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Gastroenterology Year 1 > Microbiology > Flashcards

Microbiology Flashcards

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1
Q

What is the definition of “intestinal flora”?

A

The symbiotic bacteria occurring naturally in the gut

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2
Q

What is the definition of GI colonisation?

A

The establishment of a microorganism on or within a host

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3
Q

What is the definition of a pathogen?

A

Any micro-organism that has the potential to cause disease

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4
Q

What is the definition of virulence?

A

The likelihood of causing disease

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5
Q

What are enterobacteriacaea?

A

Gram negative, non-spore forming, facultative anaerobes which are able to ferment sugars
They are pathogens

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6
Q

How do enterobacteriacaea cause disease?

A

Fimbriae helps them colonise by binding tight to tissue

They produce an endotoxin and an enterotoxin

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7
Q

What are some enterobacteriacaea coccobacilli?

A

H. Influenzae

B. pertussis

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8
Q

What are some enterobacteriacaea cocci?

A

Neisseria meningitis

Neisseria gonnorhoea

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9
Q

What are some lactose negative enterobacteriacaea bacilli?

A

Oxidase positive - Vibrio cholera, P. aeruginosa

Oxidase negative - H. pylori, Salmonella

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10
Q

What are some lactose positive enterobacteriacaea bacilli?

A

Klebsiella
E. coli
Enterobacter

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11
Q

What does clostridium difficile commonly cause?

A

Hospital- associated diarrhoea

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12
Q

What toxins does clostridium difficile produce?

A

Toxin A - enterotoxin

Toxin B - cytotoxin

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13
Q

What are the symptoms of a clostridium difficile infection?

A

Diarrhoea - sometimes bloody

Abdominal pain

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14
Q

What is the management of a moderate clostridium difficile infection?

A

Oral metronidazole

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15
Q

What is the management of a severe clostridium difficile infection?

A

Oral vancomycin

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16
Q

How can we prevent a clostridium difficile infection?

A

Avoid the 4C antibiots
Use narrow spectrum antibiotics
Isolation of patients

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17
Q

Describe a rotavirus infection

A 
Person to person spread
Commoner in the winter
Self-limiting - lasts about a week
Causes dehydration - so rehydration is key in management
Vaccine at 2 and 3 months old
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18
Q

Which is the commonest cause of diarrhoea and vomiting in children?

A

Rotavirus

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19
Q

Describe a norovirus infection

A

Can affect all ages
Faecal-oral / droplet routes of spread and person to person
Short incubation - less than 24 hours
Lasts 2-4 days

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20
Q

What are some GI infection risk factors?

A 
Malnutrition
Closed communities
Exposure to contaminated food/water
Age <5 and not breastfed
Age >65
Acid suppression
Immunosuppresion
Genetic susceptibility
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21
Q

What is the definition of diarrhoea?

A

More than 3 unformed stools per fay or a noticeable change in bowel habit

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22
Q

What is dysentery?

A

Inflammation of the intestine usually associated with fever, abdominal pain and rectal tenesmus causing diarrhoea with blood and mucus

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23
Q

What are some ways of contamination/transmission of gastroenteritis?

A

Cross contamination of raw and cooked food
Preparation of food too far in advance
Inadequate heating and cooling of food
Contaminated environment/equipment

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24
Q

What are some pathogens with an incubation time of 1-2 hours?

A

Staph aureus - preformed toxin in food that acts quickly on the vomiting centre in the brain

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25
What are some pathogens with an incubation time of 1-6 hours?
Bacillus cereus - found in starchy foods, reheated rice etc that leads to profuse vomiting due to heat-resistant spores
26
What are some pathogens with an incubation time of 12-48 hours?
Salmonella enterica - found in poultry, raw meat and raw egg C. perfrigens Norovirus Listeria monocytogenes - unpasteurised milk products and deli meats, mother to child and food borne transmission
27
What are some pathogens with an incubation time of a few hours to 5 days?
Vibrio cholera
28
What are some pathogens with an incubation time of 1-3 days?
Rotovirus
29
What are some pathogens with an incubation time of 1-4 days?
Enterotoxigenic E. Coli - produces a heat stable toxin and is usually travel related
30
What are some pathogens with an incubation time of 1-9 days?
Shigella - produces shiga toxin, binds to receptors found on renal cells, RBCs and others, inhibits protein synthesis and causes cell death
31
What are some pathogens with an incubation time of 3-10 days?
Campylobacter - poultry and raw milk
32
What are some pathogens with an incubation time of 7-21 days?
Giardia
33
What are some pathogens with an incubation time of 14-21 days?
Salmonella typhi | Salmonella parathyphi
34
What are some pathogens with an incubation time of up to 21 days?
E. coli 0157
35
What is enteric fever?
An infection most commonly caused by Salmonella typhi or paratyphoid in people returning from the Indian subcontinent and SE Asia.
36
What is the incubation period of enteric fever?
7 to 18 incubation period
37
What are some of the symptoms of enteric fever?
Fever, constipation/diarrhoea, dry cough, headache
38
What is the treatment (if severe) of enteric fever?
IV Ceftriaxone
39
What is amoebiasis?
A disease caused by entamoeba histolytic (a protozoa_
40
How is amoebiasis transmitted?
Faecal oral spread
41
What are some symptoms of amoebiasis?
Abdominal pain, fever, bloody diarrhoea, peritonism
42
What can amoebiasis cause?
A liver abscess | Management for that is metronidazole
43
What is giardiasis?
An illness caused by giardia intestinalis
44
What is the incubation period for giardiasis?
About a week
45
What are some symptoms of giardiasis?
Watery, malodorous diarrhoea | Abdominal cramps