23 Gastroenteritis Flashcards

1
Q

What are the presenting complaints of gastroenteritis?

Complications?

A

Acute onset V+D with mucous + blood. Abdo pain, fever.

Dehydration, toxic megacolon, renal failure, GBS, HUS, Salmonella.

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2
Q

What are the investigation for gastroenteritis?

A

Bloods: FBC, U&E, CRP, culture.
AXR if severe.
Stool MC&S, OCP, C.diff toxin, viral PCR.

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3
Q

What is the most common cause of viral gastroenteritis?

Disease course? Management?

A

Norovirus.
Projectile vomiting.
24-48hrs. Prevent dehydration.

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4
Q

Which organisms cause parasitic gastroenteritis?

A

Cryptosporidium
Guardia lambia.
Entamoeba histolyca.

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5
Q

How is cryptosporidiosis spread?

A

Waterborne disease, oocytes are resistant to chlorine based disinfectants.

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6
Q

Which bacterial gastroenteritis’ are caused by enterotoxin production? (6)

A
Vibrio cholerae.
Escherichia coli (ETEC  + VTEC).
Clostridium perfringens.
Staph aureus.
Bacillus cereus.
C. diff.
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7
Q

Which bacterial gastroenteritis’ are caused by adherence of the organism? (4)

A

Shigella sonnei/flexneri.
E. coli (EAEC).
Campylobacter jejuni.
Salmonellae.

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8
Q

Which strains of E.coli result in HUS?

How?

A

Enterohaemorrhagic.
EHEC/VTEC.
e.g. E.coli O157 - shiga toxin virulence factor- premature destruction of RBCs, detritus blocks kidneys.

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9
Q

How is gastroenteritis treated?

A

Supportive - avoid antibiotics as may increase salmonella carriage duration and worsen HUS.
Except in young, very old, campylobacter infection of sepsis.

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10
Q

What is antibiotic associated diarrhoea?

A

2-30% patients after antibiotics.

Disruption of microflora, change in metabolism and overgrowth of pathogenic organisms.

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11
Q

Which organisms are responsible for antibiotic associated diarrhoea?

A

C. diff.

C.perfrinfens, S.aureas, Candida, Klebsiella, Salmonella.

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12
Q

Which antibiotics are high risk for C.diff infection?

A

Cephalosporins.

Clindamycin.

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13
Q

Which antibiotics are medium risk for C.diff infection?

A

Ampicillin/amoxycillin.
Co-trimoxazole.
Macrolides.
Fluoroquinolones (O217 completely unaffected by these).

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14
Q

What is the therapy for C. diff infection?

A

Oral metronidazole/vancomycin until resolution of diarrhoea.
Risk factor for VRE selection.
New: Oral fidaxomicin.

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