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T IoD medical micrcobiology > GI infections and hepatitis > Flashcards

GI infections and hepatitis Flashcards

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USMLE® Step 1 flashcards
1
Q

what are the most common species that cause campylobacter?

A

C.jejuni

C.coli

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2
Q

what is the main mode of transmission for campylobacter?

A

contaminated raw or undercooked poultry

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3
Q

where is the site of damage from campylorbacter?

A

Terminal ileum and colon

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4
Q

what are symptoms of campylobacter?

A

Varies from loose stool to severe inflammatory diarrhoea

-malaise, cramp, pain, fever

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5
Q

how long does campylobacter infection last?

A

majority 1 week

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6
Q

what is the main way of diagnosing campylobacter?

A

Culture

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7
Q

how is c.diff diagnosed?

A

ELISA to detect toxins

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8
Q

what is the treatment for c.diff?

A

early deetection; piptazobactam

oral metronidazole

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9
Q

what are risk factors for C.diff infection?

A

Antibiotic use
hospitalisation and length
Age

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10
Q

what antibiotics are the worse for giving C.diff a competitive advantage?

A

2nd and 3rd gen cephalosporins
quinolones
clindamycin

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11
Q

what internal damage does C.dif cause?

A
  • patchy necrosis with neutrophil inflammation
  • epithelial ulcers
  • pseudomembranes
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12
Q

what is the best antibiotic for treating C.diff?

A

fidaxomicin

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13
Q

what three antibiotics can be given for mild to moderate C.diff?

A

Fidaxomicin
Metronidazole
Vancomycin

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14
Q

what can be given for severe C.diff?

A

Vancomycin

IV metronidazole

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15
Q

what can be done for recurrent C/diff infections?

A

Fidaxomicin
Pulsed reducing antibiotics
faecal transplant

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16
Q

what is the two phase test for C.diff?

A
  1. glutamate dehydrogenase which is found in all C.diff

2. Toxin ELISA for A and B that cause the infection

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17
Q

how can you detect C.diff toxin?

A
  • two phase test
  • PCR
  • toxigenic culture
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18
Q

what structure is norovirus?

A

A small non enveloped calicivirus RNA

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19
Q

why is it a problem that norovirus is non enveloped?

A

Isn’t killed by alcohol gel

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20
Q

what norovirus genogroups are found in humans?

A

1,2,4

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21
Q

what is the clinical presentation of norovirus?

A
  • acute onset
  • vomiting and non inflammatory diarrhoea
  • self limiting
  • abdo cramps
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22
Q

what is the incubation period for norovirus?

A

48 hours

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23
Q

how does norovirus cause illness?

A

It infects the villi of the small intestine

it disrupts the absorptive function

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24
Q

why is it hard to get norovirus immunity?

A
  • wide antigenic variability
  • limited cross protection
  • immunity is temporary
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25
Q

how is norovirus caught?

A

Faecal oral route.
directly including droplet spread
contaminated food and water

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26
Q

how do you diagnose norovirus?

A
  • PCR

norovirus can not be cultured

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27
Q

what is the treatment for norovirus?

A

supportive only

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28
Q

what is the most common cause of hepatocellular carcinoma?

A

Hepatitis B

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29
Q

what type of virus is hep B?

A

DNA

30
Q

how is hep B transmitted?

A

Blood
sexual intercourse
Vertical transmission

31
Q

why does hep B cause liver damage?

A

No directly but due to both the humoral and cell immune response

32
Q

what is the incubation period for acute hep B?

A

1-4 months

33
Q

what are the signs of acute hep B?

A

Flu like symptoms
RUQ pain
jaundice

34
Q

what are the lab findings in acute Hep B?

A

increased ALT and AST

35
Q

what can the outcomes be of acute hep B?

A
  • clearance of the infection (majority)
  • progression to liver failure
  • chronic hepatitis
36
Q

how does acute hep B lead to chronic hepatitis in some people?

A

Due to a suboptimal immune response where the virus can’t be cleared

37
Q

what is hepBsAg?

A

Hepatitis B antigen
Checks for ACTIVE infection
ACUTE OR CHRONIC

38
Q

what is HepBsAb?

A

Hepatitis B antibody

checks for immunity especially through vaccination

39
Q

what is HepBCore Ab total?

A

checks for immunity due to previous infection

40
Q

what is HepBCOre IGM?

A

checks for recent acute infection

41
Q

what is HepBeAg?

A

checks for high infectivity

42
Q

what is HepBeAb?

A

Checks for low infectivity

43
Q

what serology will come up if there is an acute hepaptic B infection?

A

Positive HepBsAg

Negative HepBsAb

44
Q

what pre-exposure hep B prevention is there?

A

Immunisation with the recombinant vaccination

45
Q

what is the serology timeline for hep infection?

A

HBsAg rises 4 weeks after exposure until 24 weeks
Total Anti-HbC rises 6 weeks after and stays risen
IgM rises 6 weeks until 32

46
Q

what Is HBsAg?

A

hepatitis B surface antigen present during any (acute or chronic) hepatitis infection. Also indicates they are infectious

47
Q

what is anti- HBs?

A

hepatitis B surface antibody

indicates recovery and immunity from infection and in people successfully vaccinated

48
Q

what is anti- HBc?

A

total hepatitis B core antibody

appears at the onset of symptoms in acute and remains for life

49
Q

what is IgM anti HBc?

A

IgM antibody to hepatitis B core antigen. positive indicates recent infection in the last 6 months.

50
Q

when will anti- HBs be positive?

A

Resolved infection

immunity due to vaccination

51
Q

when will anti HBc IgM be positive?

A 
acute infection
resolving infection (6 month life span)
52
Q

when will anti HbC be positive?

A 
Acute infection
resolving infection
resolved infection
high infective carrier
low infective carrier

(after acute infection it’s positive for life)

53
Q

what is the difference between HepBeAg and HepBeAb?

A

Ab- low infectivity

Ag- high infectivity.

54
Q

what type of virus is Hep A?

A

RNA

55
Q

how is hep A transmitted?

A

faecal oral route

56
Q

when is hep A most infectious?

A

Before any symptoms develop

57
Q

what is the incubation period of hep A?

A

15-50 days

58
Q

what is the difference between hep A and B?

A

Hep B can become chronic hep A can’t

Hep B can be blood spread hep A is not

59
Q

how is Hep A prevented?

A
  • an infected person should remain off work for 7 days
60
Q

what type of virus is Hep C?

A

RNA with many genotypes

61
Q

how is hep C spread?

A

person to person by blood or percutaneous
vertical transmission
dialysis

62
Q

what is the incubation period of HepC?

A

14-180 days

63
Q

what are the signs of hep C?

A

most people are asymptomatic

64
Q

what markers show chronic Hep C infection?

A

HCV RNA

HCV p22 core antigen

65
Q

Who can get hepatitis D?

A

Only people with hepatitis B

66
Q

what does hepatitis D need to replicate?

A

Hepatitis B

67
Q

what is the incubation period of hep D?

A

3-7 weeks

68
Q

what type of virus is hepatitis E?

A

Single stranded RNA

69
Q

how is hep E spreaded?

A

Faecal Oral

can be waterbourne outbreaks

70
Q

what is the incubation period of hep E?

A

15-64 days

71
Q

what is different about the levels of IgG and IgM in hep E?

A

IgM peaks early then becomes undetectable

IgG continues to increase long term

T IoD medical micrcobiology (4 decks)

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