Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 - CCC & PC > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

1
Q

What is gastroenteritis?

How is it different from gastritis and enteritis?

A

Gastritis:

  • inflammation of the stomach that presents with N&V

Enteritis:

  • inflammation of the intestines that presents with diarrhoea

Gastroenteritis:

  • inflammation of the stomach + intestines that presents with N&V + diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common cause of gastroenteritis?

What must be done if you suspect someone has this?

A
  • it is most commonly viral
  • most patients have an affected family member / contact as it is highly contagious
  • the patient must be isolated to prevent spread to others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the potential causes of viral gastroenteritis?

A
  • rotavirus
  • norovirus
  • adenovirus

adenovirus is less common and presents with a more subacute diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of E. coli is associated with gastroenteritis and how is it spread?

A
  • E. coli is a normal intestinal bacteria
  • only certain strains produce gastroenteritis (E. coli 0157)
  • it is spread through contact with infected faeces, unwashed salads or water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does E. coli 0157 produce symptoms?

What are they?

A
  • E. coli 0157 produces the Shiga toxin
  • the toxin causes abdominal cramps, bloody diarrhoea + vomiting
  • the Shiga toxin destroys blood cells and leads to haemolytic uraemic syndrome (HUS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should be avoided if E. coli gastroenteritis is suspected?

A

!! antibiotics !!

  • the use of antibiotics increases the risk of HUS
  • antimotility medication (e.g. loperamide) can also increase the risk

this is the main reason why antibiotics / loperamide are not typically used to treat gastroenteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is meant by haemolytic uraemic syndrome (HUS)?

A
  • there is thrombosis in the small blood vessels throughout the body
  • it is characterised by a triad of:
  1. thrombocytopenia (low platelets)
  2. AKI (kidneys fail to excrete waste incl. urea)
  3. haemolytic anaemia (due to RBC destruction)

90% of cases occur in children due to Shiga toxin-producing E.coli

Shigella can also produce the Shiga toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the presentation of HUS?

A
  • the symptoms typically start 5 days after bloody diarrhoea due to gastroenteritis
  • reduced urine output (due to AKI)
  • hypertension
  • haematuria (dark brown urine)
  • abdo pain
  • lethargy / irritability / confusion
  • bruising

multiple blood clots in small vessels = thrombotic microangiopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is involved in the management of HUS?

A
  • it is a medical emergency as it has a high mortality (10%)
  • management is supportive:
  • antihypertensives
  • blood transfusion if required to treat haemolytic anaemia
  • haemodialysis if severe AKI

70-80% of patients with HUS will make a complete recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is gastroenteritis caused by Campylobacter jejuni typically spread?

A
  • also known as “travellers diarrhoea”
  • raw or improperly cooked poultry
  • untreated water
  • unpasteurised milk

it is the most common bacterial cause of gastroenteritis worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of bacteria is Campylobacter jejuni?

A

gram-negative bacteria that is curved or spiral shaped

Campylobacter - “curved bacteria”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the symptoms of Campylobacter jejuni gastroenteritis and how do they develop?

A
  • there is a 2-5 day incubation period
  • symptoms resolve after 3-6 days
  1. diarrhoea (often with blood)
  2. vomiting
  3. fever
  4. abdominal cramping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for Campylobacter jejuni gastroenteritis?

A
  • antibiotics are considered ONLY after isolating the organism

AND

  • when patients have severe symptoms or other RFs (HIV / HF)
  • azithromycin or ciprofloxacin are used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is Shigella spread?

What is the risk associated with this?

A
  • spread through faeces contaminating drinking water, swimming pools or food
  • can produce the Shiga toxin and cause HUS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of Shigella gastroenteritis?

What treatment is given?

A
  • incubation period is 1-2 days
  • symptoms resolve within 1 week without treatment
  • azithromycin or ciprofloxacin may be considered in severe cases

symptoms include abdominal cramps, bloody diarrhoea and fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is salmonella spread?

A
  • spread through eating raw eggs / poultry

OR

  • food contaminated with infected faeces of small animals
17
Q

What are the symptoms of salmonella gastroenteritis?

Is treatment required?

A
  • incubation period is 12 hours - 3 days
  • symptoms resolve within 1 week
  • the main symptom is watery diarrhoea that can be associated with mucus or blood
  • there is also abdo pain + vomiting

antibiotics are only given in severe cases and are guided by stool culture + sensitivity

18
Q

What type of bacteria is Bacillus Cereus?

How is it spread?

A
  • it is a Gram positive rod
  • it is spread through inadequately cooked food
  • it grows well on food not immediately refrigerated after cooking
  • typically, associated with fried rice left out at room temperature
19
Q

What is the course of symptoms like when Bacillus cereus is ingested?

Why do these occur?

