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LC Gastroenterology Week 5 > Gastroenteritis > Flashcards

Gastroenteritis Flashcards

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1
Q

What is acute diarrhoea?

A

sudden onset and lasts less than 2 weeks
90% are infectious
10% are caused by medications, toxin ingestions and ischaemia

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2
Q

What is chronic diarrhoea?

A

Diarrhoea which lasts for more than 4 weeks

Most of the causes are non-infectious

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3
Q

What is persistent diarrhoea?

A

Diarrhoea lasting between 2-4 weeks

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4
Q

What might cause acute diarrhoea?

A 
Viral, bacterial, protozoa, medications
Laxatives or diuretic abuse 
Ingestion of environmental preferomed toxin such as seafood
Ischemic colitis
Graft verus host
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5
Q

What might cause chronic diarrhoea?

A 
IBS
Diverticular disease 
colorectal cancer 
Bowel resection 
Malabsorption 
IBD
Coeliac disease 
Carcinoid tumour
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6
Q

What is gastroenteritis?

A

Inflammation of the lining of the stomach, small and large intestine

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7
Q

What is acute gastroenteritis common in?

A

Young children and elderly, and those who are immunocompromised.

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8
Q

What are most causes of gastroenteritis?

A

Most are infectious (90%), some acute may follow ingestion of drugs and chemical toxins (10%)

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9
Q

What are the causative pathogens of gastroenteritis?

A

Bacteria
Viral
Protozoa

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10
Q

What specific viral organisms can cause gastroenteritis?

A

Rotovirus
Norovirus
Adenovirus

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11
Q

What specific protozoa can cause gastroenteritis?

A

Entamoeba histolytica
Cryptosporidium
Giardia intestinalis
Schistosomiasis

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12
Q

What specific bacterial organisms can cause gastroenteritis?

A 
Campylobacter jejunei**
Salmonella sp.
Shigella
Escherichia coli**
Clostridium difficile**
Staphylococcal enterocolitis
Bacillus cereus
Clostridium perfringens
Clostridium botulinum
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13
Q

What are the different mechanisms by which enteric pathogens can cause diarrhoea?

A
  1. stimulation of net fluid and electrolyte secretion
  2. Increased propulsive muscle contractions
  3. Mucosal destruction and increased permeability
  4. Nutrient alabsorption
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14
Q

What is enteric pathogen?

A

Pathogens of the intestine - may also refer to the gut flora

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15
Q

Describe toxin mediated food poisoning?

A 
Differentiation from acute toxin mediated 
Food poisoning 
Pre formed staph.A
Onset 1-6 hours after exposure 
Diarrhoea and adobe pain 
Resolves in 6-10 houes 
No blood or pus in faeces
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16
Q

What is the most common cause of travellers diarrhoea?

A

Enterotoxigenic E.Coli

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17
Q

what does enterotoxigenic E.coli produce?

A

Enterotoxins - increase intracellular levels of cAMP

Causes cell leakage

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18
Q

What is the major reservoir for human infection?

A

Cattle

(deer, sheep, goats, horses, dogs, birds, flies)

Bacterial can survive in manure and water troughs

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19
Q

What symptoms can E.Coli 015:H7 give you?

A

Adobe cramps

diarrhoea +/- blood

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20
Q

Where might you get E.Coli from?

A

Beef, raw milk

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21
Q

Where are you likely to get salmonella from?

Study These Flashcards
A

Poultry, raw eggs, meat

22
Q

What is the most common cause of food poisoning?

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A

Campylobacter

23
Q

Describe campylobacter in more detail?

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A

Poultry, raw milk
Blood bowel movements, abdo pain
(can mimic appendicitis)

24
Q

How would you treat severe campylobacter?

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A

Clarithromycin or azithromycin

25
What might diarrhoea from the small bowel and colon present like?
``` Large volume stool Moderate increase in number Minimal urgency No tenesmus Little mucus ```
26
What might diarrhoea from the recto-sigmoid present like?
``` Small amount of stool Frequency Urgency Tenesmus Mucus Blood ```
27
Describe enteric fever like illness?
Fever Systemically unwell Abdo pain Constipation but possibly short history of diarrhoea
28
Describe typhoid?
Almost always imposed (far eat) | Food and water or carrier
29
How does typhoid present?
Asymptomatic, mild, bacteramia, enterocolitis
30
What would you do to diagnose typhoid?
Blood cultures | Stool and urine cultures
31
What are the 3 different presenting clinical syndrome of food poisoning?
Acute enteritis : fever. D&V, abdominal pain Acute colitis: fever, pain, bloody diarrhoea Enteric fever like illness : fever, rigors, pain but little diarrhoea
32
What are some complications of bacterial enteritis - intestinal?
Severe dehydration and renal failure Acute colitis, toxic dilatation Post infective irritable bowel (very common) Transient secondary lactase intolerance
33
What are some complications of bacterial enteritis - extra-intestinal?
``` Bacteriaemia leading to sepsis +/_ metastatic infection: meningitis, aortitis. Ostyeomyelitis, endocarditis Reactive arthritis Meningism Neurological [Guillian Barre syndrome] Haemolytic uraemic syndrome Others ```
34
What type of organism is C.diff?
Anaerobic gram positive spore forming bacillus
35
What are the 4 antibiotic C's that should be reduced at all costs?
Cephalosporins Clindamycin Co-Amoxiclav Cirpofloxacin
36
What are the main drivers for CDI?
A. BROAD SPECTRUM ANTBIOTIC THERAPY B. SPECIFIC ANTIBIOTIC TYPES E.G QUINOLONES, CEPHALOSPORINS C. LONG DURATION OF THERAPY VULENRABLE POPULATION E.G ELDERLY, NURSING HOME, CO-MORBIDITIES, HOSPITALISED E. ROUTE OF THERAPY MAKES NO DIFFERENCE F. TOTAL AMOUNT OF ANTIBIOTIC USE – number of exposures G. GIVING ANTIBIOTIC IN THE ABSENCE OF INFECTION
37
What are 4 different types of travel related diarrhoea?
ETEC (E.Coli) AMOEBIASIS GIARDIASIS CRYPTOSPORIDIOSIS
38
What is the average duration of travellers diarrhoea?
Around 4 days
39
Describe what amoebiasis is?
It is a protozoal infection spread by the feacal-oral route or by an ill or asymptomatic carrier It is common in areas of poor sanitation
40
What symptoms might you get with amoebiasis?
Acute bloody diarrhoea | extra-intestinal spread can produce abscess
41
What is the treatment of amoebiasis?
Metronidazole
42
What is giardia lamblia?
Flagellated protozoan infection of the duodenum and proximal jejunum Cysts found in water and food
43
What is the spread of giardia lamblia?
Person to person infection | Intestinal parasite
44
What are the symptoms of giardia lamblia?
Acute infectious diarrhoea, no mucus or blood | Malabsorption due to diarrhoea
45
How might you diagnose giardia lamblia?
Stool analysis/duodenal aspirate
46
How would you treat giardia lamblia?
Metronidazole
47
What is Cryptosporidiosis?
Travel related diarrhoea
48
How is Cryptosporidiosis spread?
Water food contract with animals It is highly infectious
49
What might be the symptoms of Cryptosporidiosis?
Diarrhoea | Self limiting
50
How would you diagnose Cryptosporidiosis?
Duodenal aspirate/stool
51
How would you treat Cryptosporidiosis?
Supportive Antimicrobials are virtually ineffective

LC Gastroenterology Week 5 (10 decks)

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