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Infectious diseases > Sepsis and gastroenteritis > Flashcards

Sepsis and gastroenteritis Flashcards

1
Q

what is the def of sepsis?

A

a life threatening organ dysfunction caused by a dysregulated host response to an infection

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2
Q

what is the SIRS criteria?

A 
Temp >38.3 or <36.0
Tachycardia >90bpm 
Tachyapnoea >20 or PCo2 <4.3kPa
hyperglycaemia in absence of DM 
Confusion 
Leucocytosis >12 or leucopenia <4
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3
Q

what is the qSOFA criteria?

A

Confusion
Tachyapnoea >22
hypotension SBP <100mmHg

0 or 1 = not high risk
2-3 = high risk

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4
Q

what is sepsis 6?

A 
o2 
fluids 
Abx 
Lactate 
Urine output 
Cultures

Give 3 take 3

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5
Q

what investigations are useful in sepsis?

A 
blood cultures 
lactate
Hourly UO 
FBC 
ABG/VBG 
CRP 
Procalcitonin 
ECG - arrhythmias 
Urinalysis
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6
Q

What kind of bacteria is camplyobacter? how is camplybacter acquired?

A

Curved gram negative bacilli

contaminated poultry, milk or water

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7
Q

how does camplyobacter present and how is treated?

A

Bloody diarrhoea, cramping abdo pain, fever
Vomiting UNCOMMON
duration 2-10 days

fluid replacement for most
clarithromycin for severe
ciprofloxacin or gent for invasive

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8
Q

What type of bacteria is salmonella? how does it present?

A

Gram negative bacilli

Watery diarrhoea and vomiting
fever in invasive disease
can cause osteomyelitis, septic arthritis, meningitis

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9
Q

how is severe salmonella treated?

A

ciprofloxacin

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10
Q

what type of bacteria is shigella? how does it spread?

A

gram negative bacilli

faeco-oral

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11
Q

how does shigella present? what is a major complication?

A

watery diarrhoea followed by bloody diarrhoea
marked cramping abdo pain
fever
vomiting uncommon

Haemolytic uraemic syndrome

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12
Q

how does vibrio cholerae (cholera) infection present? how is treated?

A

comma shaped gram negative bacilli
faeco oral

Profuse watery diarrhoea (rice water stool)
electrolyte loss

rehydration
doxycycline

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13
Q

how does E.coli 0157:H7 present?

A

bloody diarrhoea with abdo pain and vomiting

Haemolytic uraemic syndrome in 5-10%

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14
Q

what is haemolytic uraemic syndrome?

A

Microangiopathic haemolytic anaemia
thrombocytopenia
renal failure

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15
Q

what type of food does staph auerus multiply in?

A

cooked meat, cakes, pastries

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16
Q

what bacteria is associated with fried rice related gastroenteritis?

A

bacillus cereus

can get emetic or diarrhoeal disease

17
Q

what complications can arise from clostridium botulinium infection?

A

gram positive bacilli

neuromuscular blockade - flaccid paralysis and progressive muscle weakness

resp failure if diaphragm involved

18
Q

which gram positive coccobacilli thrives in unpasteurised milk and soft cheese, pate and cooked meats? It causes a flu-like illness

A

listeria monocytogenes

19
Q

how is listeria monocytogenes treated?

A

IV ampicillin and Gent

20
Q

how is gastroenteritis investigated?

A

stool sample and culture - PCR

21
Q

which pathogens cause bloody diarrhoea?

A

Camplyobacter, E. Coli and Shigella

22
Q

how does norovirus present and how is it treated?

A

acute onset vomiting
watery diarrhoea
cramps and nausea
headache and fever in some

Oral/IV fluids
Antispasmodics
Analgesic and anti-pyretics

isolate and cohort

23
Q

which ABx can cause C. Diff?

A

Clindamycin
Cephalosporins i.e cefriaxone
Co-amoxiclav
Ciprofloxacin

24
Q

what are the S&S of C.Diff?

A 
watery diarrhoea 
Abdo pain and tenderness 
fever 
N&V 
recent ABx
25
Q

how is C. Diff investigated?

A

FBC
- leucocytosis

Stool PCR
- positive for C. Diff

AXR
- ordered in distension to check for dilation

Sigmoid/colonoscopy

  • pseudomembrane or colitis
  • pseudomembrane looks like raised yellow and white plaques agaisnt an inflamed mucosa
26
Q

what are the C. Diff severity markers?

A 
Colonic dilation >6cm 
WCC >15 
Creatinine >1.5x baseline 
Temp >38.5 
Immunosupression
27
Q

how is C. Diff treated?

A

0 sev markers = metronidazole

> 1 sev markers = oral Vancomycin

Stop offending Abx

Surgery if complications

Faecal microbiota transplant if recurrent

28
Q

what are the complications of C. Diff? How are they diagnosed and treated?

A

Ileus - worsening N&V, AXR shows dilation. NG tube and supportive therapy

Perf and peritonitis - acute abdo pain and rebound tenderness. High grade fever with shock. IV met and Vanc

toxic megacolon - increased abdo pain, distension and shock. IV met and Vanc. Colectomy

Infectious diseases (5 decks)

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