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Flashcards in GI infections Deck (96):
1

diarrhoea definition

3 or more loose stools in 24hrs

2

source/reservoir of infection =

original site of infection eg. cattle gut

3

Seagull curved gram -ve bacillus that is most common cause of GI infection

campylobacter

4

C. jejuni/coli are examples of ____ bacteria

campylobacter

5

Incubation period and infective dose of campylobacter

3-10days
10^2 - 10^6

6

sources of campylobacter

farm animals > undercooked poultry, water and unpasteurised milk

7

Treatment for campylobacter

none unless systemic illness =
erythromycin/ciprofloxacin for 5 days

8

signs of campylobacter infection =

diarrhoea +/- blood
abdo pain
bacteraemia is possible => systemic

9

incubation period and infectious dose of salmonella enterica

12-48hrs
10^5

10

Sources of salmonella =

farm animals > undercooked poultry

11

signs of salmonella =

abdo pain
vomiting
diarrhoea +/- blood (blood less likely)

12

campylobacter causes inflammation in __+__

colon and rectum

13

salmonella causes inflammation in __+__ causes __ damage and decreased ___ and increased ___

ileum and colon
mucosal damage
decreased fluid absorption
increased fluid excretion

14

treatment for salmonella enterica

none
unless systemic = cirofloxacin 5 days

15

Shigella sp. that is most benign and only one native to UK

sonnei

16

Shigella can/cant get into bloodstream?
incubation period and infecitous dose

CANNOT
1-9days
10-100

17

signs of shigella spp. infection

abdominal pain
diarrhoea +/- blood and pus

18

Shigella mainly infects ___
is spread __

children eg. nurseries
person-person or fomites

19

Treatment for shigella

none
unless systemic sonnei/sp. from abroad = ciprofloxacin

20

O and H in E.coli O157 H7=

O = surface antigen
H = flagellar antigen

21

E coli O157 toxin =
which damages ___ causing ___ syndrome

Verotoxin / VTEC
RBCs and kidneys ; HUS (haemolytic uraemic syndrome

22

bloods of HUS show

increased blood urea, WCC
lactate dehydrogenase more than 1.5xULN
RBC fragments
decreased platelets and Hb

23

E. coli is a ___ of cattles
it is spread __

commensal
person-person, minced beef/burgers, water, farm visits

24

Groups most at risk of HUS =
most common cause of renal failure in ___

under 5yos and elderly
under 5yos

25

signs of E. coli infection

abdominal pain, bloody diarrhoea

26

treatment of E. coli infection

NO antibiotics (increases VTEC release)
check bloods for HUS 1 wk after onset of symptoms

27

signs of HUS

abdo pain
fever
pallor
petechiae
oliguria
90% have bloodydiarrhoea

28

Peak presentation of HUS is ___ days after infection

7-10 days

29

salmonella, shigella, campylobacter and E. coli are gram ___, ___

-ve bacilli
differentiated by biochemistry then serology after cultured

30

Salmonella paratyphi/typhi incubation period and infectious dose

14-21 days
10^5

31

Infection that starts with a fever, headache and flu-like then causes diarrhoea 3 wks later

Salmonella paratyphi/typhi

32

Organism that goes from gut lumen to lymphatics to the blood. Then enters the reticuloendothelial system and gallbladder and goes to gut lumen and Peyer's patches

Salmonella paratyphi/typhi

33

Carriers of salmonella typhi/paratyphi carry it in their __

gallbladder

34

salmonella typhi/paratyphi is native/from abroad

abroad

35

Signs of salmonella typhi/paratyphi =

fever, rash on abdomen = rose spots
diarrhoea

36

salmonella typhi/paratyphi spreads by ___

person to person
contaminated water/food or poor sanitation

37

treatment for salmonella typhi/paratyphi

antibiotics (must sensitivity test to find which one)

38

organism that causes cholera

Vibrio cholerae

39

Comma -ve bacillus =

Vibrio cholerae

40

Infection common in refugee camps

cholera

41

incubation period and infectious dose of Vibrio cholerae

1-9 days
10^8

42

Vibrio cholerae produces an ___ that causes ___

exotoxin
outpouring of fluid from cells = watery diarrhoea

43

rice water stools =

cholera

44

Cholera is spread

person to person
contaminated water

45

Treatment for cholera

NO antibiotics
fluids and electrolyte replacement

46

Organisms that cause infection by pre-formed toxins =

Bacillus cereus
S.. aureus
Clostridium perfringens

47

S. aureus produces an ___
goes to ___>___ and stimulated vomiting within __

entero/exotoxin
vagus>VC
1-2hrs

48

large gram +ve anaerobic bacillus who causes infection by a preformed enterotoxin

clostridium perfringens

49

large gram +ve aerobic bacillus that produces a preformed exotoxin
due to poorly reheated rice

bacillus cereus

50

Cryptosporidium is a ___
from (4)
causes ___ which is severe in HIV +ve

protozoa
calves, person-person, swimming pools(Cl- resistant) and contaminated water
diarrhoea

51

Giardia lamblia is a ___
from ___
signs =
treatment =

protozoa
infected water
malabsorption, anorexia, abdo pain, flatulence, diarrhoea
metronidazole PO

