Lecture 14 - GI infections Flashcards

1
Q

Microbiome

A

All the genome within the gut

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2
Q

Microbiota

A

All the organisms within the gut

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3
Q

Functions of the microbiota

A
Pathogen inhibition
Detoxifies drugs
Immune protection - GALT
Nutrition
Gut brain axis
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4
Q

Causative organisms of watery diarrhoea

A
Norovirus and rotavirus
C difficile
E. Coli
Giardia lamblia 
Cryptosporidium parvum
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5
Q

Causative organisms of watery diarrhoea inflammatory diarrhoea

A
Non typhoidal salmonella
Campylobacter
E coli
C difficile 
Shigella 
Entamoeba histolytica
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6
Q

inflammatory diarrhoea

A

Bloody
Pain when defecating
Small volume

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7
Q

watery diarrhoea

A

Small bowel origin
Bloating and cramping
Larger volume

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8
Q

Salmonella

A

GRAM NEGATIVE

Cause:
Gastroenteritis - Salmonella enteritiditis, virchow
Enteric fever - salmonella typhi (THx and no diarrhoea)
Bacteraemia
Endovascular infection
Osteomyelitis

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9
Q

Non typhoidal salmonella

A

Incubation period: 8 - 72 hours

Transmission: faeco-oral, animals and food

Symptoms: Nausea, vomiting, abdo cramps, diarrhoea

Complications: endovascular infection, osteomyelitis, abscesses, bacteraemia and septic arthritis

Treatment: Self limiting Ceftriaxone, azithromycin, ciprofloxacin

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10
Q

Sickle cell patients

A

Tend to get bone and joint infections by gram positive infections but salmonella can cause gram negative osteomyelitis

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11
Q

Campylobacter (commonly coli)

A

Gram negative
Spiral

Found in GI tract of poultry and animals

Incubation period: 3 days

Transmission: food, water and animal contact

Symptoms: diarrhoea, abdo cramping , fever and malaise

Complications: Reactive arthritis, Guillian barre syndrome

Treatment: Self limiting
Macrolides or fluoroquinolones

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12
Q

Shigella

A

Gram negative

Incubation period: 1 - 7 days

Transmission: faeco-oral route, food and water (low infectious dose therefore can be person to person)

Symptoms: Inflammatory diarrhoea, tenesmus, fever

Complications:
Proctitis, rectal prolapse, toxic megacolon, perforation or obstruction

Bacteraemia, seizures in children, reactive arthritis and haemolytic uraemic syndrome

Treatment: Ceftriaxone, Azithromycin and ciprofloxacin

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13
Q

Tenesmus

A

Sensation to what to void but don’t need to

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14
Q

Proctitis

A

Inflammation of lower rectal lining

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15
Q

E COli STEC

A

Shiga toxin producing E coli

Particularly in children under 10 and elderly

Incubation period - 1- 10 days

Symptoms: Painful, inflammatory diarrhoea and haemolytic ureamic syndrome [no fever]

Complications- HUS - thrombocytopenia and AKI worsened by antibiotics ans more toxins released

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16
Q

Clostridiodes difficile

A

Anaerobic gram negative bacilli
Produce spores
[common nosocomial - antibiotics disrupt microbiota]

Transmission: faecal- oral route [use soap]

Symptoms: diarrhoea

RF: 65+ yrs old, antibiotic therapy, PPI theraphy , prolonged hospitalisation

Complications: Toxic megacolon, colitis and perforation

Treatment: Metronidazole, oral vancomycin, faecal microbiota transplantation

17
Q

Norovirus

A

Winter vomiting virus

Symptoms: Watery diarrhoea and vomiting

Incubation period: 12 hours - 2 days

Transmission: direct contact, aerosols and faeco-oral route

Highly infectious and small infectious dose

Self limiting

18
Q

Rotavirus

A

Gastroenteritis in young children

Incubation period - less than 2 days

Transmission: faeco-oral route - highly infective

Symptoms: watery diarrhoea, vomiting and fever. Worse in children

Complications: encephalopathy, seizures and encephalitis

[Oral vaccine]

19
Q

Parasites causing GI problems

A

Cryptosporidium
Giardia
Entamoeba histolytica

20
Q

Cryptosporidium parvum

A

Intracellular protozoan parasite

Transmission: water, food, faeco-oral route, animals [cattle], person to person

Incubation period - 7 - 10 days

Symptoms: watery diarrhoea

Treatment:
Self limiting
Nitazoxanide

21
Q

Giardia duodenalis

A

Protazoa

High risk: 
Infants and children
Travellers
Immunocompromised 
Cystic fibrosis patients

Transmission: food, water and faeco oral route

Symptoms: watery diarrhoea, steatorrhoae, bloating, abdo cramps and malaise. If persits, malabsorption and weight loss but may be asymptomatic

Treatment: Metronidazole, nitrazoxanide

22
Q

Entamoeba histolytica

A

Protazoa

Risk factors: Young age, pregnancy, corticosteroid treatment, malnutrition and alcoholism

Incubation period - 2 weeks - 2 years

Transmission: food, water and faeco oral [highly transmissable]

Symptoms: inflammatory diarrhoea, abdo pain asymptomatic, fulminant colitis with necrosis and perforation and can mimic IBD,

Complications: amoeba liver disease

Treatments: high dose metronidozole and intraluminal antibiotic for cysts - paromomycin