Infective Gastroenteritis Flashcards Preview

Gastrointestinal Conditions > Infective Gastroenteritis > Flashcards

Flashcards in Infective Gastroenteritis Deck (20):
1

What is gastroenteritis?

Diarrhoea with or without vomiting due to enteric infection with viruses, bacteria or parasites

2

Which group of pathogens most commonly cause infective gastroenteritis?

Viruses (50-60%)
Bacteria (30-40%)
Parasitic (<2%)

3

Viral causes of gastroenteritis:

* Norovirus (biggest cause in adults)
* Rotavirus (biggest cause in children)
* Adenovirus

4

Bacterial causes of gastroenteritis:

* Campylobacter
* E. coli O157
* Salmonella
* Shigella
* S. aureus toxin
* Bacillus cereus toxin
* Clostridium perfringens toxin

5

Which bacterial pathogens cause gastroenteritis by releasing toxins?

* Bacillus cereus
* Clostridium perfringens
* S. aureus

6

Which bacterial pathogens cause gastroenteritis not mediated by toxins?

* Campylobacter
* E. coli O157
* Salmonella
* Shigella

7

Parasitic causes of gastroenteritis:

* Cryptosporidium
* Entamoeaba histolytica
* Giardia

8

Risk factors for infective gastroenteritis:

* Poor personal hygeine
* Lack of sanitation
* Immunosuppression
* Achlorhydria
* PPIs/H2RAs/Antacids
* Poor food hygeine

9

Which pathogens are particularly more common in individuals with achlorhydria?

* Salmonella
* Campylobacter

10

Symptoms of infective gastroenteritis:

* Sudden onset diarrhoea +/- vomiting
* Nausea
* Abdo pain/cramps
* Bloody stool (E.coli O157, Entamoeba histolytica if exotic travel)
* Fever (usual in children. In adults suggests invasive pathogen)

11

Bloody diarrhoea is most often caused by these organisms:

* E. coli O157

* Entamoeba histolytica (if history of exotic travel)

12

Fever is usual in this group of patients:

Children

13

What does fever in adults with gastroenteritis suggest?

Invasive pathogen

14

Signs of gastroenteritis?

Dehydration:
- Postural hypotension
- Hypotension (severe)
- Tachycardia
- Confusion
- Dry mucous membranes
- Reduced skin turgor
- Shock

Others:
- Fever
- Abdo tenderness

15

Investigations for gastroenteritis

Usually none required

Otherwise

1. Bloods: FBC, U&E, CRP (if systemically unwell)

2. Stool: MC&S (if blood/mucus in stool, immunocompromised, not improving after 1/52, recent exotic travel)

16

When should blood be taken in cases of gastroenteritis?

If systemically unwell

17

When should stool MC&S be done in cases of gastroenteritis?

* Recent exotic travel
* Blood/mucus in stool
* Immunocompromised

18

What is dysentry?

Infectious gastroenteritis with bloody diarrhoea

19

Management of gastroenteritis:

* Notify PHE about food poisoning and dysentry

* Admit if shock/severe dehydration

* Oral rehydration salts in frail or elderly

* Hand hygeine

* Anti-motility agents (e.g. loperamide)

* Stay off school/work untill Sx free for 48h min.

20

Complications of infective gastroenteritis:

- Dehydration
- Electrolyte disturbance
- HUS (E.coli O157)
Uraemia (AKI)
Haemolytic anaemia
Thrombocytopenia
esp. in young and old
- Reactive complications
Arthritis
Urticaria
Erythema nodosum
Conjunctivitis
Reiter's syndrome
- Toxic megacolon (rare)
- Guillain-Barre syndrome
Campylobacter jejuni
- Malnutrition
- Post-infective IBS
- Hypovolaemic shock
- Lactose intolerance