Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pathology > Intrabdominal infections > Flashcards

Intrabdominal infections Flashcards

1
Q

define intrandominal infection

A

presence of micro-organism in normally sterile sites within the abdominal cavity e.g. peritoneal cavity and hepatobillary tree.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

why is gastroenteritis not classed as a intrabdominal infection

A

bowel lumen is not sterile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which areas of the stomach and small intestine are sterile

A

stomach

proximal small intestines- bile and acid from stomach kill all pathogens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the normal amount of flora in the large intestine ? 10 ^

A

10^9-11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what pathogens mainly occupy the large intestine flora

A

anaerobic bacteria (95-99%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 main sources of intrabdominal organs

A

GI contents, blood, external

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

defien intrapertioneal.

A

• Translocation of micro- organisms from gastrointestinal tract lumen to peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

define billary tract infection

A

• Translocation of micro-organism along a lumen- up to liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

define haematogenous spread

A

• Translocation of micro-organism from a extra-intestinal source- penetrating trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how can traslocation of an organism across a wall occur

A
  • Perforation-Perforated appendix, perforated ulcer, perforated diverticulum, malignancy
  • Loss of integrity- Ischemia, strangulation (herniation of bowel)
  • Surgery- Seeding at operation, anastomotic leak (as it is incomplete or it has broken down).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how can traslocation of an organism along a lumen occur

A

• Blockage- Cholecystitis, cholangitis, hepatic abscess
– Gall bladder is not normally sterile but bile keeps it sterile, so blockage will mean that no bile can pass so organisms can harbour
• Iatrogenic- Instrumentation (e.g. ERCP)- endoscopic retrograde cholangio pancreatography.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

causes of obstruction of lumen of vermiform appendix.

example of translocation across a wall- appendicitis

A

– Lymphoid hyperplasia, faecal obstruction, stagnation of luminal contents, bacterial growth and recruitment of inflammatory cells.
– Build up of intraluminal pressure may result in perforation
– Escape of luminal contents into peritoneal cavity is “peritonitis”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

symptoms of appendicitis

A

temperature, severe generalised pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treat for appendicitis

A

appendicecectomy and cefuroxime, and metronidazole for 5 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what form of intra abdominal infection is appendicitis

A

translocation across wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what form of intraabdominal infection is perforated diverticula

A

translocation across wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

define perforated diverticulum

A

• Herniation of mucosa and sub mucosa through muscular layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

common complication of bowel cancer

A

Intraperitoneal and/or bloodstream infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what organism cause Intraperitoneal and/or bloodstream infection in bowel cancer

A

clostridium septicum and streptococcus gallolyticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

symptoms of bowel cancer

A

weight loss, alteration of bowel habits, and blood in stool.

21
Q

what causes ischaemia of the bowel

A

– Strangulation
– Arterial occlusion
– Post operative
– E.g. Aneurysm repairs.

• Interruption of intestinal blood supply

22
Q

how does ischaemia result in translocation of lumina contents

A

lack of blood supply results in gut wall loses structurally and integrity

23
Q

causes of post operative infections

A

• Seeding at operation
– Incidence is reduced due to bowel preparation with prophylactic antibiotics- prior to surgery.
• Anastomotic leak- due to breakdown or due to non formed anastomosis
• Acute infection- abdominal pain and tenderness, shock
• Intraperitoneal abscess- walled off abscess, more indolent condition (presents some weeks after surgery).

24
Q

define cholecystitis

A

inflammation of the gall bladder

25
Q

symptoms of cholecystitis

A

fever, right upper quadrant pain, mild jaundice.

26
Q

clinical presentation of empyema in the gallbladder

A

severe pain, High fever, Chills and rigors.

27
Q

empyema of the gallbladder is a complication of what condition

A

cholecystitis

28
Q

define cholangitis

A

• Inflammation/infection of biliary tree

29
Q

causes of cholecystisis and cholangitis

A

– Mainly obstruction of common bile duct

– Can follow instrumentation (e.g. endoscopic retrograde cholangio-pancreatography, ERCP)

30
Q

symptoms of cholangitis

A

– Fever (rigors), jaundice and right upper quadrant pain

31
Q

define pyogenic liver abcesss

A

collection of pus in liver.

32
Q

routes for infection which causes pyogenic liver abcesses

A

biliary obstruction, direct from intrabdominal infections, Haematogenous- from mesenteric infections via hepatic portal vein, from systemic intravascular infection- hepatic artery

33
Q

predisposing factors to intrarittoneal abcessess

A 
–	Perforation-Peptic ulcer, Perforated appendix, Perforated diverticulum
–	Cholecystitis
–	Mesenteric ischemia/bowel infarction
–	Pancreatitis/pancreatic necrosis 
–	Penetrating trauma 
–	Postoperative anastomotic leak
34
Q

common areas for intraperitoneal abcess to form

A

– Subphrenic, subhepatic, paracolic, pelvic

35
Q

symptoms of intrapertioneal abcess

A

non specific

Sweating, anorexia, wasting, High swinging pyrexia (high then low)

36
Q

symptoms of subphrenic abcess

A

– Pain in shoulder on affected side, persistent hiccup, intercostal tenderness, apparent hepatomegaly (liver displaced downwards, ipsilateral lung collapse with pleural effusion (collapse where ulcer is and effusion is due to blood)

37
Q

symptoms of a pelvic abcess

A

– Urinary frequency

– Tenesmus- need to release bowels.

38
Q

common aerobic bacteria gram -ve bacilli

A

E .coli

39
Q

common anaerobic bacteria gram -ve bacilli

A

Bacteroides

40
Q

common aerobic Gram-positive cocci

A

Enterococcus spp.

Occasionally milleri-group streptococci

41
Q

common anaerobic Gram-positive bacilli

A

clostrisium

42
Q

common features of liver abscesses.

A

polymicrobial

43
Q

what can cause a liver abcess

A

haematogenous spread or trauma may not involve normal GI flora
Hepatobiliary tract infections usually involve lower GI flora, despite

44
Q

what blood investigations are carried out for intraabdominal infections

A
  • Full blood count: neutrophilia/neutropenia
  • C-reactive protein: raised
  • Liver function tests: abnormal in hepatobiliary disease
45
Q

what is imaging used for intraabdominal infections and why is it used

A 
Chest x-ray
–	Consolidation, pleural effusion adjacent to infected area (e.g. subphrenic abscess)
Abdominal ultrasound
–	Abdominal masses
–	Free fluid
–	Dilated bile ducts
Abdominal CT scan
–	Higher definition than ultrasound
46
Q

what microbiological investigations (excluding bloods) are carried out for intraabdominal infections

A

– Peritoneal fluid
– Ultrasound/CT guided drainage fluid
– Microscopy, culture and sensitivity testing

47
Q

most common treatment for Intraperitoneal abcess

A

drainage

48
Q

how are antibiotics used to treat intrabdominal abcesses

A

• Start smart ….
– best guess(empirical) antibiotics.
– Intestinal source- coliforms and anaerobes.
o Cefuroxime & metronidazole (

Clinical Pathology (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions