Diarrhoea

Question 1

What is the most Common cause of Travellers Diarrhoea

Answer 1

E. Coli (ETEC)

Incubation 1-6hrs

Question 2

What is the Incubation time of E.coli 0157

Answer 2

12-72 hours

Question 3

What is the presentation of E.coli 0157

Answer 3

Bloody Diarrhoea

Question 4

Complications of E.coli 0157

Answer 4

Dysentry

HUS

Question 5

Treatment of 0157

Answer 5

Cipro

May require dialysis if kidney failure

Question 6

Dx of 0157

Answer 6

Stool MC+S

Question 7

What is a common cause of 0157

Answer 7

under-cooked beef - commonly burgers.

Question 8

What organism may infect you if you eat reheated rice

Answer 8

Bacillus cereus

Incubation 1 - 6 Hours

Watery D/V

Question 9

How do you obtain a Campylobacter Organism

Answer 9

Unpasteurised milk and animal faeces.

Question 10

What is the Incubation period of campylobacter

Answer 10

2-5 days

Question 11

Presentation and complications of Campylobacter

Answer 11

Bloody diarrhoea
Fever

Complications - Guillane barre, Reactive arthritis

Question 12

Dx of Campylobacter

Answer 12

Stool MC + S

Question 13

Rx of Campylobacter

Answer 13

Cipro

Question 14

Incubation of Shigella Toxin

Answer 14

1-7 days

Question 15

presentation of shigella toxin

Answer 15

Bloody Diarrhoea, Fever, Pain

Reactive Arthritis

Question 16

Dx of Shigella toxin

Answer 16

Stool MC+S

Question 17

Rx of Shigella Toxin

Answer 17

Cipro

Question 18

What is the most common Hospital Acquired Diarrhoea

Answer 18

C. Difficile

Incubation 1-7 days

Question 19

Presentation of C. Diff

Answer 19

Blood Diarrhoea with Abdo pain and fever

Very foul smellin

Question 20

Complications of C. Diff

Answer 20

Toxin Mega Colon
Pseudomembranous colitis
GI perf

Question 21

Dx of C. Diff

Answer 21

Stool MC+S

CDT ELISA

Question 22

Rx of C. Diff

Answer 22

Stop Causative Antibiotic: Co-amox, Cipro, Clinda, Ceph

Give Vanc + Metronidazole

Question 23

Spread of Vibrio Cholerae

Answer 23

F/O route - Dirty water - Incubation is hours - 5 days

Question 24

Presentation of Cholera

Answer 24

Rice water stools

may lead to shock, acidosis and renal failure

Question 25

Dx of cholera

Answer 25

MS+C

Question 26

Rx of cholera

Answer 26

REHYDRATE - Hartmans + potassium; Rice powder solution; Zn Supps Cipro

Question 27

Most common cause of diarrhoea in children

Answer 27

Rota virus

Question 28

Most common cause of diarrhoea in adults

Answer 28

Norovirus

Question 29

How is Salmonella transmitted

Answer 29

Via infected poultry or eggs - less and less common as hens are now vaccinated in the UK

Question 30

Presentation fo salmonella

Answer 30

Fever, D/V and abdo pain

Question 31

Incubation of Salmonella

Answer 31

12 - 48 hours

Question 32

Rx of Salmonella

Answer 32

Cipro or Ceftriaxone

Question 33

Features and mechanism of secretory Diarrhoea (Cholera, E. coli, Staph a.)

Answer 33

bacteria found only in lumen --> no fever/faecal leukocytes Bacteria increases cAMP --> opening of CFTR channals --> movement of Cl followed by other ions --> finally water follows --> secretory Shits

Question 34

Features of Inflammatory Diarrhoea

Answer 34

Bacteria infiltrate lamina propria --> activate innate immunity --> fever and PMN in stool Shigella, non-typhoid salmonella, Campylobacter.

Question 35

Features of Enteric Fever

Answer 35

Abdo pain, Fever, mononuclear cells in stool Typhoid.