GIT infections

Question 1

what are examples of sterile and non-sterile sites

Answer 1

sterile - peritoneal space, pancreas, gall bladder, liver

non- intraluminal, mouth, oesophagus, stomach, bowel

Question 2

what normal flora are found in these locations and what they can cause on infections 
enteric tract 
nose
mouth 
haemophilus

Answer 2

enterococcus
s. aures = SSTI
s. viridian’s - gum brushing = endocarditis
pharynx - move from URT - LRT = pneumonia

Question 3

what is angular cheilitis and what is it caused by

Answer 3

inflammation of skin and contiguous labial mucosa act lateral commissure of mouth
caused by excessive moisture - saliva and secondary infection with albicans (common in people with denchers)

Question 4

which people are more susceptible to angular cheilits and why

Answer 4

drooling and dropping of corners of mouth from elderly and those wearing fake teeth

young children - sucking thumb and lip licking

Question 5

what is hairy leukoplakia and what is it caused by

Answer 5

white plaques on the tongue seen in HIV patients caused by EBV = glandular fever

Question 6

give three types of dentoalveolar infections (teeth)

Answer 6

caries - bacterial plaques on teeth - strep mutant and lactobacillus
pulpitis
periapical abscess - strep and anaerobes

Question 7

what are periodontal infections and give 4 examples

Answer 7

plaque beneath the gingival margin
gingivitis - bacterial gum infection, painful bleeding gums
peridonitis - progression of gingivitis - loss of connective tissue
periodontal abscess - tender palpation
Vincents angina - acute necrotising ulcerative gingivitis - infection into deep neck spaces

Question 8

what is alveolar bone

Answer 8

thickened ridge of bone that contains tooth sockets

Question 9

why are deep neck space infections dangerous

Answer 9

rapid onset and progress to life threatening complications

Question 10

what is a quinsy abscess

Answer 10

peitonsillar abscess - strep pyogenes

Question 11

which deep neck space infection is caused by staph aureus

Answer 11

acute suppurative parotitis

Question 12

what is ludwigs angina

Answer 12

submandibular space infections - from abscesses

Question 13

what are the most serious types of deep space infection

Answer 13

retro pharyngeal abscesses - lead to mediastinum infection and empyema

Question 14

what is the most serious compilation of retropharyngeal deep space infection

Answer 14

acute necrotising mediastinitis

Question 15

what is mucositis and the cause and risks

Answer 15

inflammation of the mucus membranes of the GIT - chemotherapy induced
increased risk of bacteriameia via strep viridian’s

Question 16

what are some of the causes of oesophageal rupture

Answer 16

effort - severe straining or vomiting, boerhaave syndrome

Question 17

what is the consequence of and oesophageal rupture

Answer 17

chemical mediastinitis = bacterial infection and necrosis

Question 18

what is the boerhavve feature in oesophageal rupture

Answer 18

excruciating retrosternal chest pain due to intrathoracic oesophageal perforation

Question 19

which disease would you see crepitus

Answer 19

in oesophageal rupture when you palpate the chest due to subcutaneous emphysema (cracking sound)

Question 20

what is hammans signs

Answer 20

crunching/crackling sound in mediastinal emphysema from oesophageal rupture

Question 21

how does heliobactor pylori infection occur

Answer 21

bacterial urease hydrolyses gastric luminal urea to form ammonia that neutralises gastric acid - protection and allow penetration of gastric mucus layer

Question 22

what are the clinical features and tests for H pylori infection

Answer 22

pain, bleeding, perforation, ulcers - ulcer disease

urease breath test
faecal antigen test

Question 23

what are two types of biliary tract infection

Answer 23

cholangitis

cholecystitis

Question 24

what is cholangitis

Answer 24

(common bile duct enterobacteiase infection)
fever, abdominal pain, jaundice = charots triad
elevations in ALP, GGT and bilirubin

Question 25

what cholecystitis

Answer 25

gall bladder infection abdominal pain, fever murphys sign - pain one inspiration and R subcostal pain

Question 26

what is bacterial overgrowth of the small intestine associated with

Answer 26

malabsorption or chronic diarrhoea

Question 27

what are some causes of bacterial overgrowth of small intestine

Answer 27

achlorhydria (lack HCL) | impaired motility

Question 28

what is whipples disease

Answer 28

tropheryma whipple - joint symptoms, GI pain, weight loss - white plaques in distal duodenum representing engroged lymph vessels

Question 29

if cholangitis isn't treated what can happen to the liver and how do you test for this

Answer 29

liver abscess as infection ascending biliary tract into portal vein - entamoeba histolytica serum ALP increased and bilirubin + aspartate aminotranferase

Question 30

what is entamoeba histolytica

Answer 30

parasite cyst stage - infective from trophozoite stage - invasive disease = amoebic liver abscesses

Question 31

what does a hydatid cyst cause and what is is from

Answer 31

liver abscesses | from farms with animals

Question 32

where is the most common site for TB in the GIT

Answer 32

ileo-caecal

Question 33

what is diverticulitis and common pain location

Answer 33

outpouching then inflammation - left iliac fossa pain | not infectious cause

Question 34

what is the most likely cause of intra-peritoneal abscess and what are the predisposing factors

Answer 34

anaerobes perforation, necrosis or infarction

Question 35

which disease would you see swinging pyrexia

Answer 35

temp up and down in intra peritoneal abscess

Question 36

what do symptoms of intra-peritoneal abscess depend on

Answer 36

location of abscess - near bowel then diarrhoea | near stomach then nausea

Question 37

which structures are related to subphrenic abscess and what are the clinical features

Answer 37

between diaphragm, liver and spleen | pain in shoulder on affected side - hiccup and hepatomegaly

Question 38

what are the symptoms of pelvic abscess

Answer 38

urinary frequency, urge (tenesmus)

Question 39

what is sponteaous bacterial peritonitis and treatment

Answer 39

ascitic fluid infection without an evident intra-abdominal surgical treatable cure - mesenteric lymph node infection - antibiotic treatment

Question 40

what GIT disease are associated with strep bovis/gallolyticus

Answer 40

colonic malignancy and endocarditis