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Y1 GI > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is gastroenteritis

A

Diarrhea + vomiting due to enteric infections

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2
Q

What is dysentery

A

Diarrhea with blood / mucus

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3
Q

Infection at which part of GI tract causes large volume of diarrhea

A

Large intestine

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4
Q

What is considered as acute diarrhea

A

< 14 days

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5
Q

What is considered as chronic diarrhea

A

> 4 weeks

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6
Q

What is considered as traveller’s diarrhea

A

Diarrhea that develops during or within 10 days of returning from a resource limited country

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7
Q

Common pathogens causing traveller’s diarrhea

A

E. coli
Campylobacter
Shigella
Salmonella

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8
Q

List the bacteria causing gastroenteritis

A 
Campylobacter
Bacillus cereus 
Shigella 
Salmonella
Staph. aureus 
E. coli
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9
Q

Which bacteria is the most common cause of gastroenteritis

A

Campylobacter

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10
Q

Which virus is the most common cause of gastroenteritis

A

Norovirus

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11
Q

List the viruses causing gastroenteritis

A

Rotavirus
Norovirus
Adenovirus

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12
Q

Gram stain of campylobacter

A

Gram negative bacillus

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13
Q

Which strain of campylobacter is the most common

A

C. jejuni

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14
Q

Symptoms caused by campylobacter

A

Watery /blood (30%) diarrhea + pain + fever

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15
Q

Which age group does campylobacter usually affect

A

young adults

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16
Q

How does campylobacter spread

A

from ingestion of

  • uncooked poultry
  • unpasteurized milk
  • contaminated water
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17
Q

Incubation period of campylobacter

A

16 - 48 hours

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18
Q

What are the possible post Campylobacter infection conditions

A

Reactive arthiritis

Guillain Barre syndrome

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19
Q

What protein is reactive arthiritis associated to

A

HLA B27

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20
Q

When does Guillain Barre syndrome usually occur

A

1-2 weeks after infection

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21
Q

Gram stain of bacillus cereus

A

Gram positive bacillus

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22
Q

What toxins do bacillus cereus produce

A

Heat stable vomiting enterotoxin

Heat labile diarrheal toxin

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23
Q

What type of food does Bacillus cereus like

A

Starchy food left in room temperature overnight then reheated

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24
Q

Symptoms caused by bacillus cereus

A

Profuse vomiting +/- diarrhea

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25
Q

Why may diarrhea not occur in bacillus cereus infection

A

Because the enterotoxin that causes diarrhea is heat labile so does not tolerate heat when the starchy food is reheated

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26
Q

Incubation period of Bacillus cereus

A

0.5-6 hours for vomiting

8-12 hours for diarrhea

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27
Q

Gram stain of staphylococcus aureus

A

Gram positive

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28
Q

How does staphylococcus cause symptoms

A

Preformed toxin in poultry / milk / fish

toxin act on vomiting centre

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29
Q

Symptoms caused by staphylococcus aureus

A

Vomiting + diarrhea + nausea

maybe fever and pain

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30
Q

Incubation period of Staph. aureus

A

1-6 hours

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31
Q

Gram stain of Salmonella

A

gram negative

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32
Q

Bacteria in enterobacteriaceae family

A 
E.coli
Klebsiella 
Salmonella
Shigella 
Citrobacter
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33
Q

Which type of salmonella causes gastroenteritis

A

Non-typhoidal salmonella

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34
Q

Examples of non-typhoidal salmonella

A

Salmonella enterica

Salmonella typhimurium

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35
Q

Transmission of salmonella

A

Ingestion of

  • raw poultry
  • raw egg
  • unpasteurized milk
  • contaminated fruits and veg
  • contaminated water
  • anal sex
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36
Q

Who are more at risk of salmonella infections

A

Haemochromatosis people
immunocompromised
infant sand adults

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37
Q

Why are haemochromatosis patients more at risk of salmonella infection

A

They have high iron levels. Salmonella needs iron to determine their virulence and pathogenicity

