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3A week 1 - upper GI tract > infections of the upper GI tract > Flashcards

infections of the upper GI tract Flashcards

1
Q

what type of infections are more prevelant in soft tissue rich areas

A

anerobic

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2
Q

examples of normal oropharyngeal bacteria (6)

A
  1. streprococci viridans
  2. strep milleri (!)
  3. strep pyogenes (group A strep)
  4. diphtheroids
  5. staph aureus
  6. moraxella
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3
Q

what bacteria is implicated in appendicitis, GI abcessess and quinsey

A

streptococcus milleri

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4
Q

what are aphthous ulcers (stomatitis)

A

a common ulcerative condition of the oral mucosa, presents as a painful punched-out sore on oral or genital mucous membranes

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5
Q

what organisms can cause oral aphthous ulcers + mgx (2)

A
  1. HSV1 (immunocomprimised pts) -> aciclovir
  2. candida (HIV, immunocomprimised, diabects, oral steroid users) ->oral hygeine, Nystatin (prevention), fluconazole
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6
Q

what type of disease are dental caries

A

chronic infectious disease

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7
Q

what bacteria is particularly involved in dental carie formation and how

A

S.mutans -> colonised oral cavity anf produces glycosyl transferase which promotes attachment to tooth pellicle -> converts sugar from food into lactic acid -> demineralisation of tooth enamel in plaques

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8
Q

what is gingivitis

A

pockets of infection affecting the gums

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9
Q

what non-oral condition can S.mutans result in

A

infective endocarditis

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10
Q

what is ludwig’s angina

A

suppurative infection of hypoglossal tissue -> life threatening cellulitis of the soft tissue involving the floor of the mouth and neck

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11
Q

why might ludwig’s angina be life threatening

A

airway threatened -> oedema and exudate push tongue up and backwards

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12
Q

ludwig’s angina presentation (5)

A

rapid onset
1. pain
2. fever
3. dysphagia
4. stridor
5. bull-neck (bilateral neck swelling)

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13
Q

ludwig’s angina mgx (3)

A
  1. broad spectrum abx
  2. corticosteroids
  3. surgical drainage
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14
Q

what is vincent’s angina

A

unilateral tonsillitis due to a mixed infection by spirochetes and fusobacteria that manifests as a one-sided sore throat and difficulty swallowing

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15
Q

what 2 bacteria cause vincent’s angina

A
  1. borrelia vincenti (spirochaetes)
  2. fusiformis (anaerobic bacteria)
    usually due to poor dental hygeine
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16
Q

vincent’s angine presentation

A
  1. extremely sore mouth/gums
  2. offensive smell (halitosis)
17
Q

vincent’s angina mgx

A
  1. metranidazole
  2. ampicillin
  3. improved mouth care
18
Q

what bacteria can cause streptococcal pharyngitis

A
  1. group A strep beta haemolytic - strep. pyogenes (also causes scarlet fever!)
  2. group C strep- S.equilisimus, S.anginosus
19
Q

streptococcal pharyngitis presentation (6)

A
  1. sudden onset sore throat
  2. pain when swallowing
  3. fever
  4. headache
  5. abdominal pain
  6. nausea/vomiting
  7. NO cough, hoarsenss, rhinorrhoea, conjunctivitis etc.
20
Q

pharyngitis investigations (3)

A
  1. throat swab for culture
  2. bloods - raised WBC
  3. serology - ASO titre >400
21
Q

mgx for pharyngitis

A

abx - ampicillin, amoxicillin or eythromycin (oral if mild) or IV benzylpenicillin (severe)

22
Q

complications of pharyngitis

A
  1. rheumatic fever
  2. poststreoptococcal glomerulonephritis
  3. peritonsillar abscess (quinsy)
  4. cervical lymphadenitis
  5. bacteraemia
23
Q

what is lemierre’s syndrome

A

a rare complication of bacterial pharyngitis/tonsillitis and involves an extension of the infection into the lateral pharyngeal spaces of the neck with subsequent septic thrombophlebitis of the internal jugular vein -> usually immunosuppressed pts

24
Q

what bacteria is responsible for lemierre’s syndrome

A

fusobacterium necrophorum (gram -ve)

25
Q

what is actinomycosis

A

a rare subacute to chronic infection caused by the gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria -> has fungi like properties

26
Q

what bacteria are implicated in acute epiglottitis (2)

A
  1. H.influenzae
  2. S.pyogenes
27
Q

why should amoxicillin not be given to an EBV suspected pt

A

if EBV is present it can cause an amoxicillin induced rash

28
Q

4 organisms that cause oesophagitis

A
  1. candida
  2. cytomegalovirus (CMV)
  3. HSV
  4. varicella-zoster virus
29
Q

oesophagitis presentation (5)

A
  1. dysphagia
  2. odynophagia
  3. retrosternal discomfort
  4. anorexia
  5. fever
30
Q

risk factors for oesophagitis

A
  1. abx use (candidia)
  2. HIV (CMV, candida)
  3. leukaemia
  4. lymphoma (candida, HSV)
  5. corticosteroids (candida)
31
Q

oesophagitis investigations (4)

A
  1. flexible endoscopy
  2. x ray (barium)
  3. swab/brushings
  4. tissue biopsy
32
Q

endoscopic findings of CMV infection (3)

A
  1. erythema
  2. ulcers
  3. gastric wall thickening (associated with overlying erosion)
33
Q

HSV oesophagitis appearance

A

numerous small ulcerations

34
Q

candidiasis oesophagitis appearance

A

typical white plaques/nodules

35
Q

mgx for candida oesophagitis

A
  1. antifungal (fluconazole, itraconazole)
  2. amphotericin B
36
Q

mgx for HSV/VZV oesophagitis

A
  1. antiviral (aciclovir, famciclovir etc.)
  2. foscarnet (if resistant)
37
Q

mgx for CMV oesophagitis

A
  1. valganciclovir
38
Q

complications of diptheria infection

A
  1. attacks cardiac muscle (early)
  2. attacks myelin (late) -> leading to respiratory arrest due to diaphragm paralysis
39
Q
A

3A week 1 - upper GI tract (7 decks)

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