A
  • it produces the toxin cereulide whilst growing on the food
  • cereulide causes abdominal cramping + vomiting within 5 hours of ingestion
  • when it arrives in the intestines it produces different toxins that cause a watery diarrhoea
  • this occurs more than 8 hours after ingestion
  • all symptoms resolve within 24 hours

typical course = vomiting after 5 hrs, diarrhoea after 8 hours and resolution within 24 hours

20
Q

What other conditions are associated with Bacillus cereus?

A
  • IVDUs can develop infective endocarditis as a result of Bacillus cereus infection
  • Staphylococcus is the most common cause of infective endocarditis in IVDUs
21
Q

What type of bacteria is Yersinia Enterocolitica?

How does it cause infection?

A
  • it is a Gram-negative bacillus
  • eating raw or undercooked pork causes infection
  • also spread through contamination with urine / faeces of mammals such as rats or rabbits
21
Q

What are the typical symptoms associated with Yersinia Enterocolitica infection?

A
  • it typically affects children and causes:
  1. watery or bloody diarrhoea
  2. abdominal pain
  3. fever
  4. lymphadenopathy
  • incubation period is 4-7 days
  • the illness can last for up to 3 weeks
22
Q

How is the presentation of Yersinia infection different in adults / older children?

A
  • they may present with right-sided abdominal pain due to mesenteric lymphadenitis + fever
  • this can give the impression of appendicitis

mesenteric lymphadenitis = inflammation in the intestinal lymph nodes

23
Q

What is the treatment for Yersinia infection?

A
  • antibiotics are only given in severe cases
  • they are guided by stool culture + sensitivities
24
Q

How can Staphylococcus aureus cause gastroenteritis?

A
  • it is not the bacteria that causes symptoms, but the enterotoxin it produces
  • it produces this when growing in foods such as eggs, dairy and meat
  • the toxins cause small intestine inflammation when ingested
  • this results in diarrhoea, perfuse vomiting, abdominal cramps and fever
25
Q

What is the course of symptoms like in Staphylococcal toxin gastroenteritis?

A
  • symptoms start within hours of ingestion
  • they settle within 12-24 hours
26
Q

What is Giardia lamblia and how is it transmitted?

A
  • it is a microscopic parasite
  • it lives in the small intestines of mammals (incl. pets, farm animals + humans)
  • it releases cysts into the stools of infected mammals
  • the cysts contaminate food / water or are eaten to infect a new host
  • this is faecal-oral transmission
27
Q

What are the symptoms of Giardiasis gastroenteritis?

A
  • infection may not cause any symptoms
  • or it may cause chronic diarrhoea
28
Q

How is Giardiasis infection diagnosed and managed?

A
  • it is diagnosed via stool microscopy
  • it is treated with metronidazole
29
Q

What is important for prevention of gastroenteritis?

A
  • good hygiene helps to prevent gastroenteritis
  • the patient should be immediately isolated when they develop symptoms to prevent spread
30
Q

How is gastroenteritis diagnosed?

A
  • a stool sample is collected
  • this is sent for microscopy, culture and sensitivities
  • this establishes the causative organism and its antibiotic sensitivities
31
Q

What is the first step in the management of a patient with gastroenteritis?

A

!! assess patient for dehydration !!

  • attempt a fluid challenge
  • consider outpatient management if they can tolerate oral fluids + adequately hydrated
  • rehydration solutions (e.g. dioralyte) can be used if patient is NOT vomiting
  • if dehydrated, IV fluids are used for rehydration and to prevent dehydration until oral fluids can be tolerated again
32
Q

Alongside fluid management, what is important in the management of gastroenteritis?

A

!! control of oral intake !!

  • once oral intake is tolerated, slowly introduce a light diet in small quantities
33
Q

What advice is given about returning to school / work?

A

stay off work / school for 48 hours AFTER symptoms have resolved

34
Q

What guidance is in place surrounding the use of antidiarrhoeal and antiemetic medication in gastroenteritis?

A
  • antidiarrhoeal + antiemetic medication are NOT recommended
  • they may be useful in mild - moderate symptoms
  • AVOID ANTIDIARRHOEALS in E. coli 0157 and shigella infection

OR

  • if there is bloody diarrhoea + high fever

antidiarrhoeal = loperamide
antiemetic = metoclopramide

35
Q

What guidance is in place surrounding use of antibiotics in gastroenteritis?

A
  • antibiotics are usually NOT recommended
  • should only be given in patients that are at risk of complications and once the causative organism is confirmed
36
Q

What are the 4 possible post-gastroenteritis complications?

A
  • lactose intolerance
  • Guillain-Barre syndrome
  • reactive arthritis
  • irritable bowel syndrome

Y4 - CCC & PC (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions