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Medicine > Gastrointestinal Infections > Flashcards

Gastrointestinal Infections Flashcards

1
Q

What is the second most common infection

A

GIT infections

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2
Q

Mention some examples of immunocompromised patients

A

Children below 5 years
People taking cytotoxic drugs
People with diabetes
People with HIV

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3
Q

GI infections usually occur in patients who don’t have which IG

A

IgA

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4
Q

What is hematokesia

A

Blood in stool

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5
Q

Sudden onset of bowel frequency associated with crampy abdominal pains, and a fever will point to which kind of diarrheal cause

A

An infective cause

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6
Q

Bowel frequency with loose blood-stained stools is characteristic of which diarrheal cause

A

Inflammatory basis

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7
Q

The passage of pale offensive stools that float, often accompanied by loss of appetite and weight loss is characteristic of what cause of diarrhea

A

Steatorrhoea

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8
Q

When you eat things that are non-absorbable, it could lead to which type of diarrhea

A

Osmotic diarrhea

The gut mucosa acts as a semipermeable membrane and fluid enters the bowel if there are large quantities of non-absorbed hypertonic substances in the lumen

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9
Q

Which kind of diarrhea stops when ingestion also stops

A

Osmotic diarrhea

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10
Q

Diarrhea could also occur when there’s a damage to the intestinal mucosal cells so that there is a loss of fluid and blood. What kind of diarrhea is this

A

Inflammatory diarrhea

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11
Q

What are some clinical features associated with acute diarrhea

A

Fever, abdominal pain and vomiting

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12
Q

When should you be more serious about the diarrhea

A

If diarrhea has lasted for more than a week

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13
Q

In case a stool is sent to the lab to test for diarrhea and no headway has been made, what should be done next

A

A sigmoidoscopy and rectal examination should be considered

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14
Q

Do viral and bacterial infective diarrheas last long

A

No, they don’t last for more than two weeks

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15
Q

What are some treatments of acute diarrhea

A

Oral fluid and electrolyte replacement (Special oral rehydration solutions (e.g. sodium chloride and glucose powder)

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16
Q

What are some treatments of diarrhea

A

Oral fluid and electrolyte replacement
Antidiarrheal drugs for short term relief
Antibiotics are occasionally necessary

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17
Q

Diarrhea could also be difficile associated after taking any antibiotic. Mention one antibiotic which could cause this

A

Clindamycin

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18
Q

What is the causative agent of a dificile associated diarrhea

A

Clostridium difficile

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19
Q

What are the three parasites which are isolated in HIV patients presenting with diarrhea

A

Cryptosporidium
Isospora belli
Microsporidia

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20
Q

What are some things you see in the head and neck for patients presenting with a gastrointestinal disease

A

Pallor
Jaundice
Angular stomatitis
Glossitis
Parotid enlargement
Mouth ulcers
Lymphadenopathy

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21
Q

What are some things should check for on the hands for patients presenting with a gastrointestinal disease

A

Clubbing
Koilonychia

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22
Q

What are some things you should check for skin for patients presenting with a gastrointestinal disease

A

Muscle bulk
Signs of weight loss

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23
Q

What is usually caused by faecal–oral transmission of bacteria or their toxins, viruses or parasite

A

Acute diarrhea

24
Q

What is the second commonest infection after respiratory tract infections

A

GIT infections

25
Q

What are the presentations of GI infections

A

Fever
Chills
Abdominal pain
Diarrhea
Vomiting

26
Q

What are some common organisms which cause GI infections

A

Cryptosporidium
Giardiasis
Amoebiasis
Liver flukes
Tapeworm
Salmonellosis

27
Q

Immunodeficiency and mucosal immunity play a role in GI infections
True or false

A

True

28
Q

Immunodeficiency resulting to GI infections occurs because of an antibody deficiency
What antibody is this

A

IgA

29
Q

IgA deficiency is commonly associated with which pathogen

A

Giardia and campylobacter

30
Q

What occurs after ingestion of sporangiospores by malnourished patients, premature neonates or immunocompromised hosts, and is uncommon but still occurs

A

Mucormycosis

31
Q

Bowel perforation and peritonitis could occur in this condition from invasion of mucosa, sun mucosa and bowel vessels
What condition is this

A

Mucormycosis

32
Q

The oesophagus is the site most frequently involved in this condition and most patients are asymptomatic
Which condition is this

A

Aspergillus infection

33
Q

What are the presentation of an aspergillus infection

A

Intestinal ulcers may be with bleeding or perforation
Hepatosplenic infection (30%)
Liver tenderness, abdominal pain and jaundice
Numerous small, radiolucent lesions scattered throughout the liver on the CT scan
Elevated ALP or BIL levels

