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2a Liver and GI > Infections of the GIT and Hepatobiliary system > Flashcards

Infections of the GIT and Hepatobiliary system Flashcards

1
Q

Bacteria are protective against most intraluminal infection however can also be pathogenic if in the wrong part of the body such as

A

peritoneum

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2
Q

How many species of bacteria are found in the GI tract?

A

Over 400, predominantly anaeobes

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3
Q

What is ‘normal flora’

A

the community of microorganisms that live on another living organism without causing disease

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4
Q

Stable normal flora produces antimicrobial substances such as … which discourage infection

A

bacteriocins and short chain fatty acids

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5
Q

Bacteriocins and short chain fatty acids made by normal flora inhibit overgrowth of e______ pathogens and prevent colonisation by e____ pathogens

A

endogenous,
exogenous

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6
Q

What kills most swallowed pathogens?

A

Gastric acid

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7
Q

What increases the risk of intraluminal infection?

A

Less gastric acid or broad spectrum antibiotics

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8
Q

Clostridium difficile contains e___ that can survive the acidity of the stomach and reach the large intestine

A

endospores

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9
Q

C. difficile is gram _____, spore forming bacteria

A

positive

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10
Q

Many with c diff can be asymptomatic but can become a problem if the normal gut flora is altered, notably due to….

A

broad spectrum antibiotics

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11
Q

What is the rule of Cs?

A
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12
Q

clindamycin, ciproflxacin, co-amoxiclav and cephalosporins

A
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13
Q

Altered gut flora can also occur due to acid reducing drugs such as…

A

PPIs, NG feeding and immunocompromise

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14
Q

How do you treat C. diff?

A

Metronidazole
or
oral vancomycin
(in refractory cases sometimes faecal transplant)

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15
Q

What is the definition of diarrhoea?

A

3 or more loose/liquid stools within 24 hours

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16
Q

What are some infective causes of diarrhoea?

A

campylobacter, salmonella, HIV, bacterial or amoebic dysentery, cholera, systemic infections

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17
Q

What are some non-infective causes of diarrhoea?

A

Inflammatory:
Ulcerative colitis, Chron’s, Diverticular disease

Loss of absorptive area: coeliac, small bowel resection, tropical sprue

Pancreatic disease: pancreatitis, cancer

Drugs: antibiotics, magnesium, digoxin

Colon cancer

Systemic disease (thyrotoxicosis, uraemia, carcinoid

IBS, gastrectomy

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18
Q

What may floating stool indicate?

A

Fat content, malabsorption, Coeliac?

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19
Q

Blood or mucous in stool may indicate…

A

inflammatory/invasive infection, cancer?

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20
Q

True or false: puppies can carry campylobacter

A

True

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21
Q

True or false: reptiles can carry salmonella

A

True

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22
Q

What infection commonly comes from cooked meats?

A

Clostridium perfringens

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23
Q

What bacteria comes from reheated rice and causes lots of vomiting?

A

Bacillus cereus

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24
Q

Giardia causes offensive diarrhoea, chronic bloating, flatulence and is more common in…

A

nurseries or old age facilities

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25
Q

Where can cryptosporidium be found?

A

Cryptosporidium

26
Q

Which food is salmonella commonly from?

A

Poultry, eggs and dairy

27
Q

Where is vibrio parahaemolyticus often from?

A

Shellfish

28
Q

What is a common cause of food poisoning, especially from meats and BBQs

A

campylobacter

29
Q

In the UK, __-__% of diarrhoea are caused by viruses eg rotavirus, norovirus

A

50-70%

30
Q

What are common causes of Traveller’s diarrhoea?

A

Enterotoxigenic e.coli
Campylobacter
Shigella
Non-tymphoidal salmonella
V. parahaemolyticus
Viral
Protozoal
Cholera

31
Q

What are symptoms of traveller’s diarrhoea?

A

Abdominal pain, cramps, nausea, vomiting, dysentry

32
Q

True or false: most strains of E. coli are harmless

A

True, some serotypes are pathogenic

33
Q

Is cholera found in the UK?

A

Not really but can be seen in travellers

34
Q

What causes vibrio cholerae?

A

Vontaminated food/water

35
Q

What are symptoms of cholera?

A

Profuse watery “rice water” diarrhoea, up to 20 litres a day!!
Vomiting
Rapid dehydration

36
Q

What is used to treat cholera?

A

Doxycycline and fluids
Oral rehydration therapy

37
Q

What are 3 more common protozoa (parasites)?

A

Crytpo
Giardia
Entamoeba

38
Q

What are the 2 more common worms (parasites)?

A

Schistosomiasis
Strongyloides

39
Q

Who is most at risk to both common and rarer infections?

A

Immunosuppressed patients

40
Q

What are red flags for diarrhoea?

A

Dehydration
Electrolyte imbalance
Renal failure
Immunocompromise
Sever abdominal pain (c. diff can cause toxic megacolon and can perforate)

Cancer risk factors: over 50, chronic diarrhoea, weight loss, blood in stool, Fhx cancer, change in bowel symptoms

41
Q

What other infections may cause pain in the Right Upper Quadrant?

A

Biliary sepsis (aka ascending cholangitis)
Liver abscess
Pneumonia

42
Q

What other infections may cause lower abdominal pain?

A

Pelk inflammatory disease

43
Q

Pain in the Left or right upper quadrant may be peptic ulcer disease caused by…

A

Helicobacter pylori

44
Q

Where does helicobacter pylori live?

A

Within mucous layer overlying the gastric mucosa

45
Q

How to diagnose peptic ulcer disease

A

Stool antigen test
Breath test
Blood test for antibodies (can be positive for a year after)
Endoscopy with biopsy

46
Q

How to diagnose a biliary tract infection?

A

Ultrasound

47
Q

How to treat biliary tract infection

A

IV fluids, analgesia and antibiotics
or cholecystectomy

48
Q

Obstruction of the common bile duct is called…

A

Ascending Cholangitis

49
Q

What is Charcot’s triad?

A

Fever, abdominal pain and jaundice seen with ascending cholangitis

50
Q

Management of ascending cholangitis

A

Prompt admission with IV antibiotics
ERCP
Cholecystectomy

(has high mortality)

51
Q

Liver abscess can be seen on…

A

ultrasound of CT

52
Q

What is the management of a liver abscess?

A

Antibiotics and drainage

53
Q

What are 3 main causes of liver abscess?

A

Bacterial (faecal flora eg E. Coli)
Amoebic
Hydatid (dog tapeworm)

54
Q

What is the other name for enteric fever?

A

Typhoid

55
Q

What is Enteric fever caused by

A

Salmonella typhi

56
Q

What are symptoms of enteric fever?

A

Generalised or right lower quadrant pain, high fever, “relative bradycardia”, headache, myalgia, rose spots, constipation/green diarrhoae

57
Q

How is enteric fever diagnosed?

A

Through blood cultures

58
Q

What are complications of enteric fever?

A

GI bleed, perforation, myocarditis, abscesses

59
Q

How do you treat enteric fever?

A

Emergency surgery
Antibiotics

60
Q

Biliary sepsis, peritonitis and liver abscess patients all…

A

get sick quickly!

2a Liver and GI (61 decks)

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