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Year 3 Infection (JK) > Introduction to infection and diarrhoea > Flashcards

Introduction to infection and diarrhoea Flashcards

(84 cards)

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1
Q

2 diagnostic features for gastroenteritis

A

more than 3 loose stools a day

accompanying features

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2
Q

2 main causes of dysentery

A

shigella or entamoeba histolytica

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3
Q

Clinical features of dysentery

A

large bowel inflammation and bloody stools

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4
Q

Does gastroenteritis need a microbiological diagnosis?

A

No

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5
Q

What chart can you use to rate the consistencies of stools and what are the numbers in this?

A

Bristol stool chart

1-7

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6
Q

4 main epidemiologies of gastroenteritis

A

contaminated foodstuff
poor storage of produce
travel related infections
person to person spread

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7
Q

Why is salmonella rare in UK?

A

vaccinate hens

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8
Q

Commonest bacterial pathogen in gastroenteritis

A

campylobacter

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9
Q

Commonest pathogen of gastroenteritis?

A

viral

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10
Q

Most common pathogen for food poisoning

A

campylobacter

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11
Q

Pathogen causing most hospital admissions in food poisoning

A

salmonella

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12
Q

Commonest source of food poisoning

A

poultry meat - undercooked

spike in summer with BBQ

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13
Q

4 main defences against enteric infections

A

hygiene
stomach acid
normal flora
immunity

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14
Q

Type of salmonella in HIV

A

invasive non typhoidal

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15
Q

3 categories of diarrhoeal illness

A

non inflammatory/secretory
inflammatory
mixed picture

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16
Q

Example of secretory diarrhoea

A

cholera

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17
Q

Example of inflammatory diarrhoea

A

shigella dysentery

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18
Q

Example of mixed picture diarrhoea

A

C. diff

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19
Q

Effects of secretory toxin

A

increase cAMP and chloride, sodium, potassium and water loss

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20
Q

Travellers diarrhoea cause

A

enterotoxigenic E.coli

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21
Q

Clinical features of secretory diarrhoea

A

frequent watery stool

little abdominal pain

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22
Q

treating secretory diarrhoea

A

rehydration

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23
Q

Pathogenesis of inflammatory diarrhoea

A

inflammatory toxin damage

mucosal destruction

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24
Q

Clinical features of inflammatory diarrhoea

A

pain and fever

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25
2 main pathogens of inflammatory diarrhoea
bacterial | amoebic dysentery - parasite
26
Treating inflammatory diarrhoea
antimicrobials may be appropriate | mainstay treatment still rehydration
27
Duration of diarrhoea - when is it unlikely to be infective gastroenteritis ?
longer than 2 weeks
28
3 ways to assess hydration
postural bp skin turgor pulse
29
3 main risks in history for food poisoning
dietary travel contact
30
SIRS features of inflammation
fever, raised WCC, increase RR, increase HR
31
Assessing a child for dehydration
``` sunken eyes and cheeks dry tongue and mouth sunken fontanelles decreased skin turgor few or no tears ```
32
What type of diarrhoea is fluid and electrolyte loss severe?
secretory
33
In secretory diarrhoea why is the patient hypokalaemic and hyponatraemic?
replace salt with hypotonic solution | lose potassium in stool
34
5 main investigations in infective gastroenteritis
``` 3 stool cultures blood culture renal function blood count - haemolysis and neutrophilia abdominal X-ray if distended ```
35
3 differential diagnoses for diarrhoea
IBD carcinoma spurious - secondary to constipation
36
2 clues the diarrhoea and fever is occurring with sepsis outwith the gut?
lack of abdominal pain/tenderness | no blood or mucus In stools
37
Treating gastroenteritis main treatment and how this can be done
rehydration - oral or IV? ORHT? - salt and sugar solution iv saline
38
incubation of campylobacter
up to 7 days
39
When are stools negative in campylobacter?
6 weeks
40
2 post infective sequalae of campylobacter gastroenteritis
Guillian barre syndrome | reactive arthritis
41
How to do a routine bacterial culture
variety of media and incubation conditions | takes 3 days
42
Is campylobacter associated with sporadic or outbreaks?
sporadic
43
Time of symptom onset of salmonella gastroenteritis
48 hours or more
44
What percent of people still have positive stools for salmonella after 20 weeks?
20%
45
association with chronic salmonella gastroenteritis?
gallstones
46
What is a common post infectious condition after slamonella gastroenteritis?
IBS
47
What is the basis of how salmonella is cultured?
lactose non fermenter
48
Tests following the lactose non fermenter tests of salmonella
antigen and biochemical tests
49
What species are most salmonella genetically serotypes of?
salmonella enterica
50
How are salmonella strains named?
after place of isolation
51
2 commonest salmonella isolates in UK
enteritidis | typhimurium
52
What do salmonella typhi and paratyphi cause and not cause?
cause paratyphoid and typhoid fever | do not cause gastroenteritis
53
How is Ecoli O157 spread?
contaminated meat | low inoculum person to person spread
54
What toxin does Ecoli produce?
(verocyto)toxin
55
Clinical symptom of Ecoli O157
frequent bloody stool
56
Does Ecoli O157 or the toxin get into the blood?
toxin
57
What can Ecoli O157 toxin cause?
Haemolytic uraemic syndrome
58
3 ways HUS is characterised
renal failure haemolytic anaemia thrombocytopenia
59
Thrombocytopenia
low platelet count
60
Treatment of Ecoli O157
supportive - not antibiotics
61
Where has there been outbreaks of shigella sonnei?
nurseries
62
What Ecoli strain is the only one easily distinguishable?
Ecoli O157
63
3 pathogens of food poisoning outbreaks
staph aureus bacillus cereus clostridium perfingens
64
5 occasions when antibiotics are used in gastroenteritis
``` immunocompromised severe sepsis or invasive infection valvular heart disease chronic illness diabetes ```
65
The 4 C antibiotics in c diff
ciprofloxacin co-amoxiclav cephalosporin clindamycin
66
Range of severity of c diff
mild diarrhoea --> pseudomembranous colitis
67
What 2 toxins does c diff make and which drives inflammation?
enterotoxin - A | cytotoxin - B - inflammation
68
5 treatments of c diff
``` metronidazole oral Vancomycin fidaxomicin stool transplants surgery? - also stop precipitating antibiotics ```
69
4 ways to prevent c diff infection
reduce use of broad spectrum antibiotics avoid 4C antibiotics antimicrobial management team and local policy hand washing
70
2 parasites
protozoa | helminths
71
How are parasite infections diagnosed?
microscopy - parasites, cysts, ova
72
Vegetative form and cyst form of giardia lamlia found how?
duodenal biopsy string test Stool microscopy for cysts
73
Treatment of giardia lamlia
metronidazole
74
Where are most UK parasites found?
contaminated water
75
What does entamoeba histolytica cause?
amoebic dysentery
76
What is found in a symptomatic and asymptomatic patient with amoebic dysentery
symptomatic - vegetative form - hot stool | asymptomatic - cysts
77
Long term complication of amoebic dysentery
amoebic liver abscess - Anchovy pus
78
Treatment of amoebic dysentery
metronidazole
79
Viral diarrhoea in children under 5 pathogen
rotavirus
80
How is viral diarrhoea diagnosed?
antigen detection
81
What vaccine for viral diarrhoea is available?
rotavirus
82
Norovirus is a common cause of what? where is it found?
oubreaks of winter vomiting disease | cruise ships, hospital, community
83
Diagnoses of norovirus
PCR
84
Is norovirus infectious?
yes very only need 18 particles often close wards strict infection control

Year 3 Infection (JK) (12 decks)

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