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JazGI > GI infections > Flashcards

GI infections Flashcards

1
Q

diarrhoea definition

A

3 or more loose stools in 24hrs

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2
Q

source/reservoir of infection =

A

original site of infection eg. cattle gut

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3
Q

Seagull curved gram -ve bacillus that is most common cause of GI infection

A

campylobacter

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4
Q

C. jejuni/coli are examples of ____ bacteria

A

campylobacter

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5
Q

Incubation period and infective dose of campylobacter

A

3-10days

10^2 - 10^6

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6
Q

sources of campylobacter

A

farm animals > undercooked poultry, water and unpasteurised milk

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7
Q

Treatment for campylobacter

A

none unless systemic illness =

erythromycin/ciprofloxacin for 5 days

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8
Q

signs of campylobacter infection =

A

diarrhoea +/- blood
abdo pain
bacteraemia is possible => systemic

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9
Q

incubation period and infectious dose of salmonella enterica

A

12-48hrs

10^5

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10
Q

Sources of salmonella =

A

farm animals > undercooked poultry

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11
Q

signs of salmonella =

A

abdo pain
vomiting
diarrhoea +/- blood (blood less likely)

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12
Q

campylobacter causes inflammation in __+__

A

colon and rectum

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13
Q

salmonella causes inflammation in __+__ causes __ damage and decreased ___ and increased ___

A

ileum and colon
mucosal damage
decreased fluid absorption
increased fluid excretion

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14
Q

treatment for salmonella enterica

A

none

unless systemic = cirofloxacin 5 days

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15
Q

Shigella sp. that is most benign and only one native to UK

A

sonnei

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16
Q

Shigella can/cant get into bloodstream?

incubation period and infecitous dose

A

CANNOT
1-9days
10-100

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17
Q

signs of shigella spp. infection

A

abdominal pain

diarrhoea +/- blood and pus

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18
Q

Shigella mainly infects ___

is spread __

A

children eg. nurseries

person-person or fomites

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19
Q

Treatment for shigella

A

none

unless systemic sonnei/sp. from abroad = ciprofloxacin

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20
Q

O and H in E.coli O157 H7=

A 
O = surface antigen
H = flagellar antigen
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21
Q

E coli O157 toxin =

which damages ___ causing ___ syndrome

A

Verotoxin / VTEC

RBCs and kidneys ; HUS (haemolytic uraemic syndrome

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22
Q

bloods of HUS show

A

increased blood urea, WCC
lactate dehydrogenase more than 1.5xULN
RBC fragments
decreased platelets and Hb

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23
Q

E. coli is a ___ of cattles

it is spread __

A

commensal

person-person, minced beef/burgers, water, farm visits

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24
Q

Groups most at risk of HUS =

most common cause of renal failure in ___

A

under 5yos and elderly

under 5yos

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25
Q

signs of E. coli infection

A

abdominal pain, bloody diarrhoea

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26
Q

treatment of E. coli infection

A 
NO antibiotics (increases VTEC release)
check bloods for HUS 1 wk after onset of symptoms
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27
Q

signs of HUS

A 
abdo pain
fever
pallor
petechiae
oliguria
90% have bloodydiarrhoea
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28
Q

Peak presentation of HUS is ___ days after infection

A

7-10 days

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29
Q

salmonella, shigella, campylobacter and E. coli are gram ___, ___

A

-ve bacilli

differentiated by biochemistry then serology after cultured

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30
Q

Salmonella paratyphi/typhi incubation period and infectious dose

A

14-21 days

10^5

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31
Q

Infection that starts with a fever, headache and flu-like then causes diarrhoea 3 wks later

A

Salmonella paratyphi/typhi

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32
Q

Organism that goes from gut lumen to lymphatics to the blood. Then enters the reticuloendothelial system and gallbladder and goes to gut lumen and Peyer’s patches