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38
Q

Symptoms caused by salmonella

A

Watery / bloody diarrhea + vomiting + fever + pain

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39
Q

Incubation period of salmonella

A

8 - 72 hours

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40
Q

Gram stain of shigella

A

Gram negative bacilli

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41
Q

Are enterobacteriaceae aerobic / obligate anaerobes / facultative anaerobic

A

Facultative anaerobic

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42
Q

Serotypes of shigella

A

Serogroup A
Serogroup B
Serogroup C
Serogroup D

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43
Q

Which serogroup of shigella is most pathogenic

A

A

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44
Q

Name of serogroup B of Shigella

A

S. flexneri

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45
Q

Name of serogroup A

A

S. dysenteriae

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46
Q

Which serogroup of shigella causes the mildest infection

A

D

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47
Q

What toxins do shigella produce

A

Shigella toxins (stx) - type 1 and 2

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48
Q

How does shigella toxin damage cells

A

Inhibit protein synthesis of the cell

49
Q

Which STx is more potent

A

Type 2

50
Q

Which age group is most commonly affected by shigella

A

young children

51
Q

Transmission of shigella

A

From contaminated water / human to human

52
Q

Symptoms caused by shigella

A

watery / bloody diarrhea + fever + pain

53
Q

Which serogroup of shigella can cause HUS

A

S. dysenteriae (Serogroup A)

54
Q

What is HUS (haematuria and renal failure)

A

Microangiopathic haemolytic anaemia + thrombocytopenia + kidney injury

55
Q

Which STx is the most common cause of HUS

A

type 2

56
Q

Which STx is more potent

A

Type 2

57
Q

How does STx cause HUS

A

1) STx inhibits protein synthesis of the enterocyte
2) enterocyte dies, STx enters bloodstream
3) STx damage endothelial cells
4) causes platelet activation and aggregation
5) clot forms
6) STx carried to kidneys to cause haematuria, kidney injury

58
Q

Which E.coli produces shiga toxin

A

E. coli 0157

59
Q

Strains of E. coli

A

EHEC
EIEC
ETEC
EAIC

60
Q

Which strain does E.coli 0157 belong to

A

EHEC enterohaemorrhagic

61
Q

Transmission of E.coli 0157

A

from

  • contaminated water
  • unpasteurised milk
  • contaminated meat and veg
  • human to human
62
Q

Which age groups do E.coli 0157 most commonly affect

A

young children below 5 years old

elderly

63
Q

Incubation period of shigella

A

1 - 2 days

64
Q

Incubation period of E. coli

A

3- 4 days

65
Q

What should you must do after discovering e.coli 0157

A

Notify health protection unit

66
Q

Which E. coli strains are related to traveller’s diarrhea

A

ETEC

EAIC

67
Q

Which E. coli strain produces shiga like toxin

A

EIEC

68
Q

Management of gastroenteritis

A

Rehydration is key

Antibiotics are reserved for immunosuppressed / elderly / systemically unwell patients

69
Q

Antibiotics against campylobacter

A

Macrolide - erythromycin

70
Q

What type of antibiotic is macrolide

A

Broad spectrum antibiotic

71
Q

Antibiotics against salmonella and shigella

A

Ciprofloxacin (levofloxacin)

