wk 5 1 GI infection control - GI sepsis

Question 1

perforation of which organ will lead to colonisation by e.coli, klesbiella spp., strep. faeclis and anaerobes

Answer 1

gall bladder

Question 2

t/f meckels diverticulum would be colonised by e.coli, clostridium spp. and pseudomonas aeruginosa

Answer 2

false
e.coli
colistridium spp.
anaerobes would colonise a meckels diverticulum

Question 3

what 5 organisms would colonise a perforated large bowel

Answer 3

clostridium spp.
strep faecalis 
e.coli 
proteus spp. 
pseudonomas aeruginosa

Question 4

5 incidences where e.coli could colonise GI tract

Answer 4

perforated peptic ulcer
gallbladder
large bowel 
meckels diverticulum 
bladder

Question 5

other than e.coli, which 2 organisisms could colonise the bladder

Answer 5

proteus spp.

strep faecalis

Question 6

3 areas where strep faecalis could colonise

Answer 6

perforated gallbladder
large bowel
bladder

Question 7

t/f vagina infectioin could be colonised by lactobacillus spp., anaerobes, peptostrep spp. and coliforms

Answer 7

true

Question 8

define cholangitis

Answer 8

infection in common bile duct - bile stone

Question 9

entercoccus faecalis and faecium are 2 gram +ve cocci which may infect opportunisticly, which one is more common, more resistant

Answer 9

faecalis - commin

faecium - resistant

Question 10

antibiotics for enterococcus in GI

Answer 10

amoxicillin (vanco if pen allergic)

switch to cotrimoxazole if persistent

Question 11

which type of pathogen would lead to gas gangrene q

Answer 11

clostridium pertingens

Question 12

3 organisms which are cocci and oval in shape (gram+ve)

Answer 12

strep
peptostrep
entero

Question 13

staphyloccocus
micrococcus
petococcus
t/f these are gram +ve cocci and round in clusters q

Answer 13

true

Question 14

2 organisms which are gram+ve bacilli and spore-bearing

Answer 14

bacillus

clostridium

Question 15

t/f campylobacter are gram+ve curved shape

Answer 15

false

gram-ve

Question 16

pseudomonas

Answer 16

gram-ve uniform bacilli

Question 17

peritonitis/biliary tract and intra-abdominal all recieve the same treatment, spawning 7-10 days. which 3 antibiotics are given

Answer 17

IV - amoxicillin, metronidazole, gentamicin (vancomycin if pen. allergic)

Question 18

t/f acute gastritis and pancreatitis are unlikely to be given antibiotics

Answer 18

false
gastroenteritis
pancreatitis
unlikely to affect outcome

Question 19

likely treatment for a severe clostridium difficile infection

Answer 19

vancomycin +/- metronidazole
(10days)
if non-severe - metronidazole

Question 20

it can be difficult to determine the diagnosis if there is an unusual immune response, microbe response or site of infection. give examples of when each would apply

Answer 20

host - age, immunosuppressed, co-morbidity drug genetics

microbe- virulence expression, intracellular predilation for certain sites

site - deep seated
vague symptoms

Question 21

BUFALO is a sepesi intervention too, what does the pneumonic stand for

Answer 21

Blood cultures + septic screen, U&E
Urine output - hourly
Fluid resuscitation 
Antibiotics IV 
Lactate measurement
Oxygen - hypoxic

Question 22

2 quadrants where pain may be present in pneumonia

Answer 22

R+LUQ

Question 23

t/f large abscesses cannot be treated with antibiotics

Answer 23

true - no blood supply

small - can be treated with antibiotics but large collections need incision and drainage

Question 24

what to consider if spontaneous peritonitis, what if its secondary

Answer 24

abscess

bacterial spread

Question 25

t/f all anaerobes are resistant to metronidazole

Answer 25

true

Question 26

drug choice for sepsis and enterococci in gi tract

Answer 26

amoxiciloin
cotrimoxazole - if amox contras/ oral switch
vancomycin may be used

Question 27

drug choice for sepsis and coliforms

Answer 27

gentamicin

aztreonam - genta conteas,
co-trimoxazole for oral switch

Question 28

t/f gentamicin is drug choice for sepsis and anaerobes

Answer 28

false

metronidazole