What is diarrhoea?
What is unformed stool?
Stool which holds the shape of the container it is in (liquid)
What can be found in unformed stool (re: diarrhoea) which is a red flag?
Which class of drug can cause diarrhoea?
What is food poisoning?
Illness caused by eating food contaminated with
Which GI symptoms are associated with food poisoning?
Nausea & Vomiting
Diarrhoea (vanilla, watery or bloody)
Which types of microorganism can cause food poisoning?
Food poisoning - related microorganisms invade the tissue of the GI tract. What else can they do to produce disease?
What microorganisms have a short incubation period of 1-6 hours?
Microorganisms involved in short onset food poisoning (1-6 hours) don't have time to multiply profusely. Why do they cause disease?
Pre-formed toxins in the food already
What food is Bacillus cereus associated with?
Starchy food which is poorly reheated
Food poisoning presenting rapidly (1-6 hours) are caused by which bacteria?
Which poisoning is caused by pre-formed toxins found in poorly stored fish, e.g tinned tuna?
What sort of reaction do you get?
Allergic reaction (rash, headache, shock)
Produces toxin which causes histamine response
Toxins cause an outpouring of ___ into the bowel lumen, causing diarrhoea.
Which microorganisms have a medium incubation period (12-48 hours)?
Which bacteria have a long incubation period?
E. coli 0157
What are the commonest causes of GI infection?
Which bacteria causes outbreaks of food poisoning?
Which bacteria causes outbreaks of food poisoning with morbidity?
GI tract infections are common in ___ patients.
What do bacteria need to multiply?
Why can Bacillus cereus survive in adverse conditions?
What is the most common bacteria involved in food poisoning?
What is gastroenteritis?
Infectious inflammation of GI tract
What needs to be included in a stool sample for it to be tested for the right bacteria?
Bristol stool rank
All stool samples are tested for which bacteria?
___ media allow specific pathogens to be grown on an agar plate.
How long does it take for Campylobacter to incubate?
Which foods are likely to cause Campylobacter infection?
Raw cheese, milk products
Antibiotics aren't commonly prescribed to those with Campylobacter infection. Why?
Which antibiotic would be given to select patients?
Self limiting, only given to severely immunosuppressed
Macrolides so clarithromycin
Which Campylobacter species is the one most commonly found in gastroenteritis?
Which infection commonly occurs in outbreaks and can lead to bacteriaemia?
Which foods can lead to Salmonella infection?
Which symptom is characteristic of infectious gastroenteritis?
Which species of Salmonella causes gastroenteritis?
Salmonella associated with gastroenteritis is (typhoidal / non-typhoidal).
Which antigen is found on the LPS of Salmonella?
Different types of Salmonella are classified on the type of ___ found on their cell membranes.
O antigen specifically
E. coli also have ___ antigens.
Which specific type of E. coli is commonly associated with gastroenteritis?
O157 E. coli
E. coli release cytotoxins.
What are these?
Toxic / destructive effect on cells
What is the result of cytotoxins released by E. coli and Shigella?
Why are cytotoxins also called Shiga-like toxins?
E. coli and Shigella produce similar toxins
Why does E. coli / Shigella infection have poor outcomes in older, younger and pregnant people?
Complication is haemolytic ureamic syndrome which is also very bad
Why aren't antibiotics given to people with gastroenteritis?
Antibiotics aren't effective against E. coli 0157 and allow them to proliferate (reduced competition)
So increased production of Shiga-like toxin
So increased damage and risk of complications (HUS)
So poorer patient outcome
What is the main symptom of O157 E. coli infection?
How much E. coli needs to invade you to cause infection?
Which is E. coli associated with mortality?
i.e bleeding in the colon, rectum
Which other system is damaged by E. coli infection?
Cytotoxin binds to and kills these cells as well
What is HUS?
Haemolytic ureamic syndrome
a renal complication of E. coli 0157 gastroenteritis.
How does HUS present?
Yet more bloody diarrhoea
Who needs to be notified about HUS / E. coli infection?
Health Protection Unit
Is all diarrhoea caused by infection?
What are two viruses which cause gastroenteritis?
Which virus, causing gastroenteritis, is common in children?
Which virus is also known as the "winter vomiting bug" and causes explosive diarrhoea and vomiting?