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Flashcards in Metabolic and Endocrine Deck (65)
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what is food poisoining?

-Gastroenteritis with infectious cause with presumed source being from food.
-Time from eating to symptom onset = incubation period – can inform what organism/toxin it is.
-i.e. toxins/heavy metal v.v. quick onset of D+/-V, viruses + bact. slower


what infections are the biggest burden?

-Rotavirus (mainly U5s, but vaccine now)
-Norovirus (short-lived so underreported)
-C. Diff, MRSA + Norwalk important nosocomial


what are the characteristics of salmonella?

G-ve, incubation 12-72hrs, contaminated food mainly of animal origin, or faecal from infected person. Reservoir is mainly eggs. Clinically: cause enteric fever (typhoid/paratyphoid fever) + Enterocolitis. Incidence ↓ through PH measures – peak in late summer


what are the characteristics of e.coli?

Various types, can cause renal failure in children, haemolytic uraemia, O157 H7 (enterohaemorrhagic) v. dangerous. Reservoir in cattle, can be through food/animal contact. Incidence steady. 12-48hrs


what are the characteristics of Bacillus cereus?

1-6hrs, cooked rice.


what are the characteristics of S.aureus

G+ve cocci. Previously cooked food contaminated with skin/nasal flora. Produces toxin → rapid incubation period (2-4hrs)


what are the characteristics of cryptosporidium?

Protozoa, reservoir is GIT. Associated with foreign travel. Recreational exposure – water (swimming pools), land (camping) – SEVERE illness in immunocompromised, oocysts resist chlorination.


what are the characteristics of norovirus?

RNA virus, most common cause of infectious gastroenteritis, occurs at any age and in semi-closed environments (hosps, care homes, schools and cruise ships). Reservoir = man. 24hrs D+V.


what are the characteristics of clostridium perfringens?

Part of normal gut flora. Associated with slow cooling + un-refrigerated storage – spores germinate, toxin producing (like botulinum + diff)vegetative cells, ingestion of which  gastroenteritis. Also causes gas gangrene.


what are the characteristics of campylobacter?

commonest reported cause of infectious intestinal disease. Reservoir = GIT of birds (particularly poultry). Undercooked/raw meat, unpasteurised milk/bird-pecked milk on doorstep.
-48-96 hours


what is the preliminary phase of food poisoning outbreak?

Is there an outbreak? Confirm diagnosis. What is nature + extent of the outbreak?


what are immediate steps t take during a food poisoning outbreak?

Who’s ill? How many? Case finding – contact those who have also been exposed, i.e. set menu at large events. Symptom profile? Cause? Proper care arranged? Immediate action (get rid of food).


describe data collection/descriptive epidemiology during a food poisoning outbreak?

Time, person, place, no. affected, symptoms, common factors, usually use questionnaires (chance of recall bias).


describe environmental investigation

Environmental health officers visit restaurants + inspect premises, take samples, equipment swabs, and staff not cooking properly.


what are potential causes of food safety concern?

food-borne illnesses, nutritional adequacy, environmental contaminants, naturally occurring contaminants, pesticide residues, food additives


describe the role of analytical epidemiological studies in food poisoning outbreak?

Used to ID probable cause in absence of lab confirmation. Point source outbreak = cohort study, common source outbreak = case-control study.


what is the role of the public health act in preventing food poisoning outbreeaks?

allows exclusion from work of people that pose an increase risk of spreading GIT
-Persons with doubtful personal hygiene/unsatisfactory toilet hand-washing
-Children in nursery or pre-school groups
-People whose work involves prep
-H&S care staff who have contact with highly susceptible persons (extremes of age, pregnancy, immunosuppressed)


what is the purpose of UK food law?

Based on 1° objectives of: High level of protection of human life + health, protection of consumers’ interests, fair practices in food trade.


describe the food safety act 1990?

Defines food + enforcement authorities + their responsibilities. ‘Food’ includes: drink, articles of no nutritional value but for human consumption, chewing gum, ingredients.
•Offenses under act: Sale of food rendered injurious to health, unfit for consumption, not of quality demanded by purchaser. Display of food with label falsely describing food or likely to mislead as to nature of substance/quality.


what should a doctor do if they suspect food poisoning?

•Report to consultant responsible
• Notify local food safety authority
•Manage as below if in hospital…


describe the management of hospital outbreaks of food poisoning?

•↓with handwashing, bare below elbows, clean equipment, aseptic techniques, general ward hygiene, alcohol gel, prohibit potential reservoirs i.e. cooked food, flowers etc.
•BARRIER NURSING (use PPE – gloves, gowns) • Side rooms – quarantined bay
•Restrict ward access/visiting times – or CLOSE to visitors + new admissions
•Lift new cases after 72hrs symptom free


what are the aims of clinical guidelines?

•Improve quality of healthcare - ↑ chance of better outcomes
•Provide recommendations for care, based on best evidence
•Used to develop standards against which healthcare professionals should be assessed
•Used in education of professionals
• Help pts make informed decisions
•Improve communication between patient + HC professional


how do you assess if a guideline is decent?

-scope and purpose
-stakeholder involvement
-rigour or development
-clarity of presentation
-editorial independence


what is scope and purpose?

described overall objective? Described specific health questions? Population


what is stakeholder involvement?

target users defined? Views/preferences of target population sought?


what is rigour of development?

Systematic search for evidence? Selection criteria? Appraisal of evidence? Methodology for formulation of recommendations? External review? Updating procedure?


what is clarity of presentation?

specific/unambiguous? Clearly presented options? Key recommendations easily ID’d.


what is applicability?

Advice/tools on how to put into practice? Facilitators/barriers described? Resource implications? Monitoring/auditing criteria?


what is editorial independence?

funding body did not influence content? Recorded competing interests of committee involved in development?


what are the barriers to uptake of evidence due to?

characteristics of the adopters
organisation and environment