Flashcards in diarrhoeal diseases PH Deck (45):
what is the definition of diarrhoea?
3 or more watery stools a day (but remember need to take into account what is the normal for the pt as well)
what is the bristol stool chart?
groups stools into seven types from type 1 to type 7
what is type 7 stool?
watery, no solid pieces, entirely liquid
what is type 1 stool?
separate hard lumps like nuts that are hard to pass
what type of stool is like a sausage or snake and is smooth and soft?
what are the non-infective causes of diarrhoea?
give an example of an anatomical cause of diarrhoea?
short gut syndrome either from birth or due to surgery eg for mesenteric ischaemia
what are the hormones that can cause diarrhoea?
why does radiation cause diarrhoea?
due to the inflammation of the bowel caused by the radiation
how can the infective causes of diarrhoea be classified?
what could be a reservoir of infection?
environment, human, animal
what are the 3 broad types of transmission of infection?
what are the methods of transmission within the direct group?
direct contact eg for STIs
what are the methods of transmission within indirect transmission?
vehicle borne - ie needle or transfusion products
vector borne - eg malaria and Dengue fever
is legionella and airborne disease and can it be passed from human to human?
no - can't be passed from human to human
what organisms could be causing frequent diarrhoea, flatulence, nausea and abdominal discomfort in a student returning from a backpacking holiday in south asia?
giardia - protozoa
Enteric fever (Salmonella typhi and paratyphi)
viral gastroenteritis eg norovirus and rotavirus
which pathogen is common in nurseries?
which pathogens cause illness from petting zoos?
E. coli O157
what bacterium is responsible for HUS
E. coli O157
What can the E. coli O157 toxin lead to?
acute kidney failure
haemolysis of blood cells
what pathogen is common in care homes?
give the symptoms of norovirus
how long do the symptoms in norovirus last?
where is norovirus found?
• Care Homes
• Cruise ships
what should you tell a food handler who has diarrhoea?
keep out of work for days, they need to come back to the doctor to assess their fitness to practice before going back to work
is food poisoning a notifiable disease?
yes - as this means that the source could be found and the infection and spread controlled
an elderly pt who has diarrhoea while recovering from surgery is likely to have what pathogen?
what can low volume bloody stools be caused by?
what are the characteristics of the bacterium C. diff?
produces spores - which are difficult to eradicate
people can carry C. diff
C. diff is an environmental pathogen eg found in soil
what causes psudomembranous colitis in C. diff infection?
the C. diff toxin
how is C. diff spread?
spores in the environment
what does the acronym SIGHT stand for?
Suspect C diff as a cause of diarrhoea
Isolate the case
Gloves and aprons must be worn
Hand washing with soap and water
Test stool for toxin - request this on the form as this test is not routinely done
How is C. diff managed?
infection control procedures
control antibiotic use especially the broad spectrum ones such as ampicillin, amoxicillin and cephalosporins
surveillance and case finding
any pt with diarrhoea should be isolated, enteric precautions taken, stool samples tested, environmental cleaning and treat C.diff with metronidazole or vancomycin
how is C. diff infection investigated?
test stool samples
culture stool samples to identify the strain
biopsies taken at sigmoidoscopy
Do you need to treat asymptomatic carriers of C. diff?
what may be causing altered bowel motions, increased frequency and mucous and symptoms for 6 months, weight loss and night sweats?
bowel cancer, most likely to be colorectal cancer
what is the second largest killer of children worldwide?
what is the first largest killer of children world-wide?
resp tract infections
what is the number 1 treatment for diarrhoea in developing countries?
Which parts of the world have a high infant mortality for diarrhoeal diseases?
Give examples of causative organisms for diarrhoea in children
How are diarrhoeal diseases prevented as part of the global WHO-UNICEF prevention package?
vitamin A supplementation
promote hand washing with soap
improved water supply quantity and quality
sanitation promotion in communities
How are diarrhoeal diseases treated as part of the global WHO-UNICEF treatment package?
Fluid Replacement to prevent dehydration
what are some control measures that can be taken to prevent spread of diarrhoea?
- Hand-washing with soap
- Ensure availability of safe drinking water
- Safe disposal of human waste
- Breastfeeding of infants & young children
- Safe handling and processing of food
- Control of flies/vectors
- Case management including exclusion