Diarrhoea Flashcards
What are the differentials in an 18yo presenting with diarrhoea?
Infective diarrhoea IBS Coeliac disease Crohn's disease UC Medication induced Hyperthyroidism
What are the differentials in a 64yo presenting with diarrhoea?
Neoplastic diseases Diverticular diseases Ischaemic colitis Microscopic colitis Bacterial overgrowth
Crohn’s (second incidence peak at age 50-80)
Why would you ask a patient with diarrhoea about eye problems, joint pains, or skin rashes?
Uveitis, scleritis, episcleritis, enteric arthriti, erthyma nodosum and pyoderma gangrenosum are all associated with IBD
What is the name of rash associated with Coeliac disease?
Dermatitis herpetiformis
What is the blood test for Coeliac disease?
Tissue transglutaminase (TTG) and IgA levels
What is overflow diarrhoea?
Diarrhoea caused by an obstruction that allows only fluid and air to bypass, causing liquid diarrhoea that is hard to control
Why are patients with UC offered regular colonoscopies?
They have a five-fold increased risk of colon cancer
If malignancy is detected, the usual procedure is to excise the entire colon
What is the most likely infective organisms in an outbreak of V&D in an old person’s nursing home?
Norovirus (small structured rounvirus)
What is the most likely infective organism in an outbreak of bloody diarrhoea at a local primary school?
Shigella or with E. coli 0157
What is the most likely infective organism in a university student with watery diarrhoea a few days after a BBQ?
Campylobacter jejuni
What is the most likely organism in a group of guest with sudden-onset diarrhoea a few hours after a wedding reception?
Rapid-onset diarrhoea after a meal suggests that the meal was contaminated with bacteria that have
excreted active toxins, hence the rapid onset of symptoms. When the diarrhoea is caused by the pathogen’s growth in the bowel, the onset of symptoms is usually much slower. Staphylococcus aureus and Bacillus cereus are both bacteria that grow on warm food and produce toxins that result in rapid-onset diarrhoea.
What is the most likely infective organism in an 82 year old in hospital receiving antibiotics for pneumonia?
Clostridium difficile
What is the most likely infective organism in a young woman who has just returned from Ghana and has right iliac fossa pain and diarrhoea?
The diarrhoea could be simple ‘traveller’s diarrhoea’ caused by an enterotoxigenic strain of E. coli but the right iliac fossa pain should make you suspicious of Yersinia enterocolitica
