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Infection > Infectious Dirrohea > Flashcards

Infectious Dirrohea Flashcards

1
Q

How is gastro-enteritis defined?

A
  • Three or more loose stools/day

- Accompanying features

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2
Q

What chart is used to judge the types of stools?

A
  • Bristol stool chart

- Diorrhea coming in at type 7

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3
Q

What is the epidemiology and statistics behind Gastro-enteritis?

A
  • Contamination of foodstuff
  • Poor storage of produce
  • Travel-related infection, Salmonella
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4
Q

What are the viral causes behind gastroenteritis?

A
  • Noravirus
  • Rotavris
  • Adenovirus
  • Enterovirus
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5
Q

What are the bacterial causes behind gastroenteritis?

A
  • Campylobacter
  • E Coli
  • Salmonella
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6
Q

What are the defences against enteric infection?

A
  • Hygiene
  • Stomach acidity, Antacids & Infection
  • ## Normal gut flora, Cl difficile infection
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7
Q

Describe the clinical features of non-inflammatory diarrhoea illness?

A

Secretory toxin mediated
Cholera - Increases cAMP levels and Cl secretion
- Frequently watery stools with little abdo pain
- Rehydration therapy mainstay of therapy
- Osmotic effect leads to massive loss of water

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8
Q

What are the clinical features of inflammatory diarrhoea illness?

A

Inflammatory toxin damage and mucosal destruction

  • Results in pain and fever
  • Bacterial infection and ambeoic dysentry
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9
Q

What are the possiblilitys of fluid loss with infective diarrhoea?

A
  • Can be severe with secretory diarrhoea
  • 1-7L of fluid per day containing 80-100 mmol Na
  • Hyponatremia due to sodium loss with fluid replacement by hypotonic solutions
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10
Q

What are some investigations that could be done on a person with infective diarrhoea?

A
  • Stool culture molecular/Ag testing
  • Blood culture
  • Renal function
  • Blood count - Neutrophilia, heamolysis
  • Abdominal X-ray
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11
Q

What is spurious diarrhoea?

A

Spurious diarrhoea is secondary to constapation

  • When the feacal block gets so hard that the fluid travels around the feaces
  • Rehydration therapy with salt/sugar solution
  • IV saline
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12
Q

What is the treatment of gastro-enteritis?

A
  • Rehydration therapy
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13
Q

Describe Campylobacter gastroenteritis

A

Up to 7 days incubation so dietary history may be irrelevant

  • Stools negative within 6 weeks
  • Abdominal pain can be severe
  • Post-infective sequelae, Guillan barre syndrome
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14
Q

What are the investigations and difficulties with finding pathogens in campylobacter gastroenteritis?

A
  • Difficult to find the pathogen in complex normal flora
  • Selective and enrichment methods of culture are necessary
  • Molecular detection and antigen detection are used
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15
Q

What are the species of campylobacter?

A
  • C.jejuni (90%)
  • C.Coli (9%)
    Commonest cause of bacterial food poisoing in the UK
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16
Q

Describe Salmonella gastroenteritis?

A
  • Symptoms onset usually < 48 hours after exposure
  • Diarrhoea usually lasts < 10 days
  • < 5% positive blood cultures
  • 20% patients still have positive stools at 20/52
  • Post infectious irratable bowel is common
17
Q

Routine bacterial culture salmonella?

A
  • 2 species in genus; S.enterica, S.bongori
  • > ## 2500 serotypes with individual names
18
Q

What are the common causes of salmonella infections in the UK?

A

Salmonella enteritidis and Salmonella typhimurium

19
Q

Describe E.coli?

A
  • Infection from contaminated beef meat, person to person
  • Can be a cause of infective gastroenteritis
  • Characterised by frequent bloody stools
20
Q

Describe the pathophysiology behind E.Coli?

A
  • E.coli produces the shiga toxin, the E.coli itself stays in the gut tube but the toxin gets into the blood
  • ## The toxin can cause haemolytic ureamic syndrome (HUS)
21
Q

what is haemolytic ureamic syndrome (HUS)

A

Triad of

  • Acute kidney injury/Renal insufficiency (Oliguria and oedema)
  • Thrombocytopenia (Low blood platelet count)
  • Heamolytic anemia (Schistocytes)
22
Q

What are the symptoms haemolytic ureamic syndrome (HUS)?

A
  • Abdominal pain
  • Bloody diarrhoea
  • Fever
  • Seizures
  • Lethargy
23
Q

Other types of bacteria

A
  • Shigella (4 species,
24
Q

What are other causes of food posioning outbreaks?

A
  • Staph aureus
  • Bacillus cerus
  • Clostridium perfringens (Undercooked meat/cooked food left - toxin accumulates)
25
Q

When should i give anti-biotics for gastroenteritis?

A
  • Immunocompromised
  • Severe sepsis or invasive infection
  • Chronic illness
26
Q

Describe the pathophysiology of C.diff?

A

C.diff produces enterotoxin (A) and cytotoxin (B)
Inflammatory
-

27
Q

How does C.diff usually come about?

A

Patient usually has a history of previous anti-biotic treatment

  • Cephalosporins
  • Co - amoxiclav
  • Clindamycin
  • Ciprofloxacin
28
Q

How should you treat C.diff

A
  • Oral metronidazole

- Oral vancomycin if 2 or more severity markers

Infection (6 decks)

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