Tropical Gastroenteritis Flashcards

1
Q

What is the most common organism that causes acute travellers diarrhoea?

A

E.coli.

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2
Q

What is the definition of travellers diarrhoea?

A

3 loose stools in 24 hours.

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3
Q

What investigations would you do for acute travellers diarrhoea?

A

Stool culture/microscopy.

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4
Q

What antibiotics may you give for acute travellers diarrhoea?

A

Fluoroquinolone or macrolide.

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5
Q

Where does enteric fever tend to come from?

A

Indian subcontinent/SE Asia.

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6
Q

What are the symptoms of enteric fever?

A

Fever, headache, constipation/diarrhoea, dry cough.

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7
Q

What are the potential complications of enteric fever?

A

GI bleeding, GI perforation, encephalopathy, bone and joint infection.

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8
Q

What is the antibiotic given for enteric fever?

A

IV ceftriaxone.

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9
Q

What is the organism that causes amoebiasis?

A

Entamoeba histolytica (protozoa).

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10
Q

What are the symptoms of amoebic dysentery?

A

Abdominal pain, fever, bloody diarrhoea/colitis, peritonism.

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11
Q

What investigations would you do for amoebiasis?

A

Stool microscopy, AXR (toxic megacolon), endoscopy for biopsy.

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12
Q

What is the incubation period for amoebic liver abscess?

A

8-20 weeks.

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13
Q

What is the clinical presentation of amoebic liver abscess?

A

Fever/sweats, upper abdominal pain, sometimes history of GI upset (dysentery), hepatomegaly, point tenderness.

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14
Q

What should you exclude before aspirating an amoebic liver abscess?

A

Hyatid disease.

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15
Q

What is the management of amoebic liver abscess?

A

Metronidazole or tinidazole.

Paramomycin/diloxanide to clear gut lumen of parasites.

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16
Q

What organism causes giardiasis?

A

Giardia intestinalis (flagellated protozoa).

17
Q

What is the incubation time for giardiasis?

A

Around 7 days.

18
Q

What is the clinical presentation of giardiasis?

A

Watery/malodorous diarrhoea, bloating and flatulence, abdominal cramps, weight loss.

19
Q

What investigations would you do for giardiasis?

A

Stool microscopy for cysts (or PCR), OGD for duodenal biopsy (rarely necessary).

20
Q

What is the treatment of giardiasis?

A

Metronidazole or tinidazole.

21
Q

What is the most common helminth infection in the world?

A

Ascariasis (intestinal nematodes).

22
Q

What is the life cycle of ascariasis?

A

Breaks through gut wall into venous system where it invades lungs, climbs up trachea and gets swallows again.

23
Q

Give 3 examples of flukes.

A

Schistosomiasis.

Liver flukes - clonorchis/fasciola (SE Asia).

24
Q

How does chronic schistosomiasis infection cause liver fibrosis and portal hypertension?

A

Adult worms located in portal venules.

25
Q

What is another name for tapeworms and what are they caught from?

A

Cestodes - undercooked pork and beef.

26
Q

What organism causes Chagas disease?

A

Trypanasoma cruzi (american trypanosmiasis).

27
Q

What transports the organism that causes Chagas disease?

A

The kissing bud (Triatome).

28
Q

What does Chagas disease cause?

A

Parasympathetic denervation affecting the colon or oesophagus. Can cause megaoesophagus.