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Infections and Sepsis Flashcards

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1
Q

how is gut flora a supraorganism

A

A system of multiple organisms that may be considered a single organism

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2
Q

describe the normal flora of the gut- good or bad?

A

beneficial indigeous microbiota

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3
Q

do you have the same normal flora all the time

A

no, may be transient, not all colonisation is normal

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4
Q

when does colonisation of normal gut flora begin

A

at birth

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5
Q

what help prevents colonisation in the GI tract

A

stomach acidity, normal flora, peristalsis, antimicrobial compounds

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6
Q

what traits increase an invaders chance of success

A

high growth rates, dispersal capability, phenotypic plasticity, genetic diversity

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7
Q

what is a barrier to establishment of an invader after introduction

A

abiotic resistance: pH, temperature, salinity

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8
Q

what is biotic resistance

A

barrier to invasion: competition, antagonism, predation

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9
Q

what organisms are commonly in the normal flora of the large bowl

A

enterobacteriaceae, (klebsiella), enterococci, milleri group streptococci, anaerobic gram +ve bacilli (clostridium), anaerobic gram -ve bacilli (bacteroides, candida)

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10
Q

are there more bugs in the large/ small bowl?

A

small, number increases as you go towards the rectum

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11
Q

what are the steps of pathogenic adhesion

A

exposure, adhesion, invasion, colonisation, toxicity, tissue damage and disease

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12
Q

what is colonisation

A

the establishment of a microorganism on or within a host

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13
Q

what is a pathogen

A

any microorganism that has the potential to cause disease

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14
Q

what is virulence

A

the likelihood of causing disease (opportunistic or accidental pathogen)

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15
Q

what investigations should be done when diagnosing an infection

A

radiology, biochemistry, immunology, microbiology (blood, stool, urine, wound, tissue cultures), microscopy: (of stool, urine, CSF, sputum, pus) serology, antigen detection, PCR/ molecular studies

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16
Q

what are the components of inflammation

A

calor (heat), rubor (redness), tumour (swelling), dolor (pain), functio laesa (loss of function)

