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Medicine: PBL wrap-ups > Unit 3 Case 2: GIT infection > Flashcards

Unit 3 Case 2: GIT infection Flashcards

1
Q

what is crohns

A

type of inflammatory bowel disease
most commonly occurs in small intestine and colon, can affect part of GIT from mouth to the anus

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2
Q

symptoms of crohns

A

diarrhoea
abdominal cramps
blood in stool
fissures in the lining of the anus
stricture
fistula

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3
Q

fistula

A

caused by inflammation
abnormal channel formed between one part of intestine or another
may be between intestine and vagina or bladder

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4
Q

tests used to help diagnose crohns

A

bloods
stool
endoscopy
colonoscopy
CT and MRIs
tissue scan or biopsy

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5
Q

classifications of drugs that can be used for crohns

A

anti-inflammatory
immunosuppressors
pain relievers

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6
Q

anti-inflammatory drugs in crohns

A

corticosteroids such as prednisolone and budesonide

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7
Q

immunosuppressors in crohns

A

azathiopurine
mercaptopurine
methotrexate

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8
Q

other medications used in crohns treatment

A

acetaminophen- pain reliever
anti diarrhoeals

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9
Q

other treatments of crohns

A

nutrition therapy
surgery in more severe cases

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10
Q

amoeba

A

single-celled eukaryotic organism that changes its shape
moves by pseudopodia
found in water, soil and damp

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11
Q

pseudopodia

A

temporary projections of the cell
engulf bacteria and other particles as food by phagocytosis

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12
Q

amoebiasis

A

GI infections that develops when entamoeba histolytica enters intestines
parasite lays eggs that develop into mature cysts and leave through stool
infection is transmitted when you eat or drink something the parasite has contaminated

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13
Q

symptoms of amoebiasis

A

cramping
diarrhoea
nausea
fever

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14
Q

parasite

A

organism that lives on/in host organism and gets food from expense of its host
3 main classes

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15
Q

3 main classes of parasites

A

protozoa
helminths
ectoparasites

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16
Q

protozoa

A

unicellular
live and multiply inside of your body
transmits through faecal oral route

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17
Q

helminths

A

multicellular
live in and outside of your body

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18
Q

ectoparasites

A

multicellular
ticks fleas lice mites that live and feed off your skin

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19
Q

parasitic infections

A

spread via contaminated food water soil blood equal contact and insect vectors

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20
Q

6 strains of E coli known to cause diarrhoea

A

shiga toxin producing E coli/verocytotoxin producing e coli/ Enterhohemorrhagic e coli
enteropathogenic e coli
enteroaggressive e coli
enteroinvasive e coli
diffusely adherent e coli
enterotoxigenic E. coli

STEC ETEC EAEC VTEC EHEC EIEC EPIC DAEC

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21
Q

STEC VTEC EHEC

A

severe food borne disease
severe diarrhoea, stomach cramps, vomiting
can lead to haemolytic ureic syndrome that can cause kidney damage/failre
toxins in intestines from STEC travel into bloodstream and destroy RBCs

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22
Q

EPEC

A

adheres to intestinal epithelial cells
causes diarrhoea

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23
Q

EAEC

A

adheres to small and large intestinal epithelia
causes acute and chronic diarrhoea

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24
Q

EIEC

A

invades colonic epithelial cells
lyses phagosome

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25
Q

DAEC

A

defined by a pattern of diffuse adherence where bacteria covers entire cell surface

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26
Q

ETEC

A

prodcue special toxnis which stimulate the lining of the intestines causing them to secrete excess fluid
therefore diarrhoea
produces heat stable and heat liable toxins
causes diarrhoea, abdominal cramping, fever, nausea

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27
Q

microbiological testing of E.coli

A

cultures of samples of urine, stool and other infected material taken to culture bacteria and specific toxins idenitfid
suscpetibility testingmay occur if the bacteria are identified to see which antibiotics are effective

