NURS 5461 Gastroenteritis New Exam With Questions And
Correct Answers (A+) Latest Update
Epidemiology and Causes - ANSWER Acute gastroenteritis is most often from an
infectious agent— food and waterborne outbreaks are important causes, fecal-oral
route
-Person-to-person transmission is more prevalent in hospitals and daycare centers
**Those at highest risk—anyone travelling to a developing country, immunosuppressed,
those practicing anal intercourse, residents of LTAC, those consuming raw shellfish and
seafood
Pathophysiology - ANSWER ⚫ Most forms of gastroenteritis present with
diarrhea—which is not considered an emergency unless it involves an older adult who
cannot control their fluid intake
With *viral FBD it is usually transmitted through infected food handlers, in a given
setting [café, banquet, etc.]
Most states require reporting of - ANSWER Hepatitis A - Botulinum - Salmonella - STEC
0157 - Listeria - Shigella - Vibrio
The most common players - ANSWER —**Norovirus (1/3), Hep A, Rotavirus most
common V
nontyphoid Salmonella, Clostridium perfringens, Campylobacter, Staphylococcus
aureus, Toxoplasma gondii, Listeria monocytogenes, Yersinia, and ***Shiga
toxin-producing E. coli [aka know as STEC E. coli 0157 ]
Non-Shiga toxin producing—enteropathogenic E. coli; enteroinvasive E. coli;
enteroaggregative E coli and diffusely adherent E. c
Gastroenteritis - ANSWER caused by bacterial food toxins in food- "food poisoning" In
healthy adults—the s/sx usually self-limited CDC says that 1 in 6 Americans affected q
yr.
Can be acute or chronic (food allergy)
, Shigella spp. presentation - ANSWER ⚫ Presents as mucoid/watery [possibly bloody]
diarrhea, with abdomen pain, fever and tenesmus ⚫ Symptoms begin 8-48° following
infection ⚫ Duration of illness 4-7 days ⚫ Reactive arthritis in 2-7%; Reiter's syndrome in
3% ⚫ Stool cultures [may require rectal swab] during acute illness may yield Shigella
This is a nationally reportable illness
Shigella RX - ANSWER ⚫ Antimicrobial therapy is not recommended for most
cases-because of high rates of resistance ⚫ Severe cases, those in the older adult or in
the immune suppressed-can be treated with Azithromycin, Ceftriaxone [IM] or
fluoroquinolones or sulfa [if acquired in the US] ⚫ Z-pak; Cipro 500 mg BID for 3 days;
Bactrim DS BID for 3 days; Rocephin 1-2 grams IM daily for 3-5 days
Escherichia coli - ANSWER 6 virotypes that we are concerned with [last 3 are not as well
established]: STEC [Shiga toxin-producing or enterohemorrhagic E. coli]
Enterotoxigenic E. coli— traveler's diarrhea Enteropathogenic E. coli— infantile
diarrhea
Enteroaggressive E. coli Enteroinvasive E. coli Diffusely adherent E. coli
Incubation is usually 3-4 days [can range from 1 to 10 days]
Shiga Toxin-Producing E. coli - ANSWER STECs adhere to and efface the wall of the LB
⚫ Infective dose of STEC 0157 is 10 organisms ⚫ 3 rd leading cause of FBD in the US ⚫
Fecal contaminated food/water or person to person contact with an infected person ⚫
Undercooked beef =most outbreaks - Contaminated raw milk, dry-cured meats, sprouts,
unpasteurized fruit juice, vegetables, petting zoos and cattle have been the cause of
STEC
Shiga Toxin-Producing E. coli - ANSWER Symptoms begin 1-8 days after consumption
Severe belly pain and cramping, watery diarrhea, vomiting and/or low-grade fever HCP
visits usually take place when the gastroenteritis is in the 2nd stage—when the diarrhea
becomes blood Usually STEC is self-limited, lasting 5-10 days
Correct Answers (A+) Latest Update
Epidemiology and Causes - ANSWER Acute gastroenteritis is most often from an
infectious agent— food and waterborne outbreaks are important causes, fecal-oral
route
-Person-to-person transmission is more prevalent in hospitals and daycare centers
**Those at highest risk—anyone travelling to a developing country, immunosuppressed,
those practicing anal intercourse, residents of LTAC, those consuming raw shellfish and
seafood
Pathophysiology - ANSWER ⚫ Most forms of gastroenteritis present with
diarrhea—which is not considered an emergency unless it involves an older adult who
cannot control their fluid intake
With *viral FBD it is usually transmitted through infected food handlers, in a given
setting [café, banquet, etc.]
Most states require reporting of - ANSWER Hepatitis A - Botulinum - Salmonella - STEC
0157 - Listeria - Shigella - Vibrio
The most common players - ANSWER —**Norovirus (1/3), Hep A, Rotavirus most
common V
nontyphoid Salmonella, Clostridium perfringens, Campylobacter, Staphylococcus
aureus, Toxoplasma gondii, Listeria monocytogenes, Yersinia, and ***Shiga
toxin-producing E. coli [aka know as STEC E. coli 0157 ]
Non-Shiga toxin producing—enteropathogenic E. coli; enteroinvasive E. coli;
enteroaggregative E coli and diffusely adherent E. c
Gastroenteritis - ANSWER caused by bacterial food toxins in food- "food poisoning" In
healthy adults—the s/sx usually self-limited CDC says that 1 in 6 Americans affected q
yr.
Can be acute or chronic (food allergy)
, Shigella spp. presentation - ANSWER ⚫ Presents as mucoid/watery [possibly bloody]
diarrhea, with abdomen pain, fever and tenesmus ⚫ Symptoms begin 8-48° following
infection ⚫ Duration of illness 4-7 days ⚫ Reactive arthritis in 2-7%; Reiter's syndrome in
3% ⚫ Stool cultures [may require rectal swab] during acute illness may yield Shigella
This is a nationally reportable illness
Shigella RX - ANSWER ⚫ Antimicrobial therapy is not recommended for most
cases-because of high rates of resistance ⚫ Severe cases, those in the older adult or in
the immune suppressed-can be treated with Azithromycin, Ceftriaxone [IM] or
fluoroquinolones or sulfa [if acquired in the US] ⚫ Z-pak; Cipro 500 mg BID for 3 days;
Bactrim DS BID for 3 days; Rocephin 1-2 grams IM daily for 3-5 days
Escherichia coli - ANSWER 6 virotypes that we are concerned with [last 3 are not as well
established]: STEC [Shiga toxin-producing or enterohemorrhagic E. coli]
Enterotoxigenic E. coli— traveler's diarrhea Enteropathogenic E. coli— infantile
diarrhea
Enteroaggressive E. coli Enteroinvasive E. coli Diffusely adherent E. coli
Incubation is usually 3-4 days [can range from 1 to 10 days]
Shiga Toxin-Producing E. coli - ANSWER STECs adhere to and efface the wall of the LB
⚫ Infective dose of STEC 0157 is 10 organisms ⚫ 3 rd leading cause of FBD in the US ⚫
Fecal contaminated food/water or person to person contact with an infected person ⚫
Undercooked beef =most outbreaks - Contaminated raw milk, dry-cured meats, sprouts,
unpasteurized fruit juice, vegetables, petting zoos and cattle have been the cause of
STEC
Shiga Toxin-Producing E. coli - ANSWER Symptoms begin 1-8 days after consumption
Severe belly pain and cramping, watery diarrhea, vomiting and/or low-grade fever HCP
visits usually take place when the gastroenteritis is in the 2nd stage—when the diarrhea
becomes blood Usually STEC is self-limited, lasting 5-10 days
