapy

Answer 16

Relapse in >20% of patients
3-5 days until resolution of diarrhoea
Both affect gut flora
Vancomycin and metronidazole use is a risk factor
Potential for emergence of resistance to vancomycin / metronidazole in C diff