34
Q

What are the presentations of CMV caused GI infections

A

Chronic or intermittent diarrhea with abdominal pain and fever
Mild or severe rectal bleeding
Pain may precede the development of toxic megacolon and intestinal perforation
Oesophageal infection may present as dysphagia and odynophagia
Involvement of the pancreatico-biliary tree may result in pancreatico-cholangiopathy or pancreatitis
CMV retinitis in eye involvement

35
Q

In what terms is diarrhea defined

A

Frequency (more than 3 stools per day - relative)
Stool weight or volume (should weigh > 200g per day. Varies differently and depends on diet)
Consistency

36
Q

Mention the types of diarrhea

A

Osmotic
Secretory
Inflammatory
Dysmotility

37
Q

What is acute diarrhea

A

Abrupt onset >_ 3 lose stokes per day and lasts no longer than 14 days. It could be acquired in the hospital or the community and usually self-limiting

38
Q

What are some causes of acute diarrhea

A

Infections
Drug-induced
Food allergies
Digestive/absorptive disorders
Chemotherapy/radiotherapy
Surgical conditions
Vitamin deficiency
Heavy metal ingestion (Cu, Zn)
Ingestion of herbal products (mushrooms, mistletoe)

39
Q

What is chronic diarrhea

A

Abnormal passage >_ 3 loose stools per day for more than 14 days. Daily stools weight > 200g/day. Some definitions say >_ to 4 weeks

40
Q

Mention some causes of chronic diarrhea

A

Colonic (colonic neoplasia, ulcerative and Crohn’s colitis)
Small bowel (Crohn’s disease, bile acid malabsorption, Whipple disease)
Pancreatic (chronic pancreatitis, pancreatic carcinoma, cystic fibrosis
Endocrine (diabetes, Addison’s disease, hypothyroidism, hormone secreting hormones such as a gastrinoma)
Others

41
Q

What are some things you could ask or check for in a person presenting with a GI infection

A

When and how symptoms started (abrupt, gradual onset and duration of symptoms)
Stool characteristics
Symptoms of volume depletion
Frequency of bowel movement
Presence of dysenteric symptoms
Past medical Hx and social Hx
Drug Hx (magnesium containing products, anti hypertensive and NSAIDs, theophyllines, anti arrhythmias)
Recent antibiotic therapy and C difficile infection

42
Q

What are some physical signs you should look out for in a patient with diarrhea

A

Borborygmi (significant increases in peristaltic activity causing audible and/or palpable increase in bowel activity)
Signs of malnutrition (reduced muscle/fat mass or peripheral edema)
Abdominal pain, rebound tenderness or guarding (rule out bowel perforation)
Perianal erhythma or excoriations

43
Q

What are some investigations to make of a patient whom you suspect of diarrhea

A

FBC
RFTs
LFTs
ESR, serum Fe, albumin, vitamin B12, folate, Ca
CRP
Thyroid function test
Upper and lower endoscopies (H. pylori)
ERCP
MCRP
Stool R/E and culture sensitivity (exam of three fresh stools for ova, cysts and parasites)
Enzyme immunoassay and latex agglutination assay for rotavirus
IgA anti-endometrium antibodies or retuculin antibodies

44
Q

How do you manage diarrhea

A

Identify cause of disease and treat
Hydration
Manage patient in hypovolemic shock
Prevent and manage kidney injury in severe dehydration
Correct electrolyte imbalance
Antimotility medications should not be given in GI infections
Educate patients in preventative measures

45
Q

What is the recommended therapy for C, difficile

A

Metronidazole 500mg tid

46
Q

What is the recommended therapy for E. Coli

A

No treatment with antimicrobials or anti-motility drugs

47
Q

What is the recommended therapy for E. coli (toxigenic)

A

Azithromycin 1g stat or rifaximin

48
Q

What is the recommended therapy for Giardia

A

Tinidazole

49
Q

What is the recommended drug therapy for salmonella

A

Cipro

50
Q

What is the recommended drug therapy for shigella

A

Cipro and levo

51
Q

What is the recommended drug therapy for C. jejunum

A

Azithromycin

52
Q

What is the recommended drug therapy for E. histolytica

A

Metronidazole

53
Q

What is the recommended drug therapy for Staphylococcus aureus

A

No treatment

54
Q

What is the recommended drug therapy for vibro

A

Cipro

55
Q

What is the recommended drug therapy for yersinia enterocolitica

A

No treatment unless severe

56
Q

What are some complications of diarrhea

A

Dehydration with or without shock
Hemorrhagic colitis
Hemolytic uraemic syndrome
Intuisusception (especially in children)
Seizures
Appendicitis
Perforation
Colonic perforation, liver abscess
Chronic fat malabsorption
Reuter’s syndrome

Medicine (38 decks)

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