Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DipHIV > Gastro OI > Flashcards

Gastro OI Flashcards

1
Q

Causes of oropharyngeal infections and oesophagitis

A

Candidiasis most common

HSV
CMV
TB
Drugs - doxy, nsaids, iron tablets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Treatment of oral/oesophageal candidiasis

A

Oral - 1-200mg fluconazole a day for 7-14 days
Oesophageal - 200-400mg OD for 14-21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What to do if Candida oesophagitis doesn’t improve with empirical therapy?

A

Endoscopy with swab and or biopsy - cultures and sensitivities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of CMV oesophagitis?

A

Iv ganciclovir 5mg/kg bd for 2-4 weeks or until symptoms have resolved
If able to swallow and absorb then oral valganciclovir can be used instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of HSV oesophagitis?

A

Iv aciclovir 5-10mg TDD followed by PO valaciclovir 1g bd for a total of 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Prevention of upper GI tract infection

A

CART is mainstay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Campylobacter treatment

A

None if CD4 > 200

Azithomycin if < 200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diagnosis c diff

A

Molecular test, Eia for toxins a and b, toxigenic culture, colonoscopy, biopsy, CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management c diff

A

Stop causative abx
Non severe treated with metronidazole
Severe treated with vancomycin or fidaxomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

E. coli diagnostic test

A

Stool culture preferred
EIA for shiga toxin or molecular test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

E. coli treatment

A

Only if CD4 <200
As per local guidelines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx salmonella

A

Only if CD4 <200

Cipro or ceftriaxone as per local guidelines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Shigella treatment

A

Only if CD4 <200

Cipro or azithromycin as per local guidelines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most cases of CMV disease occur in people with a prior CMV infection and CD4 count of..

A

<50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Symptoms of CMV colitis

A

Weight loss, anorexia, diarrhoea, abdo pain, fatigue

Fevers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What else should you assess if you suspect CMV colitis?

A

? Oesophagitis
? Retinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When should cART be started in CMV colitis?

A

If retinitis present start 2 weeks after CMV tx due to IRIS risk

If just colitis don’t delay cART. If diarrhoea continues may need TDM if VL not suppressing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cmv biopsy findings

A

Owls eye inclusions
Positive immunohistochemical staining for CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment for CMV colitis

A

Ganciclovir 5mg/kg bd 2-4 weeks/until symptom resolution
Oral valgancyclovir may be used in less severe disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rotavirus, norovirus, astrovirus, coronavirus treatment

A

Supportive measures

21
Q

Adenovirus diarrhoea management

A

Cidofovir iv if clinically significant infection (rare)

22
Q

CMV prophylaxis

A

Only for retinitis

Valganciclovir 900mg od until CD4 >100 for 6/12

23
Q

how is CMV resistance to ganciclovir confirmed?

A

Detection of mutations in UL97 gene

Resistance to foscarnet or cidofovir occurs through mutations in CMV UL54 gene

24
Q

Important cART and anti-CMV DDI

A

Tenofovir and ganciclovir/valganciclovir - renal toxicity

25
Q

Who is at greatest risk of cryptosporidium?

A

Those with cd4 <100

26
Q

Symptoms of cryptosporidiosis

A

Profuse watery non bloody diarrhoea
Fever and malabsorption common
Nausea vomiting and lower abdo pain may occur

27
Q

Non bowel issues with cryptosporidiosis occur in which areas?

A

Pancreatic duct and biliary tree - cholangitis and pancreatitis may occur

Sclerosing cholangitis presents with right upper quadrant pain, vomiting and raised alk phos

28
Q

How to diagnose cryptosporidiosis?

A

Microscopy of fresh unconcentrated stool
Repeat samples may be required due to intermittent oocyst secretion
Pcr should be used in addition

29
Q

Treatment of cryptosporidiosis

A

Restoration of immune system with cART

Nitazoxanide 500kg bd for 3/7 but may be required for up to 12 weeks

Rehydration, electrolyte replacement, antimotility agents, dietician input

30
Q

How to prevent cryptosporidiosis

A

Patients with CD4 <200 should avoid drinking unfiltered water and ensure careful hand hygiene

Bottles water not enough
Specific filtration employing an absolute 1um filter is required - boiling of water should be advocated

31
Q

Microsporidia presentation

A

Watery, non bloody diarrhoea with associated malabsorption

Sclerosing cholangitis can occur

Dissemination can lead to encephalitis sinusitis, myosotis and renal and occular infection

32
Q

How is microsporidia diagnosed?

A

3 stool samples should be examined with chromotrope and chemofluorescent stains
PCR to aid diagnosis
Small bowel biopsy may be considered if stool samples are consistently negative

33
Q

Treatment of microsporidia

A

Early cART

E. Birneusi - oral fumagillin- haematological toxicity

E intestinalis - albendazole

34
Q

Symptoms of giardia

A

Chronic diarrhoea. Nausea bloating cramp like abdominal pain indigestion bloating.

35
Q

Treatment of giardiasis

A

Metronidazole

Strict hand hygiene

If recurs give metro again, test and treat household contacts

If recurrent in traveller to Asia seek specialist advice

36
Q

How might amoebiasis present?

A

Fever, abdo pain, watery or bloody diarrhoea

Can be asymptomatic

Occurs at any cd4 count

Liver abscess can present with fever, RUQ pain and tenderness

37
Q

How is amoebiasis spread?

A

Ingestion of cysts in contaminated human faeces

38
Q

Diagnosis amoebiasis

A

3 stool samples for cysts and trophozoites PCR method of choice in uk

39
Q

How is amoebiasis treated?

A

Metronidazole

Afterwards paromomycin for 5-10 days to eliminate luminal infection

40
Q

Symptoms of cyclosporiasis

A

Watery diarrhoea throughout the tropics and subtropics and in returning travellers

41
Q

Diagnosis of cyclosporiasis

A

Detection of oocysts in stool
Wet prep
Examination under UB light for parasite autofluorescence or confirmed using modified ZN staining and accurate measurement

PCR can aid and samples should be sent to PHE

42
Q

Treatment of cyclosporiasis

A

Cotrimoxazole 960mg BD 7/7
Secondary prophylaxis three times a week may be needed while cART is commenced

43
Q

How does cystoisoporiasis present?

A

Chronic diarrhoea sometimes biliary involvement

44
Q

How is cystoisosporiasis diagnosed?

A

Oocysts in stool with microscopy with modified ZN staining

45
Q

How is cystoisosporiasis treated?

A

Septrin 960mg QDS for 10/7
Secondary prophylaxis 960mg three times a week is essential as relapse is common

46
Q

What is strongyloides stercoralis?

A

Gut nematode that causes chronic GI and skin disorders
Autoinfective lifecycle
Can disseminate causing life threatening hyperinfection syndromes in immunosuppressed individuals - corticosteroid use seems to be a causative factor in cases of hyper infection syndrome

47
Q

Diagnosis strongyloidiasis

A

Eosinophilia
Larvae in stool specimens
Serology may also be useful but can have cross reaction with other parasitic nematodes

48
Q

How is strongyloidiasis treated?

A

Discuss with specialist

Ivermetcin but caution if diagnosed by serology because cross reaction with filaria is possible and encephalopathy can develop

If hyperinfection continue ivermectin for at least 2 weeks

Repeat stool sample at 2-4 weeks to confirm clearance and serology and stool samples every 6-12m for 2yrs after tx

49
Q

Treatment of schistosomiasis

A

Praziquantel at dose dependent on species

DipHIV (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions