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Flashcards in Gastroenteritis Deck (49):
1

What is gastroenteritis?

This is inflammation of the stomach or intestines which inhibits nutrient absorption and excessive water and electrolyte loss

2

What can gastroenteritis be caused by?

Bacteria, virus, parasites or poisoning by microbial toxins

3

What is the most common cause of gastroenteritis?

Infection

4

How do patients present with food poisoning?

Fever
Abdominal pain
Diarrhoea
PR bleeding in some cases

5

what can cause toxin mediated food poisoning?

staph. aureus, bacillus cereus or enterotoxigenic E. Coli

6

Is there blood or pus in the faeces of a patient with toxin mediated food poisoning?

No - usually not

7

What can Arizonan turtles cause?

Salmonella

8

Give examples of resivoirs for salmonella

reptiles, eggs and undercooked poultry

9

What are the causes of non-infectious diarrhoea?

Fish toxins
Endocrine disorders
Withdrawl
Diverticulitis
Ischemic gut
Numerous drugs
GI bleed

10

What symptoms are caused by the norovirus?

Abrupt nausea, vomiting, diarrhoea, cramps, myalgia

11

what is myalgia?

Pain in a muscle or a group of muscles

12

What are the presenting complains in a patient with acute enteritis?

fever, diarrhoea, vomiting and abdominal pain

13

What are the presenting complains in a patient with acute colitis?

fever, pain, bloody diarrhoea

14

What are the presenting complains in a patient with enteric fever?

fever, rigors and pain - perhaps a little diarrhoea

15

what does bloody diarrhoea suggest?

Infection - usually colonic inflammation

16

what kind of bacteria can cause bloody diarrhoea?

Campylobacter, shigella spp or E. coli

17

what can campylobacter mimic?

appendicitis

18

name an important complication to remember of campylobacter

Guillain-Barre syndrome

19

what can be used to treat campylobacter?

if severe treat with clarithromycin and azithromycin

20

what is Guillain-Barre syndrome?

Autoimmune response - leads to tingling of the feet and progressive paralysis of the legs, arms then rest of the body

21

what are the symptoms of enteric fever like illness?

fever, systemic illness, abdominal pain and constipation - may have short history of diarrhoea

22

Give an example of an enteric fever?

typhoid fever

23

how does typhoid fever present?

Asymptomatic, mild, bacteraemia, enterocolitis

24

How is typhoid fever diagnosed?

blood, stool and urine cultures

25

What is used to treat typhoid fever?

Usually azithromycin - in Asia there is a resistance to chloramphenicol and ciprofloxacin

26

what is important when taking a drug history?

To find out if they have been on recent antibiotics or PPIs

27

what investigations can be ordered for gastroenteritis?

Stool microscopy
Stool culture
Stool toxin - for C diff
Blood cultures - Salmonella
PCR
FBC
AXR

28

what are the severity markers for CDI?

Suspicion of pseudomembranous colitis/toxic megacolon/colonic dilatation
increased WCC
Increased Creatinine
CDI symptoms despite 2 treatments

29

What are the complications of bacterial enteritis intestinal?

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

30

What are the complications of bacterial enteritis extra-intestinal?

Bacteriaemia leading to sepsis
metastatic infection: meningitis, aortitis, Ostyeomyelitis, endocarditis
Reactive arthritis
Meningism
Neurological
Haemolytic uraemic syndrome

31

what are the objectives of antibiotic treatment?

treat invasive disease
reduce severity of symptoms
eradicate faecal excretion

32

what is the treatment for gastroenteritis?

Oral rehydration - IV fluids
Anti-spasmodics
Anti-motility (short term)

33

what are risk factors for gastroenteritis?

age
immunosuppression
PPI use
Hospitalisation

34

Key factors to the treatment of C. Difficile?

treat according to severity
reduce acute complications
reduce likelihood of recurrence

35

which patients are more at risk of C. Diff?

Elderly
Antibiotic treatment
Prolonged hospitalisation
Defective immune response to toxin A
Gastric acid suppression

36

what are the drivers for C. Difficile infections?

Broad spectrum antibiotic therapy
certain antibiotic types
long duration of therapy
total amount of antibiotic use
vulnerable groups

37

How should patients with vomiting and diarrhoea be managed?

oral rehydration

38

what should be avoided in patients with vomiting and diarrhoea?

anti-motility agents

39

what can cause travel related diarrhoea?

amoebiasis
giardiasis
cryptosporidiosis

40

how should traveller's diarrhoea be treated?

treat symptomatically
ciprofloxacin
short term anti-diarrhoeals

41

what is amoebiasis?

Protozoal infection spread by faeco-oral route or by an ill or asymptomatic carrier

42

how can amoebiasis be diagnosed?

examination of hot stool for ova and cycsts
Amoebic serology

43

what may occur during amoebiasis?

an amoebic liver abscess may form

44

how does giardiasis spread?

by cysts found in normal drinking water

45

how is giardiasis diagnosed?

examination of stools for ova and cysts
duodenal aspiration

46

How is giardiasis treated?

Metronidazole

47

how is Cryptosporidiosis
transmitted?

water, food, contact with animals - highly infectious

48

how is Cryptosporidiosis
diagnosed?

duodenal aspirate

49

How is Cryptosporidiosis
treated?

supportive - nitizoxamide can be used