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28
Q

what is the stool smaple tested for

A

colour
consistency
shape
odour
mucus
looks for parasites and their cysts

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29
Q

gram staining of E coli

A

negative
bacilli
motile
variable capsule
flagellated
catalase psoitive

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30
Q

what is c.difficile

A

clostridium difficule is anaerobic, spore-formig gram postive bacillus
causes spectrum of antibiotic associated colitis through release of exotoxins called clostridial toxins
infiltrate and destroy target cells

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31
Q

symptoms of C difficile

A

diarrhoea
high temperature
loss of appetite
feeling sick
stomach ache

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32
Q

what are the c difficile symptoms caused by

A

imbalance of bacteria in the bowel due to antibiotics causing infection

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33
Q

how can c difficile be spread

A

by faeces

34
Q

who is at risk of C difficile

A

over 65
taking or have recently taken antibiotics
staying at hospital or care home for long period of time
immunosuppressed
long term health conditions like dioabetes or kidney failure or chemotherapy
taking PPI
if you have had a C diff infection

35
Q

treatment for C difficile

A

stop antibiotics you are taking if possible
10 day course of another antibiotic that can treat the c difficile infection
advice on how to avoid dehydration
dont take medication to relieve diarrhoea

36
Q

common bacteiral gut infections

A

campylobacter jejuni
salmonella
shingella

37
Q

common parasitic gut infections

A

giardia lamblia
cryptosporidium parvum
entamoeba histolytica

38
Q

common viral gut infections

A

adenovirus
rotavirus
norovirus

39
Q

surveillance of worldwide diseases

A

world health organisation uses global burden of disease

40
Q

reducing worldwide gut infections

A

care in selecting food/ drink
good sanitisation
proper sewage disposal and drainage
safe drinking water wide spread vaccination

41
Q

drugs in this case

A

prednisolone
adalimumab
picolax
metronidazole

42
Q

what is a pre-surgical prophylaxis antibiotic

A

antibiotics given to patient before a surgery in order to reduce the risk of post-surgical infections

43
Q

3 main antibiotics used as a pre-surgical prophylaxis

A

cafazolin
vancomycin
gentamicin

44
Q

limitations of pre-surgical prophylaxis antibiotics

A

should be discontnued before 24 hous as there may be alteration in patient or hospital bacteria lflora
leading to bacterial resistance, colonisation

45
Q

what is an ileocolic resection

A

surgical removal of the cecum and the ileum
most common operation performed for Crohn
may be accomplished by open or laparoscopy surgery

46
Q

open surgery

A

once large incision made in the abdomen where the surgery will be carried out

47
Q

laproscopy surgery

A

several smaller incisions made in the abdomen
safer option
with the aid of a small camera

48
Q

procedure of ileocolic resection

A

patient asked to eat low residue diet for few days prior and take some laxatives
open or laprascopic
removal of caecum and ileum
anastomosis of end of small intestine to the beginning of the large intestin
intravenous drip given to the pateint
patient usually remains in hospital for week

49
Q

stool testing for parasites

A

amoebic dysentery
giardia duodenalis
OCP testing: 3 samples over 10 dya period with no more than 24 hours, cyst and ova shedding is intermittent
barium, oil, magnesium or rystalline compounds can lead to unsatisfactory results

50
Q

ova

A

egg

51
Q

cyst

A

shell that protects the parasites during a stage in their life

52
Q

testing for C diff

A

stool chart 5-7
stool sample
GDH EIA: rule out C diff rapid
C diff toxin EIA: detect c diff toxins, low sensitivity, alongside other testing
PCR; detect presence of c diff and toxins that produce these genes

53
Q

Stool testing

A
54
Q

what is an IV fluid

A

liquids injected into a persons veins through an IV tube
prevent or treat dehydration and electrolyte imbalances

55
Q

3 categories of IV fluids

A

hypertonic
hypotonic
isotonic

56
Q

hypertonic

A

solute has highe rconcentration than cell
direction of osmosis is water drawn out of cells
cells shrink
can result in intravascular fluid overload and pulmonary edema
cant be used extensively

57
Q

isotonic IV fluids

A

no change in concentration gradeint
cells neither shrink or exppand
treat vomiting diarrhoea shock

