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SFM4 > GI Microbio and Antibiotics > Flashcards

GI Microbio and Antibiotics Flashcards

1
Q

H. pylori dx

A
  • breath test
  • stool antigen test
  • endoscopy
  • difficult to culture
  • hard to test for resistance so must f/u to ensure eradication
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2
Q

H. pylori tx

A
  • do not treat unless symptomatic
  • aggressively tx any bleeding
  • PPI
  • 2+ abx
  • bismuth
  • compliance is an issue d/t complex regimen

preferred: quadruple therapy for up to 2 wk
- PPI
- bismuth
- tetracycline
- AND nitroimidazole

amoxicillin + clarithromycin or levofloxacin ± nitroimidazole also common

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3
Q

common causes of travel-related acute diarrhea

A

E. coli
campylobacter
giardia (parasite)
norovirus

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4
Q

chicken-related acute diarrhea

A

salmonella
shigella
campylobacter

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5
Q

beef-related acute diarrhea

A

EHEC

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6
Q

soft cheese-related acute diarrhea

A

listeria

lactose intolerance

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7
Q

seafood-related acute diarrhea

A

vibrio spp

hep A

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8
Q

reheated food and fried rice related acute diarrhea

A

bacillus

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9
Q

immunodeficiency related acute diarrhea

A

cryptosporidium
isopora belli
microsporidia

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10
Q

hospital acquired acute diarrhea most common cause

A

c diff

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11
Q

abx for acute diarrhea

A

usually not needed

moderate to severe

  • quinolones (–floxacin)
  • metronidazole
  • need broad gram – coverage as most GI bugs are gram –
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12
Q

amoxicillin

ampicillin

A

broad gram + and some gram – coverage
outpatient, po
resistance common

NO:

  • MRSA
  • Pseudomonas
  • anaerobes (lower GI infections e.g. diverticulitis, appendicitis, intraabdominal abcesses)
  • atypicals
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13
Q

piperacillin/tazobactam

A

broad spectrum across GI
inpatient, iv only

YES:

  • gram +
  • gram –
  • pseudomonas
  • anaerobes (lower GI infections e.g. diverticulitis, appendicitis, intraabdominal abcesses)

NO:

  • MRSA
  • atypicals

commonly combined with vancomycin for empiric broad spectrum inpatient tx

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14
Q

metronidazole

A

broad spectrum
po and iv

YES:

  • anaerobes (lower GI infections e.g. diverticulitis, appendicitis, intraabdominal abcesses)
  • C diff
  • parasites

NO:

  • aerobic gram + or gram –
  • MRSA
  • pseudomonas
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15
Q

oral vancomycin

A

broad spectrum
when po only for GI infections
mainly C diff

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16
Q

iv vancomycin

A

gram + incl MRSA

for broadest spectrum empiric coverage commonly combined with pip/tazo

17
Q

fluoroquinolones (–floxacin)

A

broad spectrum
po and iv

YES:

  • gram –
  • pseudomonas
  • MOXI only: anaerobes
  • some gram +

NO:

  • MRSA
  • total gram + coverage
18
Q

importance of anaerobes in GI infections

A

the lower GI microbiota is largely made up of anaerobic or facultative anaerobic gram – bacteria

  • enterobacterales
    • klebsiella
    • proteus
    • E. coli
  • bacteroides fragilis
  • also some gram + anaerobes and enterococcus

when GI contents are released e.g.

  • diverticulitis
  • diverticular abscesses
  • appendicitis
  • other intraabdominal abcesses

systemic infection/sepsis by these anaerobes

good abx:
(IV, severe) *pip/tazo, carbapenems
(IV, moderate) ceftriaxone
(IV or PO, moderate) moxifloxacin, metronidazole

19
Q

clindamycin

A

targets anaerobes but only above diaphragm

may be used for mouth, esophagus but not the rest of the GI tract

20
Q

ceftriaxone

A

iv only

YES:

  • gram +
  • gram –
  • anaerobes

NO:

  • pseudomonas
  • MRSA
  • atypicals
21
Q

fecal-oral hepatitises

A

A and E

22
Q

blood/fluid hepatitises

A

B, C, and D

23
Q

hepatitis w/ viral latency

A

B

24
Q

chronic viral hepatitis

A

B (±D; not D alone)
C
in i.c., E

25
Q

curable hepatitis

A

C

26
Q

hepatitis associated with liver cancer

A

B and C

27
Q

dx hep A

A

titers: IgM and IgG vs hep A

28
Q

dx hep B

A
  • surface Ag
  • core Ab
  • surface Ab
  • E antigen
  • HBV DNA
29
Q

dx hep C

A
  • IgG vs hep C titer

- HCV RNA

30
Q

dx hep D

A
  • IgM/IgG vs hep D titers

- HDV RNA

31
Q

dx hep E

A
  • IgM/IgG vs hep E titers

- if i.c., HEV RNA

32
Q

relationship between e antigen + and HBV RNA levels

A 
direct correlation (usually, unless there's a mutation)
e+ = HBV RNA present

SFM4 (10 decks)

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