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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
signs of E. coli infection
abdominal pain, bloody diarrhoea
26
treatment of E. coli infection
``` NO antibiotics (increases VTEC release) check bloods for HUS 1 wk after onset of symptoms ```
27
signs of HUS
``` abdo pain fever pallor petechiae oliguria 90% have bloodydiarrhoea ```
28
Peak presentation of HUS is ___ days after infection
7-10 days
29
salmonella, shigella, campylobacter and E. coli are gram ___, ___
-ve bacilli | differentiated by biochemistry then serology after cultured
30
Salmonella paratyphi/typhi incubation period and infectious dose
14-21 days | 10^5
31
Infection that starts with a fever, headache and flu-like then causes diarrhoea 3 wks later
Salmonella paratyphi/typhi
32
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
Salmonella paratyphi/typhi
33
Carriers of salmonella typhi/paratyphi carry it in their __
gallbladder
34
salmonella typhi/paratyphi is native/from abroad
abroad
35
Signs of salmonella typhi/paratyphi =
fever, rash on abdomen = rose spots | diarrhoea
36
salmonella typhi/paratyphi spreads by ___
person to person | contaminated water/food or poor sanitation
37
treatment for salmonella typhi/paratyphi
antibiotics (must sensitivity test to find which one)
38
organism that causes cholera
Vibrio cholerae
39
Comma -ve bacillus =
Vibrio cholerae
40
Infection common in refugee camps
cholera
41
incubation period and infectious dose of Vibrio cholerae
1-9 days | 10^8
42
Vibrio cholerae produces an ___ that causes ___
exotoxin | outpouring of fluid from cells = watery diarrhoea
43
rice water stools =
cholera
44
Cholera is spread
person to person | contaminated water
45
Treatment for cholera
NO antibiotics | fluids and electrolyte replacement
46
Organisms that cause infection by pre-formed toxins =
Bacillus cereus S.. aureus Clostridium perfringens
47
S. aureus produces an ___ | goes to ___>___ and stimulated vomiting within __
entero/exotoxin vagus>VC 1-2hrs
48
large gram +ve anaerobic bacillus who causes infection by a preformed enterotoxin
clostridium perfringens
49
large gram +ve aerobic bacillus that produces a preformed exotoxin due to poorly reheated rice
bacillus cereus
50
Cryptosporidium is a ___ from (4) causes ___ which is severe in HIV +ve
protozoa calves, person-person, swimming pools(Cl- resistant) and contaminated water diarrhoea
51
Giardia lamblia is a ___ from ___ signs = treatment =
protozoa infected water malabsorption, anorexia, abdo pain, flatulence, diarrhoea metronidazole PO
52
Treatment of cryptosporidium =
symptomatic treatment only
53
Cryptosporidium are stained with a ___
modified ZN stain
54
``` Enterobius vermicularis/ ___ are seen commonly in ___ ova ingested and live in ___ ; females lay eggs on __ at night symptoms = Diagnose = treat = ```
``` threadworms school kids colon perianal skin perianal itch microscopy of stool mebendazole PO ```
55
Vertical transmission of microbial resistance is by __
mutations acquired and passed on
56
Horizontal transmission of microbial resistance is by ___
transformation, transduction and conjugation
57
In bacterial resistance transformation =
integrate DEAD BAC genes into genome
58
In bacterial resistance transduction =
BACTERIOPHAGES (viruses) transfer genes
59
In bacterial resistance conjugation =
PILLI transfer genes
60
4Ds of microbial stewardship =
dose deescalation duration drug
61
___ makes no difference to development of antimicrobial resistance
route of drug
62
MDR definition
multidrug resistant | non- susceptibility to 1 or more agents in 3 or more antimicrobial categories
63
XDR defintion
extremely drug resistant | non-susceptibility in 1 or more in all but 2 or fewer antimicrobial categories
64
Incubation period definition
time between contracting infection and first clinical signs/symptoms
65
C. diff toxin A is a __ | toxin B is a ___
A=enterotoxin | B=cytotoxin
66
Treatment of non-severe and severe C. diff infections
``` non = metronidazole severe = vancomycin ```
67
Smells like horse poo =
C. diff infection
68
Test for C. diff = firstly need +ve ___ test then will do ___ test if is +ve = have it, if -ve = reassess
GDH | toxin
69
Rotavirus is commonest in ___ age group | Most people have had it by age __
under 3 yos | by the age of 5
70
can rotavirus cause bacteraemia? | Usually resolves itself after ___
NO | 1 week
71
Rotavirus is spread | infective dose =
person to person | 100-1000 particles
72
Diagnosis of rotavirus is by:
Faecal PCR
73
Rotaviral vaccine is given __(route), ___ (type), given at age ____ not for over 24 wk olds as increases risk of ___
PO live attenuated in 2 doses 2-3 months intususception
74
Noravirus causes ___ diarrhoea and vomiting that lasts for ___ Diagnose by __ Treat =
explosive 2-4 days faecal/ vomit swab PCR rehydration
75
aerobe defintion =
grow better with O2 but can do without
76
Eg.s of aerobes that are normal in colon =
``` Staph Strep enterococci coliforms E. coli Klebsiella Proteus enterobacter serratis ```
77
Antibiotic given to treat aerobes (including coliforms)/strict aerobes in gut infections
gentamicin
78
Strict aerobes normally present in gut =
pseudomonas - pathological if IC
79
Eg.s of anaerobes present in large no.s in the gut
clostridium bacteroides anaerobic cocci
80
treatment of anaerobic infections of the gut =
metronidazole
81
Organisms normally present in the mouth (colonise the teeth)
Strep viridans Neisseria Candida Staph
82
Small no.s of these organisms are present in the stomach
candida | staph
83
colon contains ___ anaerobes, ___ coliforms + ___ normally
10^9 10^6 enterococci = high bacterial load
84
Antibiotics given prophylactically for GI surgery =
metronidazole (anaerobes) gentamicin (coliforms) MAGiC
85
antibiotic given for enterococci
amoxicillin
86
SIRS is defined as a non-specific inflammatory response with 2 or more of the following:
Temp >38/less than 36 HR >90bpm RR >20/min WCC>12000/less than4000/>10% immature neutro.s
87
Sepsis = SIRS +
presumed/confirmed infectious process
88
Severe sepsis is defined as
sepsis with >=1 acute organ dysfunction (due to hypoperfusion)
89
Septic shock definition
severe sepsis with hypotension that is refractory to adequate volume resuscitation
90
Common bacterial causes of sepsis in the community
S. aureus (MSSA - skin) E. coli (urine/ abdo) S. pneumoniae (resp)
91
Common bacterial causes of sepsis in hospitals
``` E coli (catheter/abdo) S aureus (MRSA - line/wound) coag -ve Strep (line/prosthesis) enterococci (urine/wound/line) Klebsiella (urine/wound) pseudomonas ```
92
Supportive management for sepsis
``` fluids and electrolytes analgesia VTE (venous thromboembolism) prophylaxis O2 assess need for surgery/transfusion ```
93
Antimicrobials for sepsis are given __(route) | for ___ unless complicated then =___
parenterally 10-14 days 4-6wks
94
For intra abdominal infections the antibiotics given are___ | then step down to __
IV amoxicillin, gentamicin and metronidazole | PO co-trimoxazole and metronidazole
95
Antibioic that you must limit the duration (72hrs then ID) monitor renal function maximum dose is 600mg
gentamicin
96
Sepsis 6 bundle for management =
``` high flow O2 IV fluid resus (500ml saline stat) blood cultures IV antibiotics measure lactate and FBC monitor hrly urine output ```

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