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BDS2 BAMS > Gi infections > Flashcards

Gi infections Flashcards

1
Q

What are 3 examples of good bacterial flora?

A
  • Bifidobacteria
  • Escherichia coli
  • Lactobacilli
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2
Q

What are 3 examples of bad bacterial flora?

A
  • Campylobacter
  • Enterococcus faecalis
  • Clostridium Difficile
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3
Q

What are 3 causative agents of GI infections?

A
  • Bacteria
  • Viruses (most common)
  • Protozoa
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4
Q

What % of duodenal ulcers are associated with Helicobacter pylori?

A

90%

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5
Q

What % of gastric ulcers are associated with Helicobacter pylori?

A

70-80%

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6
Q

Which microorganism increases the risk of gastric ulcers which can lead to an adenocarcinoma?

A

Helicobacter pylori

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7
Q

The mode of transfer of helicobacter pylori is undefined. What is the transmission probably from?

A
  • Probably faecal-oral route

- Oral-oral route also implicated

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8
Q

How is the acid tolerance of Helicobacter pylori critical for the diagnosis of it?

A

As it can turn acid into ammonia which detoxifies the acid

Ammonia is typical of the breath test

  • Causes smell on breath - diagnostic
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9
Q

What are 3 ways of diagnosing if someone has helicobacter pylori?

A
  • Endoscopy & biopsy
  • Breath test
  • Serology
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10
Q

What are the possible treatment options for someone with helicobacter pylori? (3 points)

A
  • Proton pump inhibitor
  • Bismuth salts
  • Antibiotics (amoxicillin, clarithromycin
  • Metronidazole
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11
Q

What is gastroenteritis?

A

A non-specific term for various pathological states of the GI tract

  • The primary manifestation is diarrhoea, but it may be accompanied by nausea, vomiting and abdominal pain
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12
Q

A universal definition of diarrhoea does not exist? what do definitions centre on?

A
  • Frequency, consistency and a high water content

- Disease of the small intestine and involving increased fluid and electrolyt e loss

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13
Q

What are key symptoms of viral gastroenteritis? (6 points)

A
  • Abdominal cramps (No.1)
  • Vomiting
  • Profuse watery stools
  • Myalgias
  • Fever
  • Headache
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14
Q

What is myalgias?

A
  • Muscle pain
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15
Q

What are the key symptoms of bacterial dysentery gastroenteritis? (5 points)

A
  • Small volume stools
  • Fever
  • Tenesmus
  • Bloody mucoid stools
  • Suprapubic pain
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16
Q

What is tenesmus?

A

Cramping rectal pain - gives you the feeling that you need to have a bowel movement even if you have already had one

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17
Q

What % of GI infections are viral?

A

50-70%

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18
Q

What % of GI infections are bacterial?

A
  • 15-20%
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19
Q

What % of GI infections are parasitic?

A

10-15%

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20
Q

What are examples of viruses that can cause GI infections? (6 points)

A
  • Norovirus
  • Calicivirus
  • Rotavirus
  • Adenovirus
  • Parvovirus
  • Astrovirus
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21
Q

What are examples of bacteria that cause GI infections? (3 points)

A
  • Salmonella
  • Shigella
  • Campylobacter species
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22
Q

What are examples of parasites that cause GI infections? (3 points)

A
  • Giardia lambila
  • Entamoeba
  • Cryptosporidium
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23
Q

What is an invasive infection?

A

The organism enters the mucosal cells, destroys them, causing diarrhoea usually with blood in the stool

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24
Q

What are enterotoxic syndromes?

A

The organisms do not invade the mucosa, but produce enterotoxins of which act as chemical mediators causing hypersecretion of the fluid. Little damage to the tissue is done

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25
Q

What is the norovirus?

A

A non-enveloped SS RNA virus (caliciviridae)

26
Q

How is the norovirus transmitted?

A

Via faecal-oral route

27
Q

How many particles of the norovirus are needed for infection?

A

only 10-100

28
Q

Is the norovirus highly contagious?

A

YES

29
Q

What is the incubation period for the norovirus?

A

~ 1-2 days

30
Q

What are the clinical features of the norovirus?

A

Abrupt onset of vomiting & watery diarrhoea +/- fever and abdominal pain (similar to rotavirus)

31
Q

How do you manage the norovirus?

A

Self-limiting = Correct fluid/ electrolyte balance

32
Q

Is the norovirus resilient in the environment?

