Infection in the GI tract

Question 1

What is the relation between GI infection and malnutrition?

Answer 1

GI infection cause cause malnutrition - malnutrition lowers resistance to GI infection

Question 2

GI infection syndromes =

Answer 2

Non-inflammatory
Invasive
Penetrating

Question 3

Ex of organism in which GI system is portal of entry but no GI side effects

Answer 3

Polio

Question 4

Non-inflammatory mechanisms/location/examples

Answer 4

Enetrotoxins
Proximal small bowel

Cholera
Bacillus
Enterotoxogenic E.coli

Question 5

inflammatory mechanisms/location/examples

Answer 5

Invasion of mucosa, production of cytokines

Colon

Shigella
Salmonella
Capylobacter
E.coli

Question 6

Penetrating mechanisms/location/examples

Answer 6

Induced phagocytosis
Distal small bowel
Listeria, Salmonella

Question 7

Do antibiotics help with gastroenteritis?

Answer 7

Rarely

Question 8

What do antibiotics make worse?

Answer 8

E coli 0157

Question 9

Clearance =

Answer 9

Some people are required to prove pathogen not in system before back to work

Question 10

Symptoms for gastroenteritis are due to bacteria for

Answer 10

72 hrs

Question 11

After first 72 hrs of gastroenteritis what can happen

Answer 11

Post infection syndrome

Question 12

Normal flora act to:

Answer 12

colonise resistance
compete 
remove toxins 
synthesis of folate, biotin
produce antibiotic like substance
release nutrients/energy
stimulate local immune system

Question 13

What does the appendix do?

Answer 13

Stores almost every bacteria that lives in bowel - micro environment

Question 14

C.diff organism

Answer 14

Gr+
Rod-shaped
Anaerobic

Question 15

C.diff can cause:

Answer 15

Inflammatory gastroenteritis
Pseudomembranous colitis
Toxic megacolon

Question 16

Symptoms of C.diff

Answer 16

Diarrhoea

Fever

Question 17

C.diff can for what which makes it resistant to antibiotics

Answer 17

Spores

Question 18

Nearly all c diff infections are cause by

Answer 18

The 4 C’s

1. Clindamycin
2. Cephalosporins
3. Ciprofloxacin
4. Co-amoxiclav

Question 19

Ciprofloxacin =

Answer 19

Fluoroquinolone

Question 20

What toxins does C.diff produce?

Answer 20

Toxins A and B

Question 21

Why is diagnosis of C.diff hard with stool?

Answer 21

Hard to culture - anaerobe.

Question 22

Management of C.diff:

Answer 22

1. Stop antibiotics
2. Isolate
3. Antimicrobials
4. Fecal transplant?

Question 23

Antimicrobials approves for C.diff =

Answer 23

1. Oral metronidozole
2. Oral vancomycin
3. Oral fidaxomicin

Question 24

Class of fidaxomicin

Answer 24

Cyclic macrolide

Question 25

Which medication stops C.diff spores hatching thus preventing relapse?

Answer 25

Fidaxomicin

Question 26

How long should C.diff antimicrobial treatment last?

Answer 26

10-14 days

Question 27

What bacteria are usually in stomach, duodenum and jejunum

Answer 27

Gram positive: lactobacillis, enteroccoci

Question 28

What happens if colonic flora back up into small bowel

Answer 28

Bacterial overgrowth syndrome

Question 29

Causes of bacterial overgrowth

Answer 29

Post-op Trauma Closed loop Nerve damage

Question 30

Symptoms of bacterial overgrowth =

Answer 30

``` Diarrhoea Bloating Abdominal pain Flatulence Sreatorrhoea Weight loss Anemia Eye problems ```

Question 31

Fat soluble vitamins

Answer 31

ADEK

Question 32

What can be nor absorbed in bacterial overgrowth

Answer 32

``` Fe Folate B12 Vitmain A Calcium Fats Protein ```

Question 33

Fe malabsorption =

Answer 33

Microcytic anaemia

Question 34

Folate/B12 malabsorption

Answer 34

Macrocytic anaemia

Question 35

Vitamin A malabsorption

Answer 35

Visual acuity problems

Question 36

Ca malabsorption =

Answer 36

Tetany

Question 37

Protein malabsorption =

Answer 37

Weight loss, cachexia

Question 38

Diagnosis of bacterial overgrowth can be done with

Answer 38

Hydrogen breath test

Question 39

Treatment of bacterial overgrowth =

Answer 39

Treat underlying condision Nutritional supplements Rifaxamin for life

Question 40

Rifaxamin has a similar moa to

Answer 40

Rimfampacin

Question 41

Pre-biotics vs pro-biotics

Answer 41

``` Pre-biotics = chemicals that alter microbiome Probiotics = taking in bacteria ```