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GI: Gastroenteritis > bacteria > Flashcards

bacteria Flashcards

1
Q

what host factors are risk factors for gastrointestinal infections?

A 
Age (very young & elderly)
↓ gastric acid secretion
↓ gut motility
Influence of colonic microflora
Intestinal immunity
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2
Q

what are the common bacteria seen in the UK? 5

A
  • campylobacter coli/jejuni
  • salmonella enterica
  • E.Coli 0157
  • shigella sonnei
  • Staph aureus/ clostridium perfringens/ bacillus cereus
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3
Q

what are the common viruses seen in the UK? 2

A
  • norovirus

- rotavirus

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4
Q

rota virus is seen in _____ ____

A

small children

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5
Q

what are the bacteria that are usually imported from abroad? 4

A
  • vibrio cholerae/ parahaemolyticus
  • salmonella typhi/ paratyphi
  • aeromonas
  • shigella dysenteriae/ flexneri/boydii
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6
Q

name 2 parasites found in the UK?

A

cryptosporidum sp and giardia lamblia

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7
Q

what does campylobacter look like?

A

a curved gram negative bacillus - seagull

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8
Q

______ is the commonest cause of bacterial GI infection in the UK – >6,500 cases per year in Scotland

A

campylobacter

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9
Q

what is the incubation period for campylobacter?

A

3-10 days

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10
Q

campylobacter leads to inflammation of the ___ and ___

A

colon and rectum

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11
Q

camplylobacter can become systemic, true/false?

A

true

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12
Q

what is the source/vehicle for campylobacter?

A

Farm animals, esp. undercooked poultry, water & unpasteurised milk

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13
Q

what are the symptoms of campylobacter?

A

Abdominal pain, diarrhoea +/- blood

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14
Q

the treatment for campylobacter is ___ ___ however, if it becomes systemic give ___ or ____ for 5 days

A

self limiting

erythromycin, ciprofloxacin

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15
Q

person to person spread of campylobacter , true/false?

A

false

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16
Q

non typhoidal salmonella is called ____

A

enterica

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17
Q

what is the incubation period for salmonella enterica?

A

12-48 hours

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18
Q

salmonella enterica causes inflammation of the ____ and ____. They multiply in the gut and cause ___ ___ , decreased ___ ___ and increased ___

A

ileum and colon, multiply in gut and cause mucosal damage, ↓fluid absorption and ↑fluid excretion

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19
Q

salmonella can become systemic, true/false?

A

true

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20
Q

what is the source/vehicle for salmonella ?

A

Farm animals, esp. undercooked poultry. Much less common since immunisation of poultry against Salmonella spp.

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21
Q

what are the symptoms of salmonella?

A

Abdominal pain, diarrhoea, occasionally bloody, vomiting

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22
Q

salmonella is ____ ___ ___ , -___ for 5 days if patient at risk of or develops systemic illness (fever, rigors, flu-like symptoms etc)

A

Usually self-limiting, ciprofloxacin for 5 days if patient at risk of or develops systemic illness (fever, rigors, flu-like symptoms etc)

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23
Q

Shigella sonnei, the most )_____ species of Shigella, is the only species seen in UK. ____ occur every few years amongst cohorts of vulnerable ____

A

Shigella sonnei, the most benign species of Shigella, is the only species seen in UK. Outbreaks occur every few years amongst cohorts of vulnerable children

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24
Q

what is the incubation period for shigella sonnei?

A

1-9 days

25
Q

shigella sonnei invades ___ ___ causing severe inflammation, but does not invade further (never seen in ___ ____ ). ___ cells and ____ seen in stools

A

Invades intestinal mucosa causing severe inflammation, but does not invade further (never seen in blood cultures). Pus cells and blood seen in stools

26
Q

what is the source/vehicle for shigella sonnei ?

A

Human only infection. Often spread person-person esp. amongst young children in schools, nurseries or via fomites (towels, toilet door handles etc)

27
Q

what are the symptoms of shigella sonnei?

A

Abdominal pain, diarrhoea, occasionally bloody

28
Q

what is the management for shigella?

A

symptomatic treatment only

29
Q

Other species of Shigella (dysenteriae, flexneri, boydii), acquired ___ from food or water contaminated with human ____ cause more ____ infection (bacillary dysentery) that usually requires treatment with _____

A

Other species of Shigella (dysenteriae, flexneri, boydii), acquired abroad from food or water contaminated with human sewage cause more severe infection (bacillary dysentery) that usually requires treatment with ciprofloxacin

30
Q

what does the O in e.coli 0157 refer to ?