58
Q

hypotonic IV fluids

A

solute concentration lower than the cells
osmotic direction is into the cells
shouldnt be given to patients ith icnreased intercranial pressure as may exacerbate effects of cerebral edema

59
Q

further cateogries of IV fluids

A

crystalloid
colloid

60
Q

crystalloids

A

small molecules
able to diffuse across semi-permeable membranes
intracellular
used to increase fluid volume and intravascular space
incase of hypovolemia

61
Q

colloid

A

larger molecules
dont cross semi-permeable membranes
remain intravascular rather than entering the cells
remain in the blood longer
used as plasma expandrs

62
Q

normal saline

A

0.9% nacl
crystalloid
isotonic
hydration due to vomiting and diarrhoea
can be used in conjunction with blood administration
not for cardiac or renal complications as high sodium can cause excess fluid retention

63
Q

half normal saline

A

0.45% normal salie
hypotonic
crystalloid
raise fluid volume
waterreplacement
sodium chloride depletion

64
Q

lactated ringers

A

normal saline with additional electrolytes
isotonic
crystalloid
contains Na, Cl, Ca, K
for dehydration, burn victims, hypovolemia, acute blood loss
not for renal failure or liver disease as contains potassijm

65
Q

dextrose IV fluids categories

A

in water
in saline
in lactated ringers

66
Q

dextrose in water

A

istonic in bag
hypotonic absorbed
rehydration

67
Q

dextrose in saline

A

isotonic in the bag
hypertonic absorbed
circulatory insufficiency

68
Q

dextrose in lactated ringers

A

isotonic in the bag
hypotonic absorbed
can’t be used for renal or liver failure
or if diabetic

69
Q

rehydration therapy

A

solution msuyt contain Na and gluocse
sodium ions pass through the glucose symporter
process of active transport driven by the high sodium concentration
sodium only passes if glucose prwsent
sodium high to low
glucose low to high
higher concentration of sodium and glucose in the cell
on the basal cell is na/k+ atpase
sodium against concentration gradient
gluocse through gluocse uniporter passively
increased glucose and sodium concentration in blood lowers water potential
water moves by osmosis from small intestine to the blood
rehydration

70
Q

what is dehydration

A

condition resulting when body loses more fluid than takes in
imbalance dirsupts usualy levels of salt and sugar in the blood
can interfere with body functions

71
Q

diuresis

A

increased or excessive production of urine

72
Q

electrolytes

A

minerals in body with natural positive or negative charge
in blood, urine, tissues and other body fluids
balance water

73
Q

serum sodium concentration

A

amount of sodium relative to volume of water in the blood

74
Q

pathophysiology of dehydration

A

total body water distributed into extracellular and intracellular components
fluid from extracellular depletes first then intra
intra loss results in cell shrinkage and metabolic dysfunciton
can be classified according to serum sodium concentration

75
Q

hypernatremia

A

may produce body cavity effusions (ascites)
pitting edema

76
Q

hyponatremia

A

decreased produces signs of volume depletion
dry mucous membranes
decreased skin turgor
decreased bloodpressyre
increased pulse when sitting up from supine positions

77
Q

isonatremia

A

normal skin turgor and hydration

78
Q

pathophysiology of the vomiting reflex

A

involuntary forceful expulsion of contents of ones stomach throug hthe mouth
3 steps: vomitng develops, retching and act
controlled by vomiting centre and chemoreceptor trigger zone in the medulla oblongata

79
Q

emesis

A

deep breath taken
glottis closed and larynx raised
opens upper oesophageal sphincter
diaphragm contracted sharply downwards
created negative pressure in thorax
facilitates opening of oesphagus and idstal oesphageal sphincter
simultaneously with the downward movement of the diaphragm the muscles of the abdomen vigorously contract and squeeze the stomach and increasing intragastric pressure
pylorsu is closes and oesphagus is relatively open there is an exit route

80
Q

impact of crohns disease

A

diet
fatigue
brain-gut axis
relatiosnhips and sex
reproductive health
travelling and insurance
pregnancy and breast feeding

81
Q

mental health crohns

A

anxiety
depresison
stress
low mood
self esteem disordered eating

Medicine: PBL wrap-ups (21 decks)

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