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Clinical Pathology > CP11-7 GI Infections > Flashcards

CP11-7 GI Infections Flashcards

1
Q

What sites in the GI tract are sterile?

A

Peritoneal space
Pancreas
Gall balder
Liver

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2
Q

What are some non-sterile sites of the GI tract?

A

Mouth
Oesophagus
Stomach
Small bowel
Large bowel

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3
Q

Does presence of all bacteria e.g. neisseria meningitides and strep pneumoniae, in the pharynx always mean there is infection?

A

No - a small amount of these bacteria can be present in normal pharyngeal flora

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4
Q

What are some GI infection signs seen on the mouth?

A

Angular cheilitis
Oral herpes simplex
Hairy leucoplakia

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5
Q

What are 3 examples of dental infections?

A

Caries
Pulpitis
Periapical abscesses

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6
Q

What are some examples of periodontal infection?

A

Gingivitis
Periodontitis
Periodental abscesses
Vincent’s angina aka acute necrotising ulcerative gingivitis
Oral facial space infections if spread.

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7
Q

What are the most common deep neck space infections?

A

Peritonsillar abscess aka a quinsy
Acute suppurative parotitis

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8
Q

What are some uncommon deep neck space infections?

A

Ludwig’s angina (submandibular space infections)
Parapharyngeal space infections - often have carotid sheath involvement

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9
Q

What is mucositis?

A

Inflammation of the mucous membranes if the GI tract

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10
Q

Who is most likely to get mucositis?

A

Chemotherapy patients - especially if have pre-existing periodontal disease.

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11
Q

What is another name for an effort rupture of the oesophagus?

A

Boerhaave syndrome

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12
Q

What happens as a consequence of intrathoracic oesophageal rupture?

A

Chemical mediastinitis, with mediastinal emphysema and inflammation which can lead to bacterial infection and mediastinal necrosis.

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13
Q

How does H. Pylori spread?

A

Faecal oral/ oral oral exposure

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14
Q

What percentage of h.pylori infections lead to ulcer disease?

A

10-15%

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15
Q

What are consequences of h.pylori infection?

A

Pain
Bleeding
Perforation of stomach

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16
Q

What allows h.pylori to penetrate the gastric mucus layer?

A

Formation of ammonia that neutralises gastric acid by bacterial ureases hydrolysing gastric luminal urea. Ammonia acts as a protective layer

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17
Q

What is the most common biliary tract infection?

A

Cholangitis

18
Q

How do patients with cholangitis usually present?

A

Fever
Abdominal pain
Jaundice

Known as charcot’s triad

19
Q

What bacteria most commonly cause infective cholangitis?

A

Enterobacteriaceae and enterococcus species

20
Q

How do patients with cholecystitis present?

A

Abdominal pain
Fever
History of fatty food ingestion one hour prior to onset of pain
With gall stones usually

21
Q

What LFTs are important to look at in cholangitis?

A

Conjugated bilirubin
Serum ALP
GGT

22
Q

What commonly causes bacterial overgrowth in the small bowel?

A

Achlorhydria
Impaired bowel motility
Blind loops of bowel
Surgery
Radiation damage

23
Q

How does bacterial overgrowth In the small bowel affect the body?

A

Bacteria may bind to vitamins e.g. vit B12, use nutrients and produce metabolites like fatty acids

24
Q

What is associated with bacterial overgrowth of small bowel?

A

Malabsorption
Chronic diarrhoea

25
Q

What is Whipple’s disease?

A

Infection of tropheryma whipplei affecting people with a rare immune defect causing joint symptoms, chronic diarrhoea, malabsorption and weight loss which develop over time. Usually only considered after other diagnoses are excluded.

26
Q

What is the aetiology of liver abscesses?

A

Ascending biliary tract infection
Can occur in portal vein after peritonitis or colonic perforation
Haematogenous causes e.g. endocarditis

27
Q

What is a GI disease we can get from un-wormed dogs?

A

Hydatid cyst

28
Q

How does mycobacterium tuberculosis affect the GI tract?

A

Causes local symptoms like non healing oral ulcers, gastric ulcers and enterocutaneous fistulas

29
Q

What site of the GI tract is most commonly affected by tuberculosis?

A

Ileo-caecal area

30
Q

What are some infection complications of pancreatitis caused by enteric bacteria?

A

Necrotising pancreatitis
Peripancreatic fluid collection
Pancreatic pseudocyst
Acute necrotic collection
Walled off necrosis

31
Q

How is a complicated intra-abdominal infection defined?

A

An infection that extends beyond the hollow viscus of origin into the peritoneal space and is associated with either abscess formation or peritonitis

32
Q

What is the most common cause of complicated intra-abdominal infections

A

Perforation of an inflamed organ e.g. gallbladder, appendix, duodenum

33
Q

How is complicated diverticulitis treated?

A

With antibiotics and surgery e.g. abscess drainage or resection of affected bowel

34
Q

How does treatment of appendix differ if it is complicated vs uncomplicated?

A

Both treated with surgical management plus antibiotics in complicated but only a single dose of antibiotic prophylaxis in uncomplicated

35
Q

What are some predisposing factors for intra abdominal abscesses?

A

Peptic ulcer perforation
Perforated appendix
Perforated diverticulum
Mesenteric ischemia/bowel infarction
Pancreatitis/pancreatic necrosis
Penetrating trauma
Postoperative anastamotic leak

36
Q

How do patients with an intra-abdominal abscess present?

A
37
Q

What is spontaneous bacterial peritonitis?

A

An ascitic fluid infection without an evident intra-abdominal surgically treatable source which occurs due to bacteria within the gut lumen crossing the intestinal wall into mesenteric lymph nodes which rupture due to portal hypertension.

38
Q

Who is most likely to have spontaneous bacteria peritonitis?

A

Patients with advanced cirrhosis and ascites

39
Q

How is spontaneous bacterial peritonitis diagnosed?

A

With ascitic fluid bacterial culture showing elevated ascitic fluid absolute polymorphonuclear leukocyte (PMN) count of >250 cells/mm3

40
Q

What infection is common in patients with bowel cancer?

A

Bacteraemia caused by strep bovis aka s.gallolyticus which is associated with endocarditis

Clinical Pathology (65 decks)

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