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GI system > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Is h.pylori acquired in infancy?
And how is it spread?

When do consequences arise?

A

Yes
is spread through oral-oral or faecal oral

consequences dont arise until later in life

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2
Q

What is h.pylori?

A

gram -ve microaerophillic flagellated bacillus

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3
Q

What can an H. pylori infection go on to produce?

A

No clinical disease in most cases

can go on to produce a gastric ulcer

or create a gastric Cancer

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4
Q

Where are the most bacteria in the ailementrary canal found?

A

mouth and large intestine - small bowel starts to increase the closer it gets to the large bowel

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5
Q

What is the sequence of pathogenic infection?

A

exposure, adhesion, invasion, colonisation- toxicity tissue damage or disease

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6
Q

What is the process of invasion of pathogen?

A

invasion - prodromal period, illness period, (convalescent period) starts to clear up then host might become a chronic carrier

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7
Q

What immune system component fights - bacteria

A

phagocytes, antibody and B lymphocytes, complement

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8
Q

What fights viruses (immune system)

A

T lymphocytes, antibody and B lymphocytes

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9
Q

What fights fungi?

A

Phagocytes, T lymphocytes and eosiniphils

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10
Q

What fights protozoa?

A

T lymphocytes and eosiniophils

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11
Q

What fights worms?

A

eosinophils and mast cells

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12
Q

How are enterbacteriacae classified in the GI tract?

A

Whether they are lactose fermenting or not

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13
Q

What turns pink in macConkey agar

A

lactose fermenters turn it pink

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14
Q

What method is used for rapid identification of bacteria?

A

MALDITOF - analyse composition of bacterial cell wall

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15
Q

How does 16s rRNA work?

A

Sequences whole genome

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16
Q

When is serology used?

A

differentiation between the same species

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17
Q

What is the normal flora of the bowel?

A

mouth - strep viridans, candida sp, staph
stomach/ duo - usually sterile due to low pH
jejunum - coliforms and anaerobes
coon - coliforms, enterococcus faecalis

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18
Q

define sepsis

A

systemic inflammatory response to infection

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19
Q

What is the disease continuum for sepsis?

A

Infection , systemic inflammatory response syndrome, sepsis, septic shock

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20
Q

What are some community sources of bacteremia

A 
E coli(catheter related - can be in hospital), s. pneumoniae and staph aureus(Can be in hospital also) 
klebseilla (hospital), enterococci (hospital)
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21
Q

What are coliforms?

A

inhabit the colon - E.coli that inhibit large bowel

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22
Q

What are aerobic organisms?

A

Grow better in oxygen but can still grow without it - staph strep, enterococci and coliforms (majority of human pathogens)

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23
Q

What do bactera need in order to multiply?

A

Time, temperature, food source and moisture

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24
Q

What pathogen is assocated with antibiotics

A

C . diff

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25
Q

What pathogen is involved in daycare

A

rotavirus

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26
Q

What is the pathogen involved in anal sex? (men)

A

Shigella, camplyobacter and salmonella

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27
Q

What bacteria is related to HIV

A

mycobacterium, cytomegalovirus

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28
Q

What pathogens are generally involved in outbreaks on cruises

A

Norovirus

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29
Q

What is a microorganism with a short incubation period (1-6 hrs) (bacillus cereus - how can you get it what are the symptoms

and staph aureus - What are the symptoms

A

Bacillus cereus - heat resistant spores, profuse vomiting and reheated rice

Staph aureus - preformed toxin in food
rapid absorption
vomiting and abdominal pain

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30
Q

What is shigella?

A

Facultative anaerobe, gram neagive rod

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31
Q

What does a shigella infection lead to?

A

Invasion of colonic mucosal cells and induction of an intense inflammatory response

forms mucosal ulcers and abscesses

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32
Q

What does a shiga toxin do?

A

binds to receptors found on renal cells, RBC

inhibit protein syntheis = causes cell death

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33
Q

How so patients present with an ecoli infection?

