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Flashcards in diarrhoeal diseases PH Deck (45):
1

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)

2

what is the bristol stool chart?

groups stools into seven types from type 1 to type 7

3

what is type 7 stool?

watery, no solid pieces, entirely liquid

4

what is type 1 stool?

separate hard lumps like nuts that are hard to pass

5

what type of stool is like a sausage or snake and is smooth and soft?

type 4

6

what are the non-infective causes of diarrhoea?

neoplasm
hormonal
inflammatory
radiation
irritable bowel
chemical
anatomical

7

give an example of an anatomical cause of diarrhoea?

short gut syndrome either from birth or due to surgery eg for mesenteric ischaemia

8

what are the hormones that can cause diarrhoea?

adrenaline
serotonin
thyroxine

9

why does radiation cause diarrhoea?

due to the inflammation of the bowel caused by the radiation

10

how can the infective causes of diarrhoea be classified?

bloody (dysentery)
non-bloody

11

what could be a reservoir of infection?

environment, human, animal

12

what are the 3 broad types of transmission of infection?

direct
indirect
airborne

13

what are the methods of transmission within the direct group?

direct contact eg for STIs
faeco-oral route

14

what are the methods of transmission within indirect transmission?

vehicle borne - ie needle or transfusion products
vector borne - eg malaria and Dengue fever

15

is legionella and airborne disease and can it be passed from human to human?

yes airborne
no - can't be passed from human to human

16

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
E. coli
Enteric fever (Salmonella typhi and paratyphi)
Cholera
viral gastroenteritis eg norovirus and rotavirus
Campylobacter
Entamoeba histolytica
Cryptosporidium hominis

17

which pathogen is common in nurseries?

rotavirus

18

which pathogens cause illness from petting zoos?

Campylobacter
Salmonella
E. coli O157

19

what bacterium is responsible for HUS

E. coli O157

20

What can the E. coli O157 toxin lead to?

acute kidney failure
liver dysfunction
haemolysis of blood cells
bloody diarrhoea
HUS

21

what pathogen is common in care homes?

norovirus

22

give the symptoms of norovirus

vomiting
diarrhoea
nausea
cramps
headache
fever
chills
myalgia

23

how long do the symptoms in norovirus last?

1-3 days

24

where is norovirus found?

• Hospitals
• Care Homes
• Schools
• Cruise ships
• Families

25

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

26

is food poisoning a notifiable disease?

yes - as this means that the source could be found and the infection and spread controlled

27

an elderly pt who has diarrhoea while recovering from surgery is likely to have what pathogen?

C. diff

28

what can low volume bloody stools be caused by?

Shigella

29

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

30

what causes psudomembranous colitis in C. diff infection?

the C. diff toxin

31

how is C. diff spread?

faeco-oral route
spores in the environment

32

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

33

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

34

how is C. diff infection investigated?

test stool samples
culture stool samples to identify the strain
biopsies taken at sigmoidoscopy

35

Do you need to treat asymptomatic carriers of C. diff?

no

36

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

37

what is the second largest killer of children worldwide?

diarrhoea!

38

what is the first largest killer of children world-wide?

resp tract infections

39

what is the number 1 treatment for diarrhoea in developing countries?

rehydration

40

Which parts of the world have a high infant mortality for diarrhoeal diseases?

south asia
africa

41

Give examples of causative organisms for diarrhoea in children

E. coli
Shigella
Campylobacter
Salmonella
Cryptosporidium
Rotavirus

42

How are diarrhoeal diseases prevented as part of the global WHO-UNICEF prevention package?

vaccinations
breastfeeding
vitamin A supplementation
promote hand washing with soap
improved water supply quantity and quality
sanitation promotion in communities

43

How are diarrhoeal diseases treated as part of the global WHO-UNICEF treatment package?

Fluid Replacement to prevent dehydration
Zinc treatment

44

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
- Vaccination

45

who are the 4 at risk groups fro diarrhoea?

A – Persons of doubtful personal hygiene or with
unsatisfactory hygiene facilities at home, work or
school
B – Children who attend pre school or nursery
C – People whose work involves preparing or serving
unwrapped/uncooked food
D – HCW/Social care staff working with vulnerable
people