A

Yes

33
Q

What is the norovirus a recurrent infection?

A

It is strain specific so immunity only lasts a few months. Repeated infections

34
Q

How is salmonella transmitted?

A

It is food borne

35
Q

What are the 3 types of salmonella?

A
  1. Gastroenteritis is the most common form
  2. Enteric fever - Typhoid fever
  3. Bacteremia

(eating foods produces from infected animals; meat, milk, poultry, eggs, and drinking contaminated water; and from faecal-oral trans)

36
Q

What is the incubation period for salmonella?

A

8-48hrs

37
Q

What are the symptoms of salmonella? (3 points)

A

Asymptomatic or symptoms develop within 2 days of eating infected food:

  • Watery or bloody diarrhoea
  • Fever and sometimes vomiting
  • Cramps
38
Q

How long do symptoms of salmonella last?

A

1-4 days

39
Q

How would you diagnose salmonella?

A
  • Stool

- Presence of faecal WBC’s variable

40
Q

How would you treat salmonella?

A
  • Supportive (IV hydration)

- Antibiotics usually not necessary for salmonella gastroenteritis

41
Q

What is a common cause of antibiotic-associated diarrhoea?

A

Clostridium difficile

42
Q

What is the only nosocomial organism that is anaerobic and forms spores (survive > 5 months and are hard to destroy)?

A

Clostridium difficile

43
Q

What is the pathogenesis of clostridium difficile mainly due to?

A
  • Mainly due to toxins production
44
Q

What is the infective dose of clostridium difficile?

A

<10 spores

45
Q

What are risk factors of clostridium difficile? (9 points)

A
  • Exposure to antimicrobials
  • Exposure to healthcare
  • Infection with toxic strains of C. difficile
  • Old age > 64
  • Underlying illness
  • Immunosuppression & HIV
  • Chemotherapy (immunosuppression & antibiotic-like activities)
  • Tube feeds and GI surgery
  • Exposure to gastric acid suppression meds
46
Q

What is C. difficile?

A

Gram positive spore forming bacillus (rods)

47
Q

C. difficile is an obligate anaerobe. What does this mean?

A

Can only grow in the complete absence of O2

48
Q

C. difficile is part of the GI flora in what % of healthy adults?

A

1-3%

49
Q

C. difficile is part of the GI flora in what % of children < 12 months?

A

70%

50
Q

Some strains of C. difficile produce toxins. What toxins do they produce?

A

Toxins A & B

51
Q

What is the mortality rate of C. difficile?

A

35%

52
Q

How can C. difficile be transmitted? (3 points)

A

Faecal-oral route

  • Contaminated hands of healthcare workers
  • Contaminated environmental surfaces

Person to person in hospitals

Reservoir

  • Human: colonized or infected persons
  • Contaminated environment
53
Q

How long can C. difficile spores survive on environmental surface?

A

For up to 5 months

54
Q

What are the 3 possible stages of C. difficile?

A
  • Asymptomatic carriers = colonised
  • Mild or moderate diarrhoea
  • Pseudo membranous colitis that can be fatal
55
Q

What is the general incubation period of C. difficile?

A

2-3 days

56
Q

What are the common symptoms of C. difficile infection?

A
  • Watery diarrhoea
  • Loss of appetite
  • Fever
  • Nausea
  • Abdominal pain and cramping
57
Q

What % of hospitalised patients are colonised with C. difficile?

A

20%

58
Q

What are antibiotics that are very commonly related to C. difficile? (5 points)

A
  • Clindamycin
  • Ampicillin
  • Amoxycillin
  • Cephalosporin
  • Fluoroquinolones
59
Q

What are antibiotics that are less commonly related to C. difficile? (4 points)

A
  • Sulfa
  • Macrolides
  • Carbapenems
  • Other penicillin’s
60
Q

What are antibiotics that are uncommonly related to C. difficile? (4 points)

A
  • Aminoglycsides
  • Rifampin
  • Tetracycline
  • Chloramphincol
61
Q

What is the treatment of C. Difficile? (5 points)

A
  • Oral rehydration
  • Antibiotics (Metronidazole, Vancomycin)
  • Probiotics
  • Colectomy
  • Faecal transplants
62
Q

What are ways of preventing GI infections? (4 points)

A
  • Use of statutory powers
  • Safe food handling & hand washing
  • Infection control - enteric precautions for diarrhoea & vomiting
  • Surveillance

BDS2 BAMS (57 decks)

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