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Gastrointestinal > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

epidemiology of gastroenteritis

A 
poor sanitation and hygiene 
travel 
contacts - human and animal 
food - time, storage, reheating, washing, importation 
acid suppression 
immunosuppression 
microbiome
genetics
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2
Q

risk factors for GI infection

A 
malnutrition 
closed/semi-closed communities 
exposure to contaminated food/water/travel 
winter congregating/summer floods
age<5, not breastfeeding 
elderly
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3
Q

pathogen infections common with acid suppression

A

Yersinia enterocolitica, Helicobacter pylori
Clostridium difficile
Vibrio cholera, non-typhoidal Salmonella, Campylobacter jejuni, Listeria, some E.coli

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4
Q

pathogen infections common with immunosuppression

A

Salmonella, Campylobacter, Shigella

Other organisms that are uncommon in immune competent

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5
Q

pathogen infections common with genetic differences

A

IL8 promoter variants and severe Clostridium difficile

O blood group and Vibrio cholerae

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6
Q

what is an inoculum

A

a substance introduced into the body to create or increase the body’s resistance or immunity to a disease
low infectious doses make spread of infection easier
pH affects the required dose

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7
Q

scoring system for diarrhoea

A

bristol stool chart

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8
Q

what is gastroenteritis

A

illness caused by eating food contaminated with micro-organisms such as bacteria, viruses and parasites
invasion tissue +/- toxin production
large volume tends tone small bowel

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9
Q

symptoms of gastroenteritis

A

diarrhoea associated with blood and mucus
fever
abdominal pain
rectal tenesmus

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10
Q

what is dysentery

A

a type of gastroenteritis - inflammation of intestine (especially colon)

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11
Q

what bacteria is dysentery caused by

A

shigella
campylobacter
Yersinia enterocolitica - may mimic appendicitis as it may invade mesenteric nodes

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12
Q

pathogens implicated in foreign travel causing gastroenteritis

A

E.Coli
Vibrio species
rotavirus

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13
Q

pathogens implicated in antibiotics causing gastroenteritis

A

C diff

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14
Q

pathogens implicated in day exposure causing gastroenteritis

A

rotavirus

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15
Q

pathogens implicated in anal sex causing gastroenteritis

A

shigella
salmonella
campylobacter

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16
Q

pathogens implicated in outbreaks causing gastroenteritis

A

norovirus

contaminated water/food - E.coli, salmonella, campylobacter

17
Q

describe bacillus cereus

A

gram positive bacillus
heat resistant spores
short incubation; 1-6 hours

18
Q

where Is bacillus cereus found

A

starchy foods - reheated rice

19
Q

describe staph aureus

A

gram positive coccus
performed toxin in food - rapid absorption
short incubation; 1-6 hours

20
Q

describe performed toxin of staph aureus

A

acts on vomiting centre in brain

vomiting/abdominal pain

21
Q

where is staph aureus found

A

foods left at room temperature - milk, meat, fish

22
Q

tests for gastroenteritis

A

stool sample
selection from normal bowel flora
enrichment for small number
genetic methods

23
Q

action of shigella toxin

A

binds to receptors four on renal cells, RBS and others

inhibits protein synthesis - causing cell death

24
Q

describe shigella toxin

A

type 1 and type 2 - 2 more potent

E.coli produces shiga-like toxins

25
Q

describe shiga-toxin producing E.coli

A

competes with normal bacterial bowel flora

26
Q

action of shiga-toxin producing E.coli

A

adheres to intestinal epithelial cells and elaborates shiga toxin
enters the cell, and irreversibly inhibit protein synthesis - resulting in death of enterocytes.

27
Q

entry of shiga-toxin into the bloodstream

A

via damaged intestinal epithelium

causes death of vascular endothelial cells by inhibiting protein synthesis

28
Q

endothelial cell lysis by shiga-toxin

A

accompanied by platelet activation and aggregation, cytokine secretion, vascular contraction contributing to fibrin deposition, and clot formation within capillary lumen.

29
Q

complications of gastroenteritis

A

haemolytic uraemic syndrome (HUS) - a complication of E.Coli

30
Q

how does HUS arise

A

associated primarily with serotypes that produce shiva toxin 2
may develop after diarrhoea has stopped

31
Q

symptoms of HUS

A 
abdominal pain
fever
pallor
petechiae
oliguria 
diarrhoea + blood
32
Q

signs of HUS

A 
high WBC
low platelets
low Hb
red cell fragments
LDH>1.5
33
Q

tests for HUS

A 
stool culture - blood faeces
U&amp;E
FBC
film
LFT
clotting 
urine 
lactase dehydrogenase
34
Q

treatment for HUS

A

no antibiotics
no anti-motility agents
no NSAIDS

35
Q

complications of HUS

A

acute renal failure
thrombocytopaenia
haemolytic anaemia

Gastrointestinal (71 decks)

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