rouge GI microbiology

Question 1

how is c diff diagnosed

Answer 1

PCR for toxin A/B

Question 2

what organism is C diff

Answer 2

gram +ive rod

Question 3

4 Cs of C diff

Answer 3

clindamycin // co-amox // cephlasporins (ceftriaxone) // fluroquinolones (cipro)

Question 4

apart from 4c’s what drug is RF for c diff

Answer 4

PPI

Question 5

presentation c diff

Answer 5

sudden diarrhoea // ando pain // raised WCC

Question 6

what is a serious complication of c diff

Answer 6

toxic megacolon

Question 7

what differentiates mild moderate and severe C diff

Answer 7

mild = normal WCC // moderate = WCC >15 // severe = WCC <15 // life threatening = hypotension or toxic

Question 8

invx of C diff

Answer 8

Stool for C difficile toxin // antigen shows exposure not infection

Question 9

1st, 2nd, 3rd line mx for first episode of C diff

Answer 9

1st = oral vanco // 2nd = oral fidamoxicin // rd = oral vanco +/- IV metro

Question 10

mx of C diff that returns within 12 weeks

Answer 10

oral fidamoxin

Question 11

mx of C diff that returns after 12 week

Answer 11

oral vanco OR oral fidamoxin

Question 12

mx life threatening c diff

Answer 12

oral vanco + IV metro

Question 13

mx for C diff in patients who have had 2+ previous episodes

Answer 13

faecal transplant

Question 14

what is risk factor for small bowel bacterial overgrowth syndrom (SBBOS)

Answer 14

neonates + GI abnormality // scleroderma // DM

Question 15

symptoms SBBOS

Answer 15

chronic diarrhoea // bloating // flatulence // abdo pain

Question 16

invx SBBOS

Answer 16

hydrogen breath test // small bowel aspiration + culture

Question 17

mx SBBOS

Answer 17

1st line = rifaximin // 2nd line = co-amox or metro

Question 18

mx SBBOS

Answer 18

1st line = rifaximin // 2nd line = co-amox or metro

Question 19

what causes wipple disease

Answer 19

tropheryma whippellii

Question 20

who gets whipple disease

Answer 20

HLAB27 middle aged men

Question 21

symptoms whipple’s disease

Answer 21

malabsorption // large joiny pain // lymph // hyperpigmentation + photosensitivity // pleurisy + pericarditis

Question 22

invx whipples disease

Answer 22

jejunal biopsy –> macrophages and PAS granules

Question 23

mx whipples

Answer 23

co-trimoxaazole for 1 year and IV pen

Question 24

what causes SBP

Answer 24

ascites from liver cirrhosis

Question 25

features of SBP

Answer 25

ascites, abdo pain, fever

Question 26

diagnosis SBP

Answer 26

neutrophils >250 in paracentesis

Question 27

organism SBP

Answer 27

e. coli

Question 28

mx SBP

Answer 28

IV cetriaxone