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CLS > GI tract infections > Flashcards

GI tract infections Flashcards

1
Q

Outline host defence mechanisms to prevent GI tract infections

A

Physical and chem barriers- stomach acid, digestive enzymes, mucous lining and mucin
Continuous movement
Immune system- secreted IgA and Peyer’s patches

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2
Q

List common inhabitants of the stomach

A 
Candida
Streptococcus
Lactobacilli
H pylori
Peptostreptococcus
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3
Q

List common inhabitants of the duodenum, jejunum and proximal ileum

A

Lactobacillus

Streptococcus

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4
Q

List common inhabitants of the colon

A

Enterobacterium
Bifidobacrerium
Clostridium
bacteroides

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5
Q

List common inhabitants of the distal ileum

A 
Clostridium
Streptococcus
Clostridium
Actinomycinae
Corynebacteria
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6
Q

List risk factors for infectious disease of the GI tract

A 
Immunodeficiency
Poor sanitation
Unclean water
Undercooked food
Travel to high risk areas
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7
Q

Outline the clinical features, investigations and management of H pylori

A

Chronic gastritis
Duodenal ulcer disease
Inflam response
Assoc with gastric adenocarcinoma

Urease breath test, endoscopy, gastric biopsy, serology

Treatment- triple therapy and proton pump inhibitor

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8
Q

List the main organisms causing acute diarrhoeal diseases

A

Viral- adenovirus, rotavirus, norovirus
Bac- E coli, salmonella, Shigella, V cholera
Toxins- C difficile, s aureus, B cereus
Parasites- giardia, entamoeba, cryptosporidium

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9
Q

List the main organisms causing food associated diarrhoea

A

Campylobacter
Salmonella
E coli
Bacillus staphylococcus and clostridium

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10
Q

List the main organisms causing travel associated diarrhoea

A 
Contaminated food or water
Bac and parasites
E coli most common
Salmonella, Shigella, V cholerae, Campylobacter
Giardia and entomoeba
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11
Q

Outline investigation of gastroenteritis

A 
History and examination
Blood cultures
Stool
-> microscopy-> ova, cysts, parasites
-> culture-> salmonella, shigella
-> antigen detection-> rotavirus, adenovirus
-> toxin testing-> c.diff
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12
Q

Outline viral gastroenteritis

A 
Faecal-oral spread
Explosive diarrhoea, often with vomiting
- Incubation 24-48 hrs
Detect by antigen testing/PCR
Rehydration
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13
Q

Outline E Coli

A

Common, most strains don’t cause GE
Enterotoxigenic, invasive, pathogenic, haemorrhagic do

TOXIGENIC- traveller’s diarrhoea
12 hr incubation

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14
Q

Outline campylobacter

A 
Diarrhoea, abdo cramps, vom
From raw/poorly cooked food- chicken (BBQ)
2-5 day incubation
Culture with selective agar
Self limiting
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15
Q

Outline salmonella

A

Enteriditis- cause GE, self limiting

Typhi and paratyphi- typhoid or paratyphoid fever- IV ceftriaxone

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16
Q

Outline shigella

A

Several species
S dysenteriae- severe
Bloody diarrhoea, HUS
1-3 days incubation

17
Q

Outline parasites

A

Water borne

Give metronidazole

18
Q

Outline clostridium difficile

A

Anaerobic spores- survive and spread- germinate into cells
Vegetative cells prod toxins
Colonise without disease- WORSEN WITH ANTIBIOTICS

give Metronidazole or Vancomycin

19
Q

Outline the clinical features of viral hepatitis

A

Hep A B C E
A and E faecal oral, BCD- paraentral and sex
Inflam of liver- vital
Icteris= jaundice
Pre icteric- malaise, anorexia, nausea, RUQ discomfort, pyrexia
Icteric features- pruritis, pale stools, dark urine, jaundice

20
Q

List the non viral causes of hepatitis

A

Leptospirosis

Bucellosis

21
Q

What is hepatitis secondary to?

A

EBV

cytomegalovirus

22
Q

Outline Hep A, its transmission, epidemiology and prevention

A

Simple virus
+ve ssRNA genome
Faecal oral transmission
Contam food/water

Early childhood, less severe
Prevent- take care with food and water
Vaccination is with whole killed virus

23
Q

Outline Hep B, its transmission, epidemiology and prevention

A

Unusual virus, DNA not RNA, partially double stranded
Encodes a few proteins- Core Ag (capsid), surface Ag, eAg in some patients

Transmission: perinatal (mother to baby), sexual, paraentral- unsafe injections and transfusions
Virus in blood and bodily fluids
300m HBV carriers worldwide, uneven distribution

Prevent:

  • Passive immunity- Hep B immunoglobulin
  • Active immunisation- Hep B vacccine- HbS Ag only- induces anti Hb 90% effective
  • UK- selective vaccine- low prevalence, only at risk groups vaccinated- healthcare/sex workers, drug users, sexual partners and offspring of carrier
24
Q

Outline Hep C, its transmission, epidemiology and prevention

A

Flavirus- RNA- same as yellow fever
Dengue, West Nile etc
1-6 genotypes- most genetically diverse in humans
With >30% diff in genome sequence
>100 subtypes worldwide
Quasispecies- closely related sequences in an individual

Transmission- paraenteral
Blood borne viruses- infection, transfusion, needles, Egypt
Massive gen diversity- false negatives on diagnosis
Genotypes vary in pathogenicity and therapy response

Chronic- males- elderly, alcohol intake increased

25
Q

Outline Hep E, its transmission, epidemiology and prevention

A

RNA virus, HEPE family

Faecal-oral spread
Common cause of sporadic acute disease
Higher mortality than HA in preg women
Travel abroad/endogenous- pig virus

26
Q

Describe the features and diagnosis of hep E

A

Acute icteric
Asymptomatic
Liver failure
High mort rate- transplant

27
Q

Describe the features and diagnosis of hep C

A

Acute infection- asymptomatic

75% of acute fail to clear virus- chronic hepatitis, cirrhosis, hepatocellular damage

28
Q

Describe the features and diagnosis of hep b

A

55% subclinical- no clinical pres- can become carrier
Acute icteric hep, fulminant
Chronic effect- continuous viral release- liver- all body
Neonates- vert transmission, virus doesn’t appear until child bearing age

29
Q

Describe choleocystitis

A

Gall bladder infection, secondary to gallstones and bac infection
- RUQ pain, vom, tenderness, fever
Caused by gut organisms (anaerobes) and E coli
Diagnose- clinical pres and imaging blood cultures

30
Q

Describe cholangitis

A

Biliary tree infection- secondary to infection
Gut organisms
Fever, rigor, jaundice more severe

31
Q

Describe peritonitis

A

Inflam of peri cavity, secondary to intra abdom pathology
Performation- release of organisms into peritoneum
Microbial (poly), anaerobes, coliform, enterocci, life threatening

CLS (11 decks)

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