A

the “O” (somatic) antigen on the surface of the organism i.e. it is a specific serotype of the usually benign E. coli. “H” is the flagellar antigen

31
Q

the ____:___ strain of e.coli produces verotoxin

A

The O157:H7 strain

32
Q

what does the verotoxin do?

A
  • Binds to receptors found on renal cells, RBC & others
  • Inhibit protein synthesis
  • Causes cell death
33
Q

who is most at risk at getting HUS?

A

children under 5 and the elderly

34
Q

____ is the commonest cause of renal failure in children

A

e.coli O157

35
Q

what is the source/vehicle for e.coli?

A
  • Source - Carried as part of the normal gut flora in cattle.
  • Beef becomes contaminated on the outside at slaughter – so ↑risk from minced meat & hamburgers than from a steak.
  • Nursery/school visits to farms
  • Private (untreated) water supplies – run off water from fields
  • Low infecting dose, so person-person spread causes 2y cases
36
Q

what are the symptoms of e.coli ?

A

Abdominal pain, bloody diarrhoea is common

37
Q

what is the management for what is the management for e.coli? 3

A
  • Symptomatic and supportive treatment only
  • Antibiotics contraindicated as may ↑ release of toxin
  • Check bloods for HUS 1 week after onset of symptoms
38
Q

what does the O157 strain do?

A

produces a verotoxin that damages red cells and the kidney, causing haemolytic-uraemic syndrome (HUS)

39
Q

what is HUS? 3

A

↑blood urea, red cell haemolysis & thrombocytopenia

40
Q

what is the clinical presentation of HUS?

A
  • Abdo pain, fever, pallor, petechiae (haemorrhages in skin), oliguria (↓urine production)
  • bloody diarrhoea
41
Q

Peak presentation of HUS is __-___ days after onset of diarrhoea

A

7-10

42
Q

what would be found of blood tests?5 for HUS

A
  • High white cells
  • Low platelets
  • Low HB
  • Red cell fragments
  • Lactate dehydrogenase ↑>1.5 x normal
43
Q

salmonella, shigella and e.coli O157 appears as ___ ___ ___

A

gram negative bacilli

44
Q

what? causes typhoid/paratyphoid fever

A

salmonella typhi/ salmonella paratyphi A and B

45
Q

____/____ ___ These are febrile illnesses initially (bacteria circulating in bloodstream) causing headache, flu-like symptoms followed by diarrhoea 3 weeks later

A

Typhoid/paratyphoid fever

46
Q

what is the intubation period for Typhoid/paratyphoid fever

A

14-21 days

47
Q

Organism invades from ___ ____ →_____ system→ bloodstream→______system & gall bladder→gut lumen and invades Peyer’s patches.

A

Organism invades from gut lumen→lymphatic system→ bloodstream→reticuloendothelial system & gall bladder→gut lumen and invades Peyer’s patches.

48
Q

what is the source/ vehicle of infection for salmonella typhi/ paratyphi ?

A

Human only infection. Spread person-person or from drinking contaminated water/eating contaminated food/poor sanitation

49
Q

what are the symptoms of salmonella typhi/paratyphi?

A
  • Fever, rash on abdomen (“Rose spots”) and diarrhoea
50
Q

what is the management of salmonella typhi/paratyphi?

A

Antibiotics are required, choice depends on sensitivities. Resistance to ciprofloxacin becoming common in developing countries

51
Q

what organism causes cholera?

A

vibrio cholerae - a small curved gram negative bacillus

52
Q

where are outbreaks of cholera common?

A

Outbreaks common in “disaster” or war situations

53
Q

what is the intubation period for cholera?

A

1-9 days

54
Q

in cholera
Organism produces an _____ that causes active outpouring of __ from cells of small intestine, resulting in severe ___ diarrhoea

A

Organism produces an exotoxin that causes active outpouring of fluid from cells of small intestine, resulting in severe watery diarrhoea

55
Q

cholera is the exception to the rule that ____ are produces by gram positive

A

exception to the rule that exotoxins are produces by gram positiv

56
Q

what is the source/ vehicle of infection for cholera?

A

Human only infection. Spread person-person or from drinking contaminated water/poor sanitation

57
Q

what are the symptoms of salmonella cholera?

A

Watery diarrhoea – “rice water stools” causing rapid dehydration

58
Q

what is the management of cholera? 2

A
  • Fluid and electrolyte replacement is essential

- Antibiotics NOT indicated

GI: Gastroenteritis (10 decks)

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