52

Treatment of cryptosporidium =

symptomatic treatment only

53

Cryptosporidium are stained with a ___

modified ZN stain

54

Enterobius vermicularis/ ___
are seen commonly in ___
ova ingested and live in ___ ; females lay eggs on __ at night
symptoms =
Diagnose =
treat =

threadworms
school kids
colon
perianal skin
perianal itch
microscopy of stool
mebendazole PO

55

Vertical transmission of microbial resistance is by __

mutations acquired and passed on

56

Horizontal transmission of microbial resistance is by ___

transformation, transduction and conjugation

57

In bacterial resistance transformation =

integrate DEAD BAC genes into genome

58

In bacterial resistance transduction =

BACTERIOPHAGES (viruses) transfer genes

59

In bacterial resistance conjugation =

PILLI transfer genes

60

4Ds of microbial stewardship =

dose
deescalation
duration
drug

61

___ makes no difference to development of antimicrobial resistance

route of drug

62

MDR definition

multidrug resistant
non- susceptibility to 1 or more agents in 3 or more antimicrobial categories

63

XDR defintion

extremely drug resistant
non-susceptibility in 1 or more in all but 2 or fewer antimicrobial categories

64

Incubation period definition

time between contracting infection and first clinical signs/symptoms

65

C. diff toxin A is a __
toxin B is a ___

A=enterotoxin
B=cytotoxin

66

Treatment of non-severe and severe C. diff infections

non = metronidazole
severe = vancomycin

67

Smells like horse poo =

C. diff infection

68

Test for C. diff = firstly need +ve ___ test then will do ___ test if is +ve = have it, if -ve = reassess

GDH
toxin

69

Rotavirus is commonest in ___ age group
Most people have had it by age __

under 3 yos
by the age of 5

70

can rotavirus cause bacteraemia?
Usually resolves itself after ___

NO
1 week

71

Rotavirus is spread
infective dose =

person to person
100-1000 particles

72

Diagnosis of rotavirus is by:

Faecal PCR

73

Rotaviral vaccine is given __(route), ___ (type), given at age ____
not for over 24 wk olds as increases risk of ___

PO
live attenuated in 2 doses
2-3 months
intususception

74

Noravirus causes ___ diarrhoea and vomiting that lasts for ___
Diagnose by __
Treat =

explosive
2-4 days
faecal/ vomit swab PCR
rehydration

75

aerobe defintion =

grow better with O2 but can do without

76

Eg.s of aerobes that are normal in colon =

Staph
Strep
enterococci
coliforms
E. coli
Klebsiella
Proteus
enterobacter
serratis

77

Antibiotic given to treat aerobes (including coliforms)/strict aerobes in gut infections

gentamicin

78

Strict aerobes normally present in gut =

pseudomonas - pathological if IC

79

Eg.s of anaerobes present in large no.s in the gut

clostridium
bacteroides
anaerobic cocci

80

treatment of anaerobic infections of the gut =

metronidazole

81

Organisms normally present in the mouth (colonise the teeth)

Strep viridans
Neisseria
Candida
Staph

82

Small no.s of these organisms are present in the stomach

candida
staph

83

colon contains ___ anaerobes, ___ coliforms + ___ normally

10^9
10^6
enterococci
= high bacterial load

84

Antibiotics given prophylactically for GI surgery =

metronidazole (anaerobes)
gentamicin (coliforms)
MAGiC

85

antibiotic given for enterococci

amoxicillin

86

SIRS is defined as a non-specific inflammatory response with 2 or more of the following:

Temp >38/less than 36
HR >90bpm
RR >20/min
WCC>12000/less than4000/>10% immature neutro.s

87

Sepsis = SIRS +

presumed/confirmed infectious process

88

Severe sepsis is defined as

sepsis with >=1 acute organ dysfunction (due to hypoperfusion)

89

Septic shock definition

severe sepsis with hypotension that is refractory to adequate volume resuscitation

90

Common bacterial causes of sepsis in the community

S. aureus (MSSA - skin)
E. coli (urine/ abdo)
S. pneumoniae (resp)

91

Common bacterial causes of sepsis in hospitals

E coli (catheter/abdo)
S aureus (MRSA - line/wound)
coag -ve Strep (line/prosthesis)
enterococci (urine/wound/line)
Klebsiella (urine/wound)
pseudomonas

92

Supportive management for sepsis

fluids and electrolytes
analgesia
VTE (venous thromboembolism) prophylaxis
O2
assess need for surgery/transfusion

93

Antimicrobials for sepsis are given __(route)
for ___ unless complicated then =___

parenterally
10-14 days
4-6wks

94

For intra abdominal infections the antibiotics given are___
then step down to __

IV amoxicillin, gentamicin and metronidazole
PO co-trimoxazole and metronidazole

95

Antibioic that you must limit the duration (72hrs then ID)
monitor renal function
maximum dose is 600mg

gentamicin

96

Sepsis 6 bundle for management =

high flow O2
IV fluid resus (500ml saline stat)
blood cultures
IV antibiotics
measure lactate and FBC
monitor hrly urine output