A

Most common infections of ecoli is travellers diarrhoea

sometimes patients present with severe abdominal apin, diarrhoea which is bloody

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34
Q

What is the clinical indication for Ecoli -157

A

bloody diarrhoea - related to foods and is spread from person to person

Haemolytic ureamic syndrome
diarrhoea may have stopped so get help!

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35
Q

what is the incubation of Ecoli 0157

A

1-14 days

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36
Q

What is campylobacter?

Incubation?

How is it acquired?

Treatment?

A

gram negative enterobacyeriales

16 to 48 hrs incubation

usually passed around through poultry (raw milk)

water diahorrea - sometimes need admission

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37
Q

What are the most common type of campylobacter strain?

A

C jejuni

38
Q

What are non typhoidal salmonella?

what is the incubation time

How is it transferred?

What is it found in?

Symptoms?

A

motile gram neg bacilli

8-72 hrs inucbation

fecal oral route

food - poultry, meat

cause d and vomiting (sometimes blood)

39
Q

Where are H and O antigens found?

A

H = flagellum O = part of the Lipopolysaccharide

40
Q

What is a useful test in salmonella for detecting outbreaks? - which groups are most common?

A

serotyping - help pinpoint the source of infection

Groups B, C and D and most common

41
Q

How is salmonella diagnosed?

How is it treated?

A

blood cultures and stool samples

self limiting
suportive treatment - oral hydration

42
Q

What are some key differences between typhoid and non-typhoidal salmonella

A

T = human NT = animals
incubation - T = 1-3 weeks NT= 8-72 hrs
T = typhoid fever NT= acute gastroenteritis

43
Q

What is listeria monocytogene? - how is it acquired and was temp is good for it to grow?

A

non spore forming gram +ve rod, infection acquired form contaminated food - can grow at low temperature

44
Q

What can listeria monocytogenes cause?

what are some complications?

A

Gastroenteritis - 9-48 hrs, fever muscle aches + diarrhoea

complications - meningitis/ bacteria, brain abscess

45
Q

How is the diagnosis made in listeria monocytogenes ?

A

culture - CSF, in stool needs specific media

46
Q

What are some risk factors of LM?

A

Iron overload (haemachromotosis)

47
Q

Yersinia entercolitica?

A

appendicitis like symptoms: diarrhea vomiting, fever

caused by water or food contaminated with fecal matter

48
Q

What are some casues of Acute travellers diahorrea?

A

Enterotoxigneic E coli
bacteri - camplyobacter, salmonella
virus - norovirus (cruise ships)

Cholera - big outbreaks in area of poor hygiene

49
Q

What are the investigation of acute traveller’s diarrhoea?

A

stool culture

stool microscopy for cysts and parasites

50
Q

Treatment for ATD?

A

Supportive - fluids

bloody diarrhoea may warrant treatment

51
Q

What are the 2 types of enteric fever?

A

Typhoid or paratyphoid fever

52
Q

What people usually get enteric fever?

A

Travelled to India or SE asia

53
Q

What is the incubation period of enteric fever?

A

7-18 days

54
Q

What are some symptoms of enteric fever?

A

fever, sweating, dry cough, chills, constipation/ diarrhoea

55
Q

Complications of enteric fever?

A

GI bleeding GI perforation

56
Q

What is the treatment for epirically for people with enteric fever?

A

IV Ceftriexone

57
Q

What are the three different causes of jaundice?

A

Pre-heptatic - malaria, HUS

Hepatic - Acute viral hepatitis (Hep A and E)
leptospirosis - weils disease (acute liver failure and renal failure)
malaria, enteric fever

post hepatic - ascending cholangitis - and helminths

58
Q

What are the investigations and treatment of jaundice (pathogen)

A

blood cultures
USS abdomen (obstruction)
serology for testing

supportive - then direct treatment for pathogen found if there has been one identified

59
Q

What is amoebiasis? DP

What is it?
How is it spread?
symptoms?

investigation

treatment - metronidazole - luminal amoebicide

A

Entamoeba histolytica - a protoza
fecal oral spread

abdominal pain, fever, bloody diahorrea
toxic and unwell

investigation - stool microscopy for trophozoites or cysts

treatment - metronidazole followed by luminal amoebicide

60
Q

What is amebic liver abcess? DP
What is it and what is the incubation period?
What are the symptoms?
Investigations?

treatment?

