Gastroenteritis

Question 1

most common cause travellers diarrhoea

Answer 1

E coli

Question 2

ix for norovirus and rotavirus

Answer 2

stool/vomit PCR

Question 3

ix for parasitic infection

Answer 3

stool microscopy +/- duodenal aspiration

Question 4

ix for c diff

Answer 4

stool PCR for toxin

Question 5

ix for bacterial gastroenteritis

Answer 5

C+S

Question 6

norovirus presentation

Answer 6

adults - diarrhoea

kids - vomiting

Question 7

hospital measures if norovirus

Answer 7

side room
infection control measures - droplet, person to person
cohort nursing

Question 8

most common cause of diarrhoea in kids < 3

Answer 8

rota virus

Question 9

who gets rotavirus

Answer 9

children < 5 and immunocompromised

Question 10

when to consider parasitic infection

Answer 10

> 7 days

Question 11

chronic diarrhoea in HIV

Answer 11

cryptosporidium

Question 12

ix for cryptosporidium

Answer 12

culture and duodenal aspirate

Question 13

tx cryptosporidium

Answer 13

rifamixin or nirazoxanide

Question 14

foul smelling explosive diarrhoea
malaborption
hx of travelling

Answer 14

giardiasis

Question 15

investigation for giardiasis

Answer 15

stool microscopy

Question 16

tx giardiasis

Answer 16

Tinidazole, Albendazole, Mebendazole or Metronidazole

Question 17

bloody diarrhoea +/- liver abscess

may last for several weeks

Answer 17

amoebiasis

Question 18

tx amoebiasis

Answer 18

metronidazole

Question 19

incubation of 1-6 hours

Answer 19

staph aureus and bascilus cerus

Question 20

presentation of salmonella enteritis

Answer 20

12-48 hours

N+V and bloody diarrhoea

Question 21

presentation of salmonella typhi

Answer 21

enteric fever - 12-48 hours
macular rash on chest and fever/rigors
tropical regions
rose spots
'pea soup' diarrhoea

Question 22

ix of salmonella typhi/enteric fever

Answer 22

blood cultures

Question 23

blood diarrhoea in E coli

Answer 23

HUS

Question 24

presentation of campylobacter

Answer 24

2-5 days incubation
pain + diarrhoea +/- blood
flu like prodrome

Question 25

tx of severe campylobacter

Answer 25

clarithromycin

Question 26

campylobacter is associated with what neuological presentation

Answer 26

gullian barre | reactive arthritis

Question 27

fever pain diarrhoea +/- blood | painful bowel movements

Answer 27

shigella | campylobacter?

Question 28

rice water stools / profuse watery diarrhoea | associated with foreign travel e.g. india

Answer 28

cholera

Question 29

what should you NOT give in Ecoli 0157 as they can precipitate HUS

Answer 29

antibiotics, nsaids, anti-motility agents

Question 30

haemolysis in HUS

Answer 30

intravascular

Question 31

what investigation do all patients with gastroenteritis and blood in stool get

Answer 31

stool culture

Question 32

presentation of HUS

Answer 32

``` abdo pain fever pallot oliguria petechiae ```

Question 33

name 2 notifiable gastroenteritis diseases

Answer 33

salmonella | ecoli 0157

Question 34

5 drugs associated with increased risk of Cdiff

Answer 34

``` PPI clindamycin co-amoxiclav cephalosporins - ceftriaxone quinoloes - ciprofloxacin ```

Question 35

presentation of c diff

Answer 35

high quantity of bloody foul smelling diarrhoea

Question 36

what would be seen on sigmoidoscopy of c diff

Answer 36

pseudomembranous colitis

Question 37

1st line treatment C diff

Answer 37

oral vanc 10 days

Question 38

2nd line treatment C diff

Answer 38

oral fidaxomicin

Question 39

3rd line treatment C diff or lifethreatening

Answer 39

oral vanc + IV met

Question 40

treatment C diff recurrent

Answer 40

fidaxomicin | if after 12 weeks of symptom resolution - oral vanc or fidaxomicin

Question 41

empirical treatment of intra-abdominal sepsis

Answer 41

IV amox met and gent | IV vanc met and gent if PS

Question 42

step down treatment of intra-abdominal sepsis

Answer 42

co-trim + met