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17
Q

what happens in the incubation period

A

pathogen replicates in the host

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18
Q

what happens in the prodromal period

A

early signs and symptoms

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19
Q

what is the convalescent period

A

signs and symptoms recede, person returns to health

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20
Q

what immune response does bacteria usually initiat

A

phagocytes, antibody and t lymphocytes, complement

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21
Q

what immune response do viruses usually intiate

A

t lymphocytes, anti body and b lymphocytes

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22
Q

what immune response does fungi usually initiate

A

phagocytes, t lymphocytes, eosinophils

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23
Q

what immune response do protozoa usually intiate

A

t lymphocytes, eosinophils

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24
Q

what immune response do worms usually initiate

A

eosinophils, mast cells

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25
what age groups are usually most susceptible to infection
neonates and the elderly
26
what infections of the abdomen can cause abscesses
hepatitis (liver abscesses) gastroenteritis perineal abscesses
27
what shape are enterobacteraeciae
bacilli
28
what shape are streptococcus and enterococcus
cocci
29
what shape are helicobacter pylori
spirochete
30
what do gram -ves have that gram +ves lack
lipopolysaccharide
31
what is usually the causative agent of oesophagitis
candida/ malfunctioning T cells
32
what causes pancreatitis
not usually caused by infection
33
what drives gram -ve sepsis
lipopolysaccharide
34
what further step is used distinguish enterobacteriaceae
lactose or non lactose ferminting
35
what is an abligate anaerobe
one that is poisoned by oxygen
36
how do you tell non lactose fermenting drugs apart
oxidase test, urease tests
37
what antibiotic do all UK E coli respond to
gentamycin
38
are enterobacteriaceae | gram -/+ve
negative
39
enterobacteriacae are coliforms- what is this
rod-shaped Gram-negative non-spore forming and motile (most) or non-motile bacteria which can ferment lactose with the production of acid and gas
40
how do enteronacteriaceae cause disease
motility- flagella colonisation factors- fimbriae endotoxin- cell wall component enterotoxin- sgiga toxin
41
what enterobacteriaceae are not mobile
shigella and klebsiella
42
how does maldi-tof mass spectrometry identify bacteria
analyses the protein composition of bacteria cell wall, ionises the proteins, then uses a database
43
how does serotyping work
immunoreactivity of various antigens, relates to gram -ve, helps you identify bug by antigen reactions
44
what gram +ve organiams are found in the mouth
strep viridans anaerobes candida neisseria sthaphylococci
45
what gram +ve organisms can be found in the stomach
usually sterile- some candda and staphylococci may survive
46
name the most important enterobacteriaceae
e coli
47
where are most anaerobic and aerobic organism in the GI tract
aerobic closer to mouth- upper GI tract anaerobic closer to rectum- lower GI tract
48
what is the main anaerobe to remeber
bacteroids and costridium
49
what is the normal flora of the bowel
small number of coliforms and anaerobes
50
what is the normal flora of the colon
lots of coliforms, anaerobes and enterococcus
51
what is the normal flora of the bile ducts
usually sterile
52
what antibiotic is used for anaerobes
metronidazole
53
what is cholangitis
an infection in the common bile duct, usually resulting from a common bile duct stone
54
what should you review after 48 hours of initial treatment
antibiotics, even if results from lab haven't come back yet; change or IV/Oral switch if patient improving
55
how are enterococcus in the GI tract treated
amoxicillin (vancomycin if penicillin allergic) | cotrimoxalzole when time to switch to oral from IV
56
what are the antibiotics for an intra abdominal sepsis
treat as enterococcus: amoxicillin (vancomycin if penicillin allergic) cotrimoxalzole when time to switch to oral from IV
57
how do gall stones reach the liver
via bile ducts
58
how does malignancy spread to the liver
bile ducts and portal vein
59
how does bacteremia spread to the liver
portal vein and hepatic artery
60
what is sepsis
uncontrolled amplification of the immune response throughout the whole body- life-threatening organ dysfunction caused by a dysregulated host response to infection. 
61
what is septic shock
a subset of sepsis with circulatory and cellular/ metabolic dysfunction associated with a higher risk of mortality
62
when do you know its sepsis
infection + news > 5
63
what could lead to an unusual host response
age, immunosuppressed, co morbidity, drugs, genetics
64
what is an occult
a disease of no readily discernible signs or symptoms
65
what should be done to treat sepsis
``` B-lood cultures + septic screen, U&Es U-rine output- monitor hourly F-luid resuscitation A-ntibiotics IV L-lactate measurement O-xygen to correct hypoxia ```
66
what could cause pain in the left iliac fossa on deep palpation
diverticular disease, inguinal hernia
67
what could cause pain in the right iliac fossa
appendicitis, inguinal hernia
68
what can cause pain in the epigastric region
peptic ulcer disease, cholecystitis, pancreatitis, MI
69
what can cause pain in the periumbilical region
small or large bowl obstruction, appendicitis, abdominal aortic aneursym
70
why are antibiotics not helpful in large abscesess
as they have no blood supply- need surgical drainage
71
what is a spontaneous peritonitis
think ascites- is an infection of ascitic fluid that cannot be attributed to any intra-abdominal, ongoing inflammatory, or surgically correctable condition
72
what is secondary peritonitis
an acute infection of the peritoneum due to loss of integrity of the gastrointestinal tract or other visceral organ (a burst that introduces the bacteria)
73
what antibiotic for enterococcus
amoxicillin
74
what antibiotic for enterobacteriaceae
gentamycin
75
what is the drug of choice for sepsis and enterococci in the GI tract
amoxicillin
76
what is the drug of choice for sepsis and coliforms
gentamycin
77
what is the mutant selection window
where the wrong dose of antibiotics selects the resistant sub population of the infection

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