GI Infections

Question 1

Treatment for acute pancreatitis?

Answer 1

Antibiotics unlikely to affect outcome

Question 2

Treatment for gastroenteritis?

Answer 2

Supportive

Question 3

Non severe C Difficile infection?

Answer 3

Metronidazole PO 400mg tds (10 days)

Question 4

Severe C Difficile infection?

Answer 4

Vancomycin PO/NG (10 days)

+/- IV Metronidazole

Question 5

Treatment for infection of the biliary tract (acute cholecystitis/cholangitis)?

Answer 5

IV Amoxicillin + Metronidazole + Gentamicin

Question 6

Treatment for severe spontaneous bacterial peritonitis?

Answer 6

Piperacillin/Tazobactam then step down to Co-trimoxazole

Question 7

Treatment for mild spontaneous bacterial peritonitis?

Answer 7

Co-trimoxazole

Question 8

Treatment for peritonitis of an uknown cause (i.e. possible biliary tract perforation)

Answer 8

IV Amoxicillin + Metronidazole + Gentamicin

Question 9

Treatment for intraabdominal infection if penicillin allergic?

Answer 9

Swap amoxicillin for Vancomycin -

Vancomycin + Metronidazole + Gentamicin

Question 10

All anaerobes are sensitive to which antibiotic?

Answer 10

Metronidazole

Question 11

All coliforms are sensitive to which antibiotic?

Answer 11

Gentamicin

Question 12

What are the common causative organisms of intraabdominal infections?

Answer 12

Coliforms, anaerobes and enterococci

Question 13

What are the common causative organisms of spontaneous bacterial peritonitis?

Answer 13

coliforms +/- anaerobes

Question 14

What are the features of coliforms?

Answer 14

• Gram negative (stain pink)
• bacilli
• able to ferment lactose
• found in faeces
• unable to form spores

Question 15

What are enterococci?

Answer 15

• Gram positive (stain purple)
• facultative anaerobic
• usually found as diplococci
• Part of normal COLON flora
• unable to form spores

Question 16

What are the features of C difficile?

Answer 16

• spore forming
• gram positive
• bacilli
• anaerobic
• produce toxins

Question 17

Which pathogens are resistant to all penicillins and why?

Answer 17

Extended-spectrum beta-lactamase producing bacteria
This enzyme breaks down the beta lactam ring that some antibiotics (such as penicillins and cephalosporins) use to inhibit bacterial cell wall synthesis.

Question 18

What steps should you take if an infection of the E Coli strain 0157 is SUSPECTED?

Answer 18

• Notify Health Protection & Infection Control
• Faeces for culture
• film for fragmented blood cells for suspected Heamolytic-Uraemic Syndrome
• Biochemistry: U&E, LDH, CRP for baseline assessment

Question 19

Which parts of the GI system are usually sterile?

Answer 19

The peritoneum, the duodenum, the stomach and the biliary tract

Question 20

Which group of organisms are in the normal flora of the mouth?

Answer 20

Streptococcus viridans
Neisseria species
Anaerobic organims

Question 21

Which organisms are found in the colon or faecal flora?

Answer 21

Coliforms, anaerobes, enterococci

Question 22

Organisms such as C dif are strict anaerobes, what does this mean?

Answer 22

The organism will NOT grow in the presence of oxygen

Question 23

What is the drug of choice for enterococci?

Answer 23

Amoxicillin (co -trimoxazole if allergic)