Gastrointestinal Infections Flashcards
(103 cards)
1
Q
What is candidiasis and who is likely to get it
A
Thrush
Immunocompromised patients
Diabetics
Those taking antibiotics
2
Q
What is candidiasis and who is likely to get it
A
Thrush
Immunocompromised patients
Diabetics
Those taking antibiotics
3
Q
How is oral candidiasis treated
A
Nystatin or amphotericin
4
Q
What are the common presentations of Vincent’s angina
A
Appalling oral hygiene deep, sloughing ulcers severe pain halitosis fever malaise
5
Q
What might be needed to treat Vincent’s angina
A
Oral antibiotics or anaesthetic mouthwashes
6
Q
What is parotitis
A
Viral or bacterial infections of the parotid glands causing swelling and pain
7
Q
What is required for parotitis is an abscess is present
A
Surgical drainage
8
Q
What is the differential for parotid swelling
A
Salivary gland stones
Sjogren’s syndrome
sarcoidosis
tumours
9
Q
What is a common observation of oesophageal problems
A
Oesophageal candidiasis
10
Q
Is H pylori usually symptomatic or asymptomatic
A
Asymptomatic
11
Q
What can H pylori result in (2 things)
A
Antral gastritis (predisoposes to duodenal ulcer) Pan-gastritis (predisposes to gastric carcinoma)
12
Q
What 2 things are gastric ulcers associated with
A
Both antral and pan gastritis
13
Q
What is the most common way to test for H pylori
A
Urea breath test
14
Q
How long do PPIs have to be stopped before the urea breath test
A
4 weeks
15
Q
What enzyme does H pylori produce and what does it cleave to
A
Urease which can cleave urea to ammonia and CO2
16
Q
What is the colour change for the pH indicator for a positive H pylori test
A
it turns to pink
17
Q
WHat is the first line treatment for H pylori
A
1 week of triple therapy
18
Q
What is triple therapy
A
PPI and 2 antibiotics: amoxicilin and metronidazole
19
Q
What is the second line treatment for H pylori infection
A
Quadruple therapy
20
Q
What is quadruple therapy
A
Bismuth-containing prearation of triple therapy incoroprated tetracycline
21
Q
Why does treatment often fail in quadruple therapy
A
Poor compliance
22
Q
What does an infection in the GI tract usually result in
A
Diarrhoea, abdominal pain and occasional vomiting
23
Q
How long do most GI tract infections last
A
24
Q
Investigation for the specific organisms is required in which 4 situations
A
Elderly patients, especially those in institutes
Immunocompromised patients
Symtoms >5days
Epidemics
25
What is the incubation period for Staph aureus
1-6 hours
26
What is the incubation for Ecoli, Campylobacter and Clostrium perfringens
8-18hours
27
What is the incubation for salmonella
12-36 hours
28
What organisms can cause bloody diarrhoea
Shigella,
enterotoxic E coli
Campylobacter
29
What is the most common organism for causing abdominal pain
Campylobacter
30
How is oral candidiasis treated
Nystatin or amphotericin
31
What are the common presentations of Vincent's angina
```
Appalling oral hygiene
deep, sloughing ulcers
severe pain
halitosis
fever
malaise
```
32
What might be needed to treat Vincent's angina
Oral antibiotics or anaesthetic mouthwashes
33
What is parotitis
Viral or bacterial infections of the parotid glands causing swelling and pain
34
What is required for parotitis is an abscess is present
Surgical drainage
35
What is the differential for parotid swelling
Salivary gland stones
Sjogren's syndrome
sarcoidosis
tumours
36
What is a common observation of oesophageal problems
Oesophageal candidiasis
37
Is H pylori usually symptomatic or asymptomatic
Asymptomatic
38
What can H pylori result in (2 things)
```
Antral gastritis (predisoposes to duodenal ulcer)
Pan-gastritis (predisposes to gastric carcinoma)
```
39
What 2 things are gastric ulcers associated with
Both antral and pan gastritis
40
What is the most common way to test for H pylori
Urea breath test
41
How long do PPIs have to be stopped before the urea breath test
4 weeks
42
What enzyme does H pylori produce and what does it cleave to
Urease which can cleave urea to ammonia and CO2
43
What is the colour change for the pH indicator for a positive H pylori test
it turns to pink
44
WHat is the first line treatment for H pylori
1 week of triple therapy
45
What is triple therapy
PPI and 2 antibiotics: amoxicilin and metronidazole
46
What is the second line treatment for H pylori infection
Quadruple therapy
47
What is quadruple therapy
Bismuth-containing prearation of triple therapy incoroprated tetracycline
48
Why does treatment often fail in quadruple therapy
Poor compliance
49
What does an infection in the GI tract usually result in
Diarrhoea, abdominal pain and occasional vomiting
50
How long do most GI tract infections last
51
Investigation for the specific organisms is required in which 4 situations
Elderly patients, especially those in institutes
Immunocompromised patients
Symtoms >5days
Epidemics
52
What is the incubation period for Staph aureus
1-6 hours
53
What is the incubation for Ecoli, Campylobacter and Clostrium perfringens
8-18hours
54
What is the incubation for salmonella
12-36 hours
55
What organisms can cause bloody diarrhoea
Shigella,
enterotoxic E coli
Campylobacter
56
What is the most common organism for causing abdominal pain
Campylobacter
57
What is quadruple therapy
Bismuth-containing preparation of triple therapy incorporated tetracycline
