Gastroenteritis Flashcards Preview

Gastro > Gastroenteritis > Flashcards

Flashcards in Gastroenteritis Deck (61):
1

What is gastroenteritis?

Inflammation of the stomach or intestines

2

What does gastroenteritis do?

inhibits nutrient absorption and excessive H2O and electrolyte loss

3

What are the 4 causes of gastroenteritis

Bacterial
Viral
Parasitic
Poisoning by microbial toxins

4

What makes you feel worse - bacterial or viral?

Bacterial

5

What is the most common cause of gastroenteritis

Infection mostly caused by a virus, bacteria or parasite

6

Why is there a lower incidence of Gastroenteritis in Dundee than there is in London

The number of parasites increases with the population of a city

7

What are the main common presentations of gastroenteritis

Fever
Abdo pain
Diarrhoea
Sometime blood PR

8

Why is there only sometimes blood PR

Certain pathogens cause blood- some are more likely than others

9

What is an example of a pathogen likely to cause blood

Campylobacter

10

When is the onset for toxin mediated food poisoning

1-6 hours after exposure

11

Why is foodborne illness a rapidly emerging crisis in industrialised countries

Poor sanitation and hygiene
Change in eating habits
Importation of food
Increase in day care centre attendance
Increase in elderly care
institutes
Increased travel
Pets carry many pathogens

12

What do poultry and eggs carry? How could we get this?

Campylobacter - if we do not cook the meat well enough

13

What are some non-infectious diarrhoea examples

GI bleed
Ischaemic gut
Diverticulitis
Endocirne disorders
Numerous drugs
Fish toxins
Withdrawl

14

How do we approach any clinical infection syndrome

Find what the key clinical symptoms and signs are that suggest infection
Differential diagnosis
Severity of infection
Site and microbiological diagnosis and investigations
Antibiotic and supportive management
Infection control
Public health

15

How does the norovirus spread

As a spray in vomit
Faecal/ oral

16

How long does it take for the norovirus to resolve

24-48 hours

17

What are the common symptoms of norovirus

Abrupt nausea, vomiting, diarrhoea, cramps, myalgias

18

Who is most likely to get the norovirus

Older children and adults - not children

19

What are the 3 common presentations of food poisoning

Acute enteritis: fever, D&V, abdo pain
Acute colitis: fever, pain, bloody diarrhoea
Enteric fever like illness: fever, rigors, pain, but little diarrhoea by the time the present

20

What does blood diarrhoea usually indicate

Infection
IBD
Malignancy
Iscahemia

21

What is a complication of campylobacter

Guillain Barre

22

How long does Campylobacter affect us for

5-14 days

23

What do indentations on an AXR indicate

Inflammation

24

What are the common symptoms of enteric fever like illness
Give an example of enteric fever

Fever
Systemically unwell
Abdo pain
Constipation but possibly short history if diarrhoea

Typhoid is an example

25

What is typhoid?

A type of salmonella

26

In what countries is typhoid present?

India
SE Asia
Far East,
Middle East
Africa
Central America
South America

27

How is typhoid carried?

In food and water

28

What are the symptoms of typhoidW

Usually asymptomatic,
mild,
bacteriaemia,
enterocolitis

29

Define enterocolitis

inflammation of the small intestine and the colon

30

How can we diagnose typhoid

Blood, Stool and urine cultures

31

How can we treat typhoid?

Chloramphenicol and ciprofloxacin

32

What antibiotics are used in India, China or Middle east and why are they different?

Ceftriaxone or axithromycin
Resistance - the antibiotics were over used there

33

How can we prevent Typhoid?
How effective is this method?

VI or oral vaccine
70% effective

34

What does the thyphoid vaccine not protect against?

Paratyphoid

35

What are the 3 main investigations for determining the pathogen of gastroenteritis

Stool microscopy
Stool culture
Stool toxin

36

What investigation should be done for salmonella, campylobacter and shigella

Stool culture

37

What investigation should be done for a history of travel for giardia, amoeba etc

Stool microscopy

38

What investigation should be done for C difficile, cytotoxin for E coli 0157

Stool toxin

39

What would PCR detect?

Norovirus

40

How can you assess the severity of gastroenteritis?

Underlying medical condition
Presence or absence of fever
Rigors
Shock (hypotension / tachycardia)
Blood in stools
Abdo pain
Number of stools in 24 hours
Colonic dilation
WCC, U&Es

41

What determines how severe CDI is?

Suspicion of psudomembranous colitis (PMC) or toxic megacolon or ileus or colonic dilation in CT / AXR >6cm
WCC >15cells / mm3
Creatinine >1.5 x baseline

42

Name 4 complications of Bacterial Enteritis within the small bowel

Severe dehydration and renal failure
Acute colitis, toxic dilation
Post infective irritable bowel
Transient secondary lactase intolerance

43

Name 6 complications of bacterial enteritis outside of the bowel

Septicaemia
Metastatic infection: meingitis , aortitis, endocarditis
Reactive arthritis
Guillian Barre syndrome
Haemolytic uraemic syndrome

44

What supportive treatment is given>

Oral rehydration
IV fluids (saline!!)

45

What are specific treatments which can be used

Anti-spasmodics
Anti-motility
Antibiotics - only in specific regions

46

What is bad about long term antimotility drugs

They stop the normal peristaltic movements and prevent the body naturally clearing toxins

47

What 3 drugs are used as antidiarrhoeal agents

Antimotility agents
Antisecretory agents
Absorbents

48

Name 4 indications for antibiotic treatment

Enteric fever (tyohoid)
Shigellosis
Cholea
C difficile diarrhoea

49

What are the 3 main aims of antibiotic treatment

To prevent and treat invasive disease especially in immunocompromised patients
To reduce the severity and duration of symptoms
To eradicate faecal excretion in order to reduce environmental contamination and to limit the spread of infection to the community

50

What type of organism is clostridium difficile

Anaerobic, gram positive spore forming bacillus

51

What is the major cause of diarrhoea and colitis in patients exposed to antibiotics

C diff

52

How can we minimise the spread of CDI

Patients positive in a private room where possible
Full barrier praucations
Soap and water and not gel!

53

How do we treat c diff

Treeat according tot he severity
Reduce the acute complitions
Reduce the likelihood of recurrence
Treat recurrence

54

What are 3 pathogens found in travel related diarrhoea

Amoebiasis
Giardiasis
Cryptosporidiosis

55

What is the most common cause of traveller's diarrhoea

ETEC

56

How long does traveller's diarrhoea last

Around 4 days

57

What is amoebiasis

A protozoal infection which is spread by faeco-oral route or by an ill or asymptomatic carrier

58

Where is there a high prevelance of amoebiasis

In areas of poor sanitation

59

What is Giardiasis

Protozoon Giardia lambia trophoxoites colonises the small bowel mucosa to produce diarrhoea and malabstoptions

60

How is Giardiasis spread

Cysts found in the normal drinking water

61

How can we treat giardiasis

Metronidazole

Decks in Gastro Class (67):