🍔Gastro🍔 - GI Infections

Question 1

What markers show an inflammatory/infective process?

Answer 1

Increased WCC and CRP

Question 2

What are the causes of infections diarrhoea?

Answer 2

C. difficile
Klebsiella oxytoca
C. perfringens
Salmonella spp

Question 3

What are the causes of non-infectious diarrhoea?

Answer 3

Antibiotics side effect
Post +infectious IBS
IBS
Microscopic colitis
Ischaemic colitis
Coeliac disease

Question 4

What should be done for a patient who is on antibiotics who has suddenly developed diarrhoea?

Answer 4

Infection control - moved to a side room
Discontinue inciting antibiotic agents
Management of fluids, nutrition and diarrhoea

Question 5

What are the signs/symptoms of fulminant colitis?

Answer 5

Hypotension/shock
Ileus
Toxic megacolon

Question 6

What is ileus?

Answer 6

Disruption of the normal propulsive ability of the intestine. It can be caused by lack of peristalsis or by mechanical obstruction

Question 7

What are the markers of a severe infection?

Answer 7

WCC>15
Creatinine>150

Question 8

What is the treatment for non-severe GI infection disease?

Answer 8

Ab therapy with oral vancomycin or fidaxomicin or metronidazole
Possibly faecal microbiota transplantation (FMT)

Question 9

What is the treatments for severe infectious GI disease or fulminant colitis?

Answer 9

Ab therapy, supportive care, close monitoring
Early surgical consultation

Question 10

What is the treatment for pseudomembranous colitis?

Answer 10

Medical therapy with Abx and supportive management
Patient transferred to ITU for invasive monitoring

Question 11

What are the indications for bowel surgery?

Answer 11

Colonic perforation
Necrosis/full-thickness ischaemia
Intra-abdominal hypertension or abdominal compartment syndrome
Clinical signs of peritonitis/worsening abdominal exam despite medical therapy
End-organ failure

Question 12

Outline pseudomembranous colitis

Answer 12

Most often associated with C.difficile infection
Manifestation of severe colonic disease
Characteristic yellow-white plaques
Confirmed on endoscopy +/- biopsy

Question 13

What is CRP vs calprotectin?

Answer 13

CRP is a marker of infection/inflammation
Calprotectin is a marker of specifically bowel inflammation

Question 14

What are the management options for Ulcerative colitis?

Answer 14

Steroids
5-ASA
Immunosuppressants - azathioprine, methotrexate
Biologic therapy
Others - Diet, FMT, Abx, probiotics, novel agents

Question 15

Describe mild UC

Answer 15

Question 16

Describe moderate UC

Answer 16

Question 17

Describe severe UC

Answer 17