Intra-abdominal

Question 1

What tests should be performed if there is suspected intraabdominal infection?

Answer 1

Send blood cultures

Pus or other intra-abdominal samples as appropriate

E.coli 0157- faeces culture, haematology (HUS), biochemistry

Question 2

What is the treatment for non-severe c. diff?

Answer 2

Metronidazole PO (10days)

Question 3

What is the treatment for severe c. diff?

Answer 3

Vancomycin PO/NG +/- IV metronidazole

Question 4

Describe the gram stain of clostridium difficile

Answer 4

Gram +ve

Gamma haemolytic

Question 5

What are the common causal organisms of non-infectious diarrhoea?

Answer 5

E. coli 0157, campylobacter

Question 6

Describe E.coli

Answer 6

Escherichia Coli
Gram -ve Rod Shaped
Beta haemolytic

Question 7

Describe campylobacter

Answer 7

helical- gram negative

Uncooked poultry
Un-pasteurised milk

Question 8

What is the treatment for non-infectious diarrhoea?

Answer 8

Supportive

Question 9

What are the common causal organisms of peritonitis/biliary tract sepsis/intra-abdominal

Answer 9

Polymicrobial coliforms
Anaerobes
Enterococci

Question 10

Describe coliforms

Answer 10

Gram -ve rod

Question 11

Describe anaerobes

Answer 11

gram -ve; bacteroides

gram +ve; clostridia

Question 12

What is the treatment for peritonitis/biliary tract sepsis/ intraabdominal

Answer 12

IV amoxicillin + Metronidazole + gentamicin

Step down: PO co-trimoxazole + metronidazole

(if penicillin allergic: IV vancomycin + metronidazole + gentamicin)

Question 13

What are the common causative organisms of spontaneous bacterial peritonitis?

Answer 13

Coliforms
Anaerobes
Strep pneumoniae

Question 14

Describe strep pneumoniae

Answer 14

Facultative anaerobe

Gram +ve, alpha haemolytic

Question 15

What is the treatment of mild SBP?

Answer 15

PO Co-trimoxazole + Metronidazole

Question 16

What is the treatment of severe SBP?

Answer 16

Piperacillin/Tazobactam IV then step down to co-trimoxazole