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Phase 2a Gastrointestinal system > GI infections > Flashcards

GI infections Flashcards

1
Q

What is the general GI antibiotic?

A

Metronidazole

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2
Q

What is dysentery?

A

Bloody diarrhoea w/ mucus

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3
Q

What is infection of the biliary tract, liver and peritoneum usually a result of?

A

Spread of colonic flora (e.g. E. coli)

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4
Q

Describe the shape of H. pylori

A

Gram -ve curved bacillus

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5
Q

How does H.pylori protect itself from stomach acid?

A

Production of urease (formation of ammonia and CO2 from urea)

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6
Q

How does H. pylori cause gastritis?

A

Causes a neutrophil influx (pro-inflam cytokines), CagA and VacA genes, ammonia

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7
Q

how does H. pylori cause increased gastric acid production?

A

Increases parietal cell mass, inhibits D cells and stimulates G cells

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8
Q

What diseases are linked with H. pylori infection?

A

Gastritis, peptic ulcers, GORD (–> barret’s oesophagus –> oesophageal adenocarcinoma)

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9
Q

What investigations would you do to test for H. pylori infection?

A

Urea breath test 13C, stool Ag, endoscopy + biopsy

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10
Q

What is the treatment for the eradication of H. pylori?

A

Omeprazole, amoxicillin + clarithromycin (I.e. 2 Abx + 1 PPI)

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11
Q

What is gastroenteritis?

A

Infective diarrhoea

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12
Q

What are some of the viral causes of infective diarrhoea?

A

Rotavirus (infants), norovirus, adenovirus

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13
Q

What are some of the bacterial causes of infective diarrhoea?

A

E. coli, campylobacter jejuni, salmonella, shigella, C. difficile

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14
Q

What are some parasitic causes of infective diarrhoea?

A

Cryptosporidium, giardia

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15
Q

What are some non-infective causes of diarrhoea?

A

Coeliac disease, UC, Crohn’s, malignancy, tropical sprue hyperthyroidism

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16
Q

What is the commonest cause of gastroenteritis (infective diarrhoea)?

A

Campylobacter jejuni

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17
Q

What E. coli causes bloody diarrhoea? How?

A

EHEC - shiga-like toxin (1 + 2)

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18
Q

What might you ask in a history if someone presents with diarrhoea?

A

Food handler? Travel? Pets?

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19
Q

What is the commonest cause of traveller’s diarrhoea?

A

ETEC

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20
Q

Give 3 parasitic causes of traveller’s diarrhoea?

A

cryptosporidiosis, giardiasis, amoebiasis

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21
Q

Give a non-infectious cause of traveller’s diarrhoea

A

Tropical sprue

22
Q

How would you treat giardia and amoebiasis infections?

A

Metronidazole

23
Q

give 6 forms of E. coli?

A

ETEC, EHEC, EIEC, EPEC, EAEC, DAEC

24
Q

Which two forms of E. coli are toxin producing? What do they produce?

A

ETEC (produces LT [heat labile] and ST [heat stable]) and EHEC (shiga-like toxin 1 + 2)

25
Q

What does ETEC produce - what does this cause?

A

LT and ST toxins –> increase water loss from enterocytes (watery diarrhoea)

26
Q

What does EHEC produce - what does this cause?

A

Shiga-like toxins 1 and 2 –> bloody diarrhoea

27
Q

What does EIEC do?

A

It invades enterocytes causing them to die –> bloody diarrhoea

28
Q

What type of diarrhoea does EPEC produce - how does it do this?

A

It causes watery diarrhoea by adhering to the intestinal epithelium preventing the absorption of water

29
Q

What causes C. difficile?

A

It is an antibiotic associated diarrhoea - antibiotic misuse (such as fluoroquinolones)

30
Q

How does C. difficile stain?

A

gram +ve

31
Q

Does C. difficile produce spores?

A

Yes

32
Q

How is C. difficile spread?

A

Faeco-oral route

33
Q

What toxins does C. difficile produce? What do they do?

A

Toxins A and B –> increase permeability of the intestinal epithelium to water by reducing tight junctions between cells

34
Q

What type of diarrhoea does C. diff produce?

A

Watery

35
Q

How would you test for C. difficile?

A

Stool sample (GDH), ELISA (toxin A + B), tissue culture cytotoxicity assay

36
Q

What is the GOLD STANDARD investigation for C. difficile?

A

Tissue culture cytotoxicity assay

37
Q

What is the 1st and 2nd line antibiotic for C. difficile?

A

1st: metronidazole

2nd line: vancomycin

38
Q

What are the features that separate diarrhoea in an immunocompromised host from a healthy host?

A

In immunocompromised:

  1. lasts longer
  2. broader range of causative organisms (such as CMV)
  3. more severe presentation
39
Q

What are those who have B cell depletion (e.g. after using rituximab) at risk of? Why?

A

Giardia (a parasite) due to reduced IgE production

40
Q

When do HIV patients start to get opportunistic infection? When do they get diarrhoea related infections?

A
41
Q

Give a viral, bacterial and parasitic cause of diarrhoea in HIV patients with a CD4 count of

A

viral (CMV), bacterial (MAC), parasitic (cryptosporidium)

42
Q

What is unusual about the presentation of cryptosporidium parvum?

A

No fever

43
Q

What are the 3 types of liver abscesses?

A

Bacterial (pyogenic), hydatid cyst and amoebic liver abscess

44
Q

What are the sites of origin of bacteria that cause pyogenic liver abscesses? Give an example for each

A

Intestine (E. coli), dental source (K. pneumoniae), biliary tract…

45
Q

What are the symptoms of a pyogenic liver abscess?

A

Fever, weight loss, RUQ pain

46
Q

what are the signs of a pyogenic liver abscesses?

A

tachycardia, TENDER HEPATOMEGALY, fever

47
Q

What Ix’s would you do to diagnose a pyogenic liver abscesses?

A

Blood cultures, US guided percutaneous aspirate

48
Q

What is the 1st and 2nd line treatment for a pyogenic liver abscesses?

A

1st line: co-amoxiclav and metronidazole

2nd line: catheter drainage (US guided)

49
Q

What causes a hydatid cyst? How would you diagnose it?

A

Dog tapeworm - ELISA serology

50
Q

What is the treatment for a hydatid cyst?

A

Drainage + albendazole

51
Q

What is the treatment for an amoebic liver abscess?

A

Metronidazole

Phase 2a Gastrointestinal system (4 decks)

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