58
What is the most common organism for causing abdominal pain
Campylobacter
59
What are the investigations that should be carried out if needs be
Stool culture and microscopy (for cysts and trophoziotes)
Serology for toxins (C.difficile, E coli, Shigella, Campylobacter)
Sigmoidoscopy and biopsy (if symptoms > 2 weeks)
Joint X rays and aspiration if joint is swollen and there is fever and leucocytosis
60
What is the general management for gastroenteritis
Resuscitation: oral hydration is preferred
Meticulous hand hygienge
antidiarrhoeal should be AVOIDED
antiemetics
61
What is the treatment for viral gastroenteritis
Supportive
62
What is the first line antibiotic used in salmonella, shigella, Ecoli , campylobacter
Ciprofloxacin
63
Where does Ecoli usually come from
Infected meat
64
What type of organism is C difficile
Gram positive anaerobe
65
Why is C difficile such a big problem in hospitals
It is resistant to most disinfectants
66
What are 3 of the main risk factors for developing C difficile
Antibiotics
Old age
Immunocompromised
67
What is the treatment for C difficile
Oral metronidazole for 7-10 days
| Oral vancomycin for 14-28 days
68
What is the treatment for C difficile
Oral metronidazole for 7-10 days
| Oral vancomycin for 14-28 days
69
How might mycobacterium tb cause intestinal infection
ingestion of infected milk
blood borne spread from the lung
direct spread from adjacent organs (rare)
70
Who does intestinal TB most commonly affect
Immigrant populations Saharan africa and south east asia
71
What are the clinical features of Intestinal TB
Ileocaecal disease - diarrhoea, abdo pain, weight loss, systemic ill health, abdombinal mass
TB adenitis - mimics appendicitis
TB peritonitis - weight loss, systemic ill health and asciteis
72
What are the investigations for Intestinal TB
Tissue diagnosis is key!
| Ascites: exudate with increased lymphocytes supported by Ziehl-Nielsen staining and culture of acid-fast bacilli
73
What might be seen on an abdominal CT of a patient with Abdominal TB
indistinguishable from Crohn;'s disease (small bowel thickening, intra abdominal lymphadenopathy, peritoneal reaction
74
What is the management for abdominal TB
Triple therapy ( rifampicin, isoniaxid and pyrazinamide) for 2 months followed by dual therapy (rifampixin and isonizid ) for 4 months
75
Who is Amoebiasis most common in
Immigrant populations after ingestion of contaminated water of food
76
What drug might patients be on if they develop Amoebiasis
Corticosteroids
77
How is ameobiasis diagnosed
Entameoba histolytica antigen in stool and serum
78
What is the management for Amoebiasis
Metronidaxole for 5 days followed by paramyocin to eradicate luminal parasites
79
How is eradication of Amoebiasis confirmed
3 sequential clear stool samples
80
Who presents most commonly with Typhoid and paratyphoid
Returning travellers
81
What causes Typhoid and paratyphoid
Salmonella typhi or paratyphi
82
What are the symptoms of Typhoid and paratyphoid
```
usually systemic and non-specific
Rose-spot rash
constipation with diarrhoea later
bradycardia
hepatosplnomegaly
lucopaenia
```
83
What is the management of Typhoid and paratyphoid
Cirpofloxacin or chloramphenicol to eradicate the bacterium and prednisolone for encephalopathy
84
How are worms consumed
Either by eating contaminated uncooked meat or through the faeco-oral route
85
What are the symptoms of worms
Often asymptomatic
May cause low-grade abdominal distension and nausea
Anaemia
86
What type of worm gives the more dramatic symptoms
Tapeworms
87
What symtpoms do Tapeworms cause
Fever
enterocolitis
cyst formation in brain or muscle
weight loss
88
What is the treatment for Tapeworms
Niclosamide as a stat dose
89
What is the treatment for other forms of worms
3 days of mebendazole or levamisole
90
What is the commonest STV
HPV
91
What is the characteristic appearance of anal warts
Cauliflower appearance and may extend to the dentate line
92
What is the treatment for anal warts
Topical antiviral (podophyllin, podofilox or imiquimod)
93
When might surgery be indicated for anal warts
For when there is large clusters of lesions or when there is extension into the rectum
94
What is the commonest STD in the developed world
Chlamydia
95
Men are affected by chlamydia more than women. true or false
False - women are more commonly affected
96
What are the symptoms of chlamydia
Urethral discharge and dysuria precede a shallow ulcer on the penis before the characteristic groin hymphadenopathy occurs
97
How is chlamydia diagnosed
Based on antibody and complemetn fixation testing
98
What is the treatment for chlamydia
Azithromycin
| Doxicycline or co-trimoxazole
99
What parts of the GI tract can be affected by HIV infection
any part of the GI tract
100
What are 6 of the common symptoms suggest specific opportunistic infection
```
Oral ulceraltion - herpes simplex
Dysphagia - cytomegalovirus
Abdominal pain - TB, CMV in the gallbladder
Diarrhoea - TB
rectal stricture - Chlamydia
Rectal bleeding - syphilis
```
101
Where can cytomegalovirus invade
The mucosa of any region of the gut
102
What confirms cytomegalovirus
Histology
103
Who can get infected with Cytomegalovirus
Anyone who is immunocompromised
| flare up of UC