A

Salmonella paratyphi/typhi

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33
Q

Carriers of salmonella typhi/paratyphi carry it in their __

A

gallbladder

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34
Q

salmonella typhi/paratyphi is native/from abroad

A

abroad

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35
Q

Signs of salmonella typhi/paratyphi =

A

fever, rash on abdomen = rose spots

diarrhoea

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36
Q

salmonella typhi/paratyphi spreads by ___

A

person to person

contaminated water/food or poor sanitation

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37
Q

treatment for salmonella typhi/paratyphi

A

antibiotics (must sensitivity test to find which one)

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38
Q

organism that causes cholera

A

Vibrio cholerae

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39
Q

Comma -ve bacillus =

A

Vibrio cholerae

40
Q

Infection common in refugee camps

A

cholera

41
Q

incubation period and infectious dose of Vibrio cholerae

A

1-9 days

10^8

42
Q

Vibrio cholerae produces an ___ that causes ___

A

exotoxin

outpouring of fluid from cells = watery diarrhoea

43
Q

rice water stools =

A

cholera

44
Q

Cholera is spread

A

person to person

contaminated water

45
Q

Treatment for cholera

A

NO antibiotics

fluids and electrolyte replacement

46
Q

Organisms that cause infection by pre-formed toxins =

A

Bacillus cereus
S.. aureus
Clostridium perfringens

47
Q

S. aureus produces an ___

goes to ___>___ and stimulated vomiting within __

A

entero/exotoxin
vagus>VC
1-2hrs

48
Q

large gram +ve anaerobic bacillus who causes infection by a preformed enterotoxin

A

clostridium perfringens

49
Q

large gram +ve aerobic bacillus that produces a preformed exotoxin
due to poorly reheated rice

A

bacillus cereus

50
Q

Cryptosporidium is a ___
from (4)
causes ___ which is severe in HIV +ve

A

protozoa
calves, person-person, swimming pools(Cl- resistant) and contaminated water
diarrhoea

51
Q

Giardia lamblia is a ___
from ___
signs =
treatment =

A

protozoa
infected water
malabsorption, anorexia, abdo pain, flatulence, diarrhoea
metronidazole PO

52
Q

Treatment of cryptosporidium =

A

symptomatic treatment only

53
Q

Cryptosporidium are stained with a ___

A

modified ZN stain

54
Q 
Enterobius vermicularis/ \_\_\_
are seen commonly in \_\_\_
ova ingested and live in \_\_\_ ; females lay eggs on \_\_ at night
symptoms =
Diagnose =
treat =
A 
threadworms
school kids
colon
perianal skin
perianal itch
microscopy of stool
mebendazole PO
55
Q

Vertical transmission of microbial resistance is by __

A

mutations acquired and passed on

56
Q

Horizontal transmission of microbial resistance is by ___

A

transformation, transduction and conjugation

57
Q

In bacterial resistance transformation =

A

integrate DEAD BAC genes into genome

58
Q

In bacterial resistance transduction =

A

BACTERIOPHAGES (viruses) transfer genes

59
Q

In bacterial resistance conjugation =

A

PILLI transfer genes

60
Q

4Ds of microbial stewardship =

A

dose
deescalation
duration
drug

61
Q

___ makes no difference to development of antimicrobial resistance

A

route of drug

62
Q

MDR definition

A

multidrug resistant

non- susceptibility to 1 or more agents in 3 or more antimicrobial categories

63
Q

XDR defintion

A

extremely drug resistant

non-susceptibility in 1 or more in all but 2 or fewer antimicrobial categories

64
Q

Incubation period definition

A

time between contracting infection and first clinical signs/symptoms

65
Q

C. diff toxin A is a __

toxin B is a ___

A

A=enterotoxin

B=cytotoxin

66
Q

Treatment of non-severe and severe C. diff infections

A 
non = metronidazole
severe = vancomycin
67
Q

Smells like horse poo =

A

C. diff infection

68
Q

Test for C. diff = firstly need +ve ___ test then will do ___ test if is +ve = have it, if -ve = reassess

A

GDH

toxin

69
Q

Rotavirus is commonest in ___ age group

Most people have had it by age __

A

under 3 yos

by the age of 5

70
Q

can rotavirus cause bacteraemia?