A

Entamoeba histolyica
incubation period - 8-20 weeks
sub acute over 2-4 weeks

fever, sweats, upper ab pain, hepatomegaly, tender over right lower ribs

investigations - Abnormal LFT’s USS or CT scan

metronidazole, - need to clear gut lumen of parasites with luminal amoebicide

61
Q

Giardiasis - DP
What is it?
How is it spread?
What is the incubation period?

What are they symptoms?

What are the investigations?

What is the treatment?

A

Giarda intestinalis - flagellated protozoa

faecal oral spread (contaminated water)
incubation is around 7 days

presentation - watery, malodorous(foul smelling) diarrhoea, blaoting + cramps, weight loss

Investigations - stool microscopy for cysts (often difficult)

treatment - Metronidazole or tinidazole

62
Q

Provide some characteristics of helminth infections:

Where are they found?

How are they diagnosed?

A

In the gut, in the tissue

associated with eosinophillia, often diagnosed by the adult worm passed or eggs in stool

63
Q

What are intestinal nematodes?

A

round worms - ascariasis most common helminthic infection in the world affecting 25 % of the worlds population

64
Q

What is the life cycle of parasite?

A

Egg ingested, hatch in small intestine, into venous system and via liver and heart to reach lungs
ascend tracheobronchial tree and then swallowed into the gut to develop into adult worm and start to produce eggs

65
Q

What is schistomaiasis ? - what can this lead to?

A

infection from fresh water -
chronic infection, adult worms located in portal venules which can lead to hepatomegaly and liver fibrosis/ portal hypertension

66
Q

What are cestodes? - how are they acquired?

A

tape worms - acquired by eating undercooked meat containing infectious larval cysts

67
Q

Cysticercosis?

A

Tissue cyts muscle and brain that can lead to seizures

68
Q

What is chagas disease?

A

Trypanasoma cruzi - transmitted by the kissing bug (triatome) - parasympathetic denerrvation affecting colon or Oesopahgus

69
Q

What are the most common viruses that cause viral gastroenteritis?

A

rota virus, norovirus, sapovirus, adenovirus, astrovirus

70
Q

When is rotavirus prevalent?

What can it cause

What are some clinical signs

how long does it last for

How is it diagnosed

What is the treatment

A

kids under 3 yrs - - repeat infection gets milder over time
can cause outbreaks
person to person
faecal oral - usually in winter

cincial effects - mild watery to perfuse diarrhoea causing shock
may have moderate fever first, vomiting then diarrhoea
NOT BLOODY
lasts about a week

Diagnosis is PCR on faeces

hydration is key management

71
Q

How is rotavirus combatted?

A

The use of a vaccine - risk of intususseption increases as babies get older

72
Q

When is norovirus prevalent?

A

winter vomiting disease - affects all ages

related to outbreaks - faecal oral or droplet spread

Survivial on fomites for days- weeks

73
Q

Norovirus (most common adult GI viral infection)

What are the symptoms?

How is it diagnosed?

What is the treatment?

A

asymptomatic shedding - 48 hrs post stop of symptoms
D and V
short incubation - less than 24 hrs and lasts 2-4 days

diagnosed PCR stool

usually self limiting and hydration is key

74
Q

How are infections tranmitted during sex?

A

Sexual/ genital secretions
direct innoculation
Fomites (inanimate object used as a vector for transmission - vibrator eg)
IVDU - Iv drug use (HIV, HCV)

75
Q

How is syphilis spread?

A

Systemic/ haematogenous spread

76
Q

Give an example of an infection spreading locally

A

herpes/ warts

77
Q

What are some risk factors for STI’s

A

Under 25, change in sexual partner, non condom use

78
Q

What can STI’s present with?

