Diarrhoea

Question 1

medication commonly taken for immunosuppression following organ transplant

Answer 1

mycophenolate

Question 2

investigations for individual presenting with diarrhoea + signs of sepsis

Answer 2

• FBC, U+E, LFTs, lactate, CRP
• blood cultures
• urine analysis + cultures
• faecal sample for culture + micrcoscopy
• ABG
• ECG

Question 3

possible findings from faecal sample culture + microscopy for a patients presenting with diarrhoea

Answer 3

• ova
• cysts
• parasites
• c dificile toxin

Question 4

management of diarrhoea

Answer 4

• IV fluids
• oral rehydration salts
• IV hydrocortisone
• IV piperacillin/tazobactam w/metronidazole

Question 5

benefit of IV hydrocortisone for diarrhoea

Answer 5

dampens down immune system overactivity in the lining of bowel + rectum… calming inflammation

Question 6

benefit of IV piperacillin/tazobactam with metronidazole

Answer 6

to cover for translocation of gut pathogens during an episode of severe sepsis

Question 7

further investigations specifically for an immunocompromised patient with diarrhoea

Answer 7

• CMV infection status
• HIV status
• gastro referral for urgent flexible sigmoidoscopy

Question 8

test to rule out systemic fungal infections such as candidaemia

Answer 8

serum fungal antigen test = beta D glucan test (BDG)

Question 9

differentials for fever, sore throat, non itchy morbilliform rash + swollen neck glands

Answer 9

• glandular fever caused by EBV

- primary CMV infection

Question 10

incubation period for mononucleosis

Answer 10

4-6 weeks

Question 11

rash in chickenpox (primary varicella zoster infection)

Answer 11

• itchy
• vesicular
• involves: mouth + conjunctivae

Question 12

typical rash in HSV

Answer 12

• itchy + vesicular

- presents as severe gingivostomatitis

Question 13

investigations for presentation of:

- fever, sore throat, non itchy morbilliform rash + swollen neck glands

Answer 13

• fbc
• blood film
• U + E
• LFT
• CRP
• monotest for EBV
• CMV + EBV serology

Question 14

causes of bloody (+ non bloody) diarrhoea

Answer 14

• campylobacter sp
• shigella sp
• non typhi salmonella
• e coli
• clostridium difficile

Question 15

causes of viral diarrhoea

Answer 15

• rotavirus
• ## norovirus

Question 16

viral cause of diarrhoea in immunocompromised patient

Answer 16

CMV

can cause colitis which may present with abdo pain + diarrhoea

Question 17

parasitic causes of diarrhoea

Answer 17

Entamoeba histolytica –> amoebic colitis

Question 18

name 2 opportunistic pathogens

Answer 18

Pseudomonas aerugnosa

Candida albicans