Usually resolves itself after ___

A

NO

1 week

71
Q

Rotavirus is spread

infective dose =

A

person to person

100-1000 particles

72
Q

Diagnosis of rotavirus is by:

A

Faecal PCR

73
Q

Rotaviral vaccine is given __(route), ___ (type), given at age ____
not for over 24 wk olds as increases risk of ___

A

PO
live attenuated in 2 doses
2-3 months
intususception

74
Q

Noravirus causes ___ diarrhoea and vomiting that lasts for ___
Diagnose by __
Treat =

A

explosive
2-4 days
faecal/ vomit swab PCR
rehydration

75
Q

aerobe defintion =

A

grow better with O2 but can do without

76
Q

Eg.s of aerobes that are normal in colon =

A 
Staph
Strep
enterococci
coliforms
E. coli
Klebsiella
Proteus
enterobacter
serratis
77
Q

Antibiotic given to treat aerobes (including coliforms)/strict aerobes in gut infections

A

gentamicin

78
Q

Strict aerobes normally present in gut =

A

pseudomonas - pathological if IC

79
Q

Eg.s of anaerobes present in large no.s in the gut

A

clostridium
bacteroides
anaerobic cocci

80
Q

treatment of anaerobic infections of the gut =

A

metronidazole

81
Q

Organisms normally present in the mouth (colonise the teeth)

A

Strep viridans
Neisseria
Candida
Staph

82
Q

Small no.s of these organisms are present in the stomach

A

candida

staph

83
Q

colon contains ___ anaerobes, ___ coliforms + ___ normally

A

10^9
10^6
enterococci
= high bacterial load

84
Q

Antibiotics given prophylactically for GI surgery =

A

metronidazole (anaerobes)
gentamicin (coliforms)
MAGiC

85
Q

antibiotic given for enterococci

A

amoxicillin

86
Q

SIRS is defined as a non-specific inflammatory response with 2 or more of the following:

A

Temp >38/less than 36
HR >90bpm
RR >20/min
WCC>12000/less than4000/>10% immature neutro.s

87
Q

Sepsis = SIRS +

A

presumed/confirmed infectious process

88
Q

Severe sepsis is defined as

A

sepsis with >=1 acute organ dysfunction (due to hypoperfusion)

89
Q

Septic shock definition

A

severe sepsis with hypotension that is refractory to adequate volume resuscitation

90
Q

Common bacterial causes of sepsis in the community

A

S. aureus (MSSA - skin)
E. coli (urine/ abdo)
S. pneumoniae (resp)

91
Q

Common bacterial causes of sepsis in hospitals

A 
E coli (catheter/abdo)
S aureus (MRSA - line/wound)
coag -ve Strep (line/prosthesis)
enterococci (urine/wound/line)
Klebsiella (urine/wound)
pseudomonas
92
Q

Supportive management for sepsis

A 
fluids and electrolytes
analgesia
VTE (venous thromboembolism) prophylaxis
O2
assess need for surgery/transfusion
93
Q

Antimicrobials for sepsis are given __(route)

for ___ unless complicated then =___

A

parenterally
10-14 days
4-6wks

94
Q

For intra abdominal infections the antibiotics given are___

then step down to __

A

IV amoxicillin, gentamicin and metronidazole

PO co-trimoxazole and metronidazole

95
Q

Antibioic that you must limit the duration (72hrs then ID)
monitor renal function
maximum dose is 600mg

A

gentamicin

96
Q

Sepsis 6 bundle for management =

A 
high flow O2
IV fluid resus (500ml saline stat)
blood cultures
IV antibiotics
measure lactate and FBC
monitor hrly urine output

JazGI (26 decks)

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