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GI Extra > 9.2 GI Infections > Flashcards

9.2 GI Infections Flashcards

1
Q

4 benefits of the microbiome

A
  1. Harmful bacteria cant colonise/compete for nutrients
  2. Oroduces antimicrobials
  3. Develops newborn immune system
  4. Make vit K (byproduct kf bacteria metabolism)
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2
Q

Which short chain fatty acids do bacteria in colon make, and whats their functions?

A

Butyrate- energy for colonocytes, regulates gut environment
Acetate- cholesterol metabolism
Propionate- regulates satiety

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3
Q

Consequences of poor gut microbiota

A

Obesity
IBD
Poor chemotherapy response
Poor insulin response
(Less diversity)

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4
Q

Which factors of lifestyle can negatively impact microbiota diversity?

A

-sweeteners
-gluten free diet if not coeliac
-ppi’s
-antibiotics in meat

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5
Q

Faecal microbiota transplant
-what is it
-helps to treat?

A

Healthy faeces given to unwell person, replaces imbalanced bacteria

-c diff
-IBD
-crihns

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6
Q

Where is the faeces from in Faecal microbiota transplant?

A

10-25 year old, no ABx or laxatives or diet pills, no GI disease, screened for HIV etc
1 hour

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7
Q

Length of salmonella infection

A

2-3 days

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8
Q

Describe the pathogenesis of salmonella

A

-enter enterocytes via endocytosis
-go to submucosa, taken up by macrophages
-carries to RES
-multiply intracellularly
-cause lymphoid hyperplasia
-reenter bowel via liver and gallbladder

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9
Q

Is campylobacter microaerophilic?

A

Yes

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10
Q

Incubation of campylobacter

A

1-7 days

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11
Q

Type of diarrhoea in campylobacter

A

Profuse (due to cytotoxin), can be bloody

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12
Q

Whos commonly affected by shigella?

A

Children under 5

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13
Q

Why is shigella diarrhoea so bloody?

A

Kills colonocytes and forms abscesses in mucosa

Also mucus in diarrhoea

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14
Q

Resolution of shigella

A

A week

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15
Q

Pathogenesis of ET E coli

A

-adheres to enterocytes, makes enterotoxins
-hypersecretion of chloride ions from enterocytes
-water cleaves to lumen as Na+ also in lumen

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16
Q

Commonest cause of travellers diarrhoea

A

ET E coli

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17
Q

Which gram negative bacteria cause bloody diarrhoea?

A

Shigella
Campylobacter

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18
Q

Which gram negative bacteria cause watery diarrhoea?

A

ET e coli
Slamonella

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19
Q

Which gram negative bacteria can cause HUS?

A

Shigella
Campylobacter

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20
Q

HUS

A

Anaemia
Thrombocytopenia
AKI

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21
Q

What type of bacteria is c diff?

A

Gram positive, anaerobic, spore forming

22
Q

Main precipitating factor for c diff colonisation

A

Antibiotics

23
Q

C diff toxins and their actioms

A

A- enterotoxin that causes excess secretions and inflammation
B- cytotoxin kills meterocytes

24
Q

Symptoms of c diff infection

A

Asymptomatic
Varying diarrhoea severity
Abdo cramps

25
Q

Serious complications of c diff infection

A

Pseudomembranous colitis
Toxic megacolon

26
Q

Whats Pseudomembranous colitis?

A

Complication of c diff, elecatedyellow plaques join to form a pseudomembrane

27
Q

C diff treatment

A

Remove offending antibiotic
Fluid resus
Metronidazole/vancomycin
Probiotics (replace commensal bacteria)

28
Q

2 viral causes of gastroenteritis

A

Rotavirus
Norovirus

29
Q

3 parasitic causes of gastroenteritis

A

Cryptosporidium
Giardia
Entamoeba

30
Q

Whos affected by rotavirus (also whos not?)

A

Under 5s
Not adults as immunity lasts

31
Q

First symptom of rotavirus

A

Vomiting with fever

32
Q

Treatment of rotavirus

A

Manage dehydration

33
Q

Explain 3 mechanisms of rotavirsu causing diarrhoea

A
  1. Increases chloride secretion
    -via cAMP so opens CFTR
    -Na+ follows and water by osmosis
  2. SGLT1 disruption
    -redyced movementof Na+ and water, stay in lumen
    -hugher osmotic load exters osmotic presure
    -water moves by osmosis
  3. Bursh border dysfunction
    -general malabsorption so increased osmotic pressure
34
Q

Where does norovirus infect?

A

Small intestibne, damages microvilli

35
Q

Why vomiting in norovirus?

A

Pressure of timach increases due to delayed gastric emptying, so vomiting releives the pressure

36
Q

Pathogenesis of cryptosporidium causing gastroenteritis

A

-ingestion of oocyst
-resproduces inside epithelial cells of distal small intestine
-excreted in faeces and cycle continues

37
Q

Type of diarrhoea in cryptosporidium

A

Watery, due to chlroide secretion and brush border affceted

38
Q

Incubation period for giardia

A

10 days

39
Q

Duration of abdo cramps in giardia

A

Up to 6 weeks

40
Q

Lifecycle of giardia

A

1 cyst ingested, stomach + oancreatic enxymes release parasite from cyst
Damages proximal small intestine = diarrhoea
2. Parasite reformes cyst in colon
Excreted and repeats cycle

41
Q

Treatment of giardia

A

ABx and fluid replacement

42
Q

Common deficiency after giardia

A

Lactase = kactose intolerance

43
Q

Symptoms of entamoeba

A

Asymptomatic 80%
Diarrhoea, ,iver abscesses

44
Q

Highest prevalence of entamoeba

A

Developing countries

45
Q

Pathogenesis of entamoeba

A

-ingest cyst, excystaion in colon
-trophozoites invade mucosa = bloody diarrhoea
-can soread to lover and heart (abscesses)
-pass out in faeces after cyst reforms

46
Q

Entamoeba treatment

A

Antiprotzoals/metronidazole
Surgery if toxic megacolon

47
Q

Trophozoite

A

Activate dfeeding stage of entamoeba, not infective to others

48
Q

Whos given antibiotics cor travellers diarrhoea?

A

Immunocompromised

49
Q

Treatment of mild travellers diarrhoea

A

Hydration
Antidarrhoeal agents

50
Q

Treatment of severe travellers diarrhoea (>6stools per day)

A

IV fluids
ABx

GI Extra (16 decks)

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