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GI infections Flashcards

1
Q

Where in GI tract are streptococci usually found

A
  • Stomach
  • Duodenum
  • Jejunum
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2
Q

Where in GI tract are Staphylococci normally found

A
  • Stomach
  • Duodenum
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3
Q

Physical and chemical defenses in GI tract?

A
  • Enzymes in saliva and small bowel
  • Acidic stomach environment
  • Bile in small bowel
  • Mucosa and mucin
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4
Q

Immune system GI specific defences

A

Secreted IgA

Peyer’s patches in SI

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5
Q

Risk factors for GI tract infection

A
  • Immunodeficiency
  • Poor sanitation
  • Diabetes
  • Unclean water
  • Undercooked food
  • Travel
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6
Q

bacterial characteristics of H. pylori

A
  • Gram -ve spiral
  • Bacillus
  • Microaerophile, motile and urease positive
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7
Q

Signs and symptoms of H. pylori infection

A
  • Epigastric pain, nausea, vomiting, haematemesis
  • 20-30% population affected - faecal/oral oral/oral transmission
  • Chronic gastritis; antrum or duodenal ulcer
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8
Q

Treatment for H.pylor infection

A

triple therapy antibiotics plus omeprazole

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9
Q

Causes of acute gastroenterisits

A
  • Viral: Rotavirus, adenovirus, norovirus
  • Bacterial: E.Coli, salmonella, shingella
  • Toxins: C. difficile, S. aureus, B. cereus, C. perfrinegens
  • Parasites: Giardia lambliem entamoeba histolytics
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10
Q

Investigation of gastroenteritis

A
  • History and examination
  • Blood cultures
  • Stool samples
    • Microscopu
    • Culture
    • Antigen detection
    • Toxin
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11
Q

Characteristics of viral gastroenteritis

A
  • Faecal/oral spread, incredibly infectious
  • 24-48 hrs incubation, explosive diarrhoea
  • Supportive managment e.g. ORT
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12
Q

Characteristics of Enterotoxigenic Bacterial Gastroenteritis

A

Enterotoxigenic

  • Heat labile and stable toxins
  • Abdominal pain
  • RAPID 12hr incubation
  • ORT
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13
Q

Characteristics of Enterohaemorrhagic Bacterial Gastroenteritis

A
  • E. coli 157
  • From mild diarrhoea to HUS in 8%(life-threatening)
  • 2-10 day incubation
  • Person/Person
  • DO NOT give antibiotics
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14
Q

Subtypes and characteristics of salmonella

A
  • Common: Enteridis
  • Severe: Typhis, paratyphi…..sepsis
  • Usually self-limiting diarrhoeal illness
  • Diagnose via stool or blood

Ciprofloxacin if severe

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15
Q

Characteristics of shigella infection

A
  • Subspecies: S. dysenteriae, S flexneri, S boydii
  • Severe: Dysentry; haemorrhagic colitis, fluid loss, choxk
  • Incubation 1-3 days
  • Faecal/oral
  • Stool
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16
Q

Campyolobacter infection characteristics

A

C. jejuni, C.coli

  • From food, water, chicken
  • 2-5 days
  • Malaise, abdominal pain, fever, nausea, vomiting
  • Diagnose with selective agar
17
Q

Characteristics of parasitic GI

A

Cryptosporidium parvum, Giardia lambia, Entamoeba histolytica

Water borne due to faecal contamination

7-10 days

Giardia/entamoeba: metronidazole

Cryptosporidium: Self-limiting

18
Q

Two main forms of liver infections and their causes

A
  1. Heaptitis
    • Inflammation of the liver by hep viruses
  2. Liver abscesses
    • ​​Amoebic (entamoeba)
    • Pyogenic(polymicrobial)
19
Q

Pre-icteric clinical features of viral hepatitis

A

=preceding appearance of jaundice

  • Malaise
  • Anorexia
  • Nausea
  • Abdominal discomfort
  • Pyrexia
20
Q

Icteric features of viral hepatitis

A
  • Pale stool; pigments not leaving via faeces
  • Dark urine; Increased bilrubin in blood, filtered in kidneys
  • Jaundice, from increased bilrubin
21
Q

Characteristics of HAV

A
  • Positive single stranded RNA genome
  • Unenveloped
22
Q

Characteristics of HBV

A
  • DNA genome
    • Partially double stranded
      • Complete circle of dna with incomplete complementary strand
  • 3 antigens
    • Surface HBsAg
      • Envelope lipid
    • Core HBcAg
  • HBeAg
23
Q

Characteristics of HCV

A
  • Positive single stranded RNA
  • Related to yellow fever, dengue
  • Enveloped
24
Q

Non-viral causes of hepatitis

A

Leptospirosis

Brucellosis

25
Q

Spread, Clinical features and prevention of Hep A

A

Spread: Faecal oral via food, water

Features:

  • Asymptomatic in children
  • Acute icteric hepatitis; potentially fulminant

Prognosis: If survived, immunity gained

Vaccination

26
Q

Spread of HBV

A

Perinatal

Sexual MSM

Parenteral: Unsafe injections, transfusions

27
Q

Clinical features/outcomes of HBV in adults

A

Acute:

  1. Subclinical most common
  2. Acute icteric hepatisis indistinguishable from hep A
  3. Fulminant hepatitis more common in B than A
  4. Chronic infection 10%
    • ​​Healthy, unaware
    • Chronic hepatitis; immune response, death of hepatocytes
    • Cirrhosis 20-30 yeards
    • Cancer
28
Q

Outcomes of HBV in neotates

A
  • Subclinical
  • Acute icteric hep
  • Fulminant hep
  • Chronic infection: 90%
    • Immune system isnt mature
    • Cirrhosis; death in 30-40s
    • Passed on vertically
29
Q

Detecting HBV

A

3 antigens:

HBsAg: shows infection, not when.

  • Over 6 mnths is chronic

HBcAg

HBeAg

3 corresponding antibodies

IgM Anti-HBc: Shows recent exposure to antigen

  • If negative, chronic hepatitis
30
Q

Distinguishing between different non a, non b hepatitis

A
31
Q

Diagnosis of Hep C

A
  • Genetically diverse, chance of false negative
  • Anti-HCV detection
    • Infection at some time
  • HCV RNA detection
    • Current infection
32
Q

Causes of cholesystitis

A

=infection of gall bladder

  • Seconary to gall stones
  • Gut organisms
33
Q

Features of cholesystitis/cholangitis

A

Abdominal pain

Rigors

Fever

Jaundice

34
Q

Virus causing splenomegaly

A

EBV

35
Q

Pancreatitis due to:

A

Gallstones, alcohol

Secondary to bacterial infection

36
Q
A

CLS (20 decks)

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