A

Peri anal pathology
Proctitis
Proctocolitis
Hepatobiliary problems

79
Q

What does an HIV infection do?

Where are you more likely to get it?

A

Depletion of intestinal GALT (largest immune compartment in the body)

Rectum more likely to get the virus than through the oral route

80
Q

Difference between antimicrobials and antibiotics

A

antimicrobial for all micro-organisms all agnets

Antibiotic is for bacteria - produced naturally by microorganisms and kill or inhbit the growth of other microorganisms

81
Q

What is antibiotic resistance?

define multi drug resistant

Extensively drug resistant

Pan drug resistant

A

antibiotic will not inhibit bacterial growth at clinically achievable concentrations

Pumping it out of the bacterial cell or by producing molecules that can destory the antibiotic

Multi drug resistant - bacteria is non - susepctibale to at least 1 agent in 3 or more antimicrobial categories

XDR(extensive) - : non-susceptibility to at least 1 agent in all but 2 or fewer
antimicrobial categories

PDR - non sus to all agents in all antimicrobial categories

82
Q

How is antibiotic resistance acquired?

Horizontal and vertical gene transfer

3 mechanisms - transformation, transduction, conjugation

A

In vertical transmission, a
bacterium accumulates
errors or mutations that cause antibiotic resistance during replication;

In horizontal transmission,
resistant genes are swapped
from one microbe to
another

This can occur via three mechanisms:
transformation, when bacteria scavenge resistance genes from dead bacterial cells and integrate
them into their own genomes;

transduction, when resistance genes are transferred by bacteriophages (viruses that infect bacteria); or

conjugation, when genes are transferred between bacterial cells through tubes called pilli.

83
Q

What are some drivers of antibiotic resistance?

A

sicker inpatient population
increasing resistance in community
chronically ill

84
Q

What is antimicrobial stewardship?

What is prudent prescribing?

A

Promoting and monitoring judicious use
of antimicrobials to preserve their future effectiveness’.

The optimal selection, dosage, and
duration of antimicrobial treatment that
results in the best clinical outcome for the
treatment with
minimal toxicity to the patient low risk of resistance

85
Q

Antibiotic prescribing - What is the main thing to consider in antibiotic prescribing?

A

Constant review!

86
Q

What does the HPV virus cause?

A

anal Warts that can extended rectum

87
Q

How can Herpes simplex virus present?

How is spread?

A

1) Pain, ulcers, painful defection, bleeding,

spread through oral anal oral genital

88
Q

What are the different types of syphilis(primary and secondary)

what symptoms does it present with?

What investigation is carried out?

A

Primary – solitary painless ulcer

Secondary – mucosal patches and ulcers

Multisystem disease!

Symptoms:
Pain of movement of bowels, blood in stool, crampy abdominal pains,

Colonsocpy – patchy mild congestion at rectum
Rectal biopsy

89
Q

What are piles?

A

Piles – ulcers around the bottom

90
Q

What can flare up a C. diff infection?

What are the main tests carried out for a Cdiff infection?

What is the main sign of C.diff infection?

Treatments before test comes back?

What are the complications?

What can cause a flare up of C.diff

What are the treatments for severe and non-severe?

A

Use of antibiotics

Stool C+S, FBC, U + E and abdominal x-ray is done for anyone with gastroenteritis

C.diff is detected with EIA toxin being positive then a C.diff infection is highly likely

IV fluids
Single side room
contact precautions

Sepsis
toxic megacolon
bowel perforation
Renal failure

Antibiotics - clindamycin, ciprofloxacin (+ other quinolones) cephalosporins and co-amoxiclav
(anti motility drugs, Age immunosuppression)

Severe = vancomycin
non severe = oral metronidazole

91
Q

How is threadworm treated?

A

Strict hygiene measures and mebendazole for all of the household

92
Q

What is the most likely organism for infective diarrhoea?

treatment?

Complications?

A

E Coli0157

Supportive treatment

Haemolytic urea syndrome - antibiotics can increase the risk of this happening

GI system (8 decks)

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