72
Q

Which virus causing gastroenteritis is associated with daycare exposure

A

Rotavirus

73
Q

Transmission of rotavirus

A

person - person

faecal - oral

74
Q

Which age group is most commonly affected by rotavirus

A

Young children

75
Q

What may develop post rotavirus infection

A

Malabsorption, causing more diarrhea

76
Q

How to diagnose rotavirus

A

PCR in faeces

77
Q

Symptoms caused by rotavirus

A

watery diarrhea + vomiting + fever

78
Q

What pathogens do not cause bloody diarrhea

A

Bacillus cereus
Rotavirus
Staph. aureus
EIEC

79
Q

Type of vaccine for rotavirus

A

Live attenuated

80
Q

Transmission of norovirus

A

faecal - oral

droplet

81
Q

Effect of norovirus on healthy vs frail

A

Self limiting in healthy people but can cause kidney injury in frail

82
Q

Symptoms caused by norovirus

A

explosive diarrhea + vomiting + fever + myalgia

83
Q

What is special about norovirus

A

Symptoms come abruptly and unpredictably

84
Q

Incubation period of norovirus

A

< 24 hours

85
Q

How is norovirus diagnosed

A

PCR on vomit

86
Q

What immune cells are for protection against worms

A

Eosinophils

Mast cells

87
Q

What immune cells are for protection against bacteria

A

T lymphocytes
B lymphocytes
Complement system

88
Q

What immune cells are for protection against viruses

A

T lymphocytes

B lymphocytes

89
Q

What immune cells are for protection against fungi

A

T lymphocytes

eosinophils

90
Q

What immune cells are for protection against protozoa

A

t lymphocytes

eosinophils

91
Q

Which pathogens causes dysenteric gastroenteritis

A

E.coli 0157
Campylobacter
Salmonella
Shigella

92
Q

What are the characteristics of enterobacteriaceae

A 
Gram negative bacilli 
Oxidase negative
Glucose fermenting
Facultative anaerobic 
Non spore forming
93
Q

What agar is used to test for lactose

A

Macconkey agar

94
Q

Which enterobacteriaceae are lactose negative

A

Shigella

Salmonella

95
Q

Which enterobacteriaceae are lactose positive

A

Klebsiella
Citrobacter
E.coli

96
Q

What molecular tests are used to classify bacteria

A

MALDI-TOF

16sRNA

97
Q

What does MALDI-TOF look at

A

mass spectrometry, analyses protein components in cell wall

98
Q

Gram positives in GI tract

A

Candida
Strep. viridans
Staphylococci

99
Q

Where are gram positives mostly located

A

In mouth, only few in stomach

100
Q

Timeline of septic shock

A

Infection -> SIRS -> Sepsis -> Septic shock

101
Q

What is SIRS and what causes it

A

Systemic inflammatory response syndrome; caused by infection / burns / trauma / injury / pancreatitis

102
Q

What are the signs that show SIRS

A 
HR = <90 
Temp = >38 or <36
RR = >20 
WCC = >12000
103
Q

What is sepsis

A

Organ dysfunction caused by a dysregulated host response to infection

104
Q

What causes of SIRS do not cause sepsis

A

Burns / trauma / injury / pancreatitis; sepsis must be due to infection

105
Q

What pathogens are commonly found in hospitals

A

Staphylococcus aureus (often MRSA)
E. coli
Klebsiella
Pseudomonas

106
Q

What should be monitored when giving gentamicin

A

Renal function

107
Q

Complications of gastroenteritis

A 
Post infectious IBS
Sepsis / septic shock 
Acute kidney injury
HUS 
Dehydration 
Guillain Barre / reactive arthritis - campylobacter
108
Q

Gram stain for C. difficile

A

Gram positive

109
Q

When does C.difficile become infectious

A

When the normal gut flora becomes suppressed by broad spectrum antibiotics

110
Q

What drug increases risk of C.difficile infection

A

Any broad spectrum antibiotics

PPI

111
Q

Complication of C.difficile

A

toxic megacolon

112
Q

Symptoms and signs of C.difficile infection

A

abdominal pain
Diarrhea
Raised WCC
Neutrophilia

113
Q

Treatment of C.difficile

A

oral vancomycin

114
Q

Second line treatment of C.difficile

A

oral fidaxomicin

115
Q

Third line treatment of C.difficile

A

Oral vancomycin + IV metronidazole

116
Q

What is the treatment for recurrent C.difficile infection

A

Faecal microbiota transplant

117
Q

Antibiotic for travellers diarrhea due to E. coli

A

Rifaximin

118
Q

Which antibiotics are highly associated with C.difficile infection

A

Cephalosporins - ceftriaxone
Clindamycin
Co-amoxiclav

Y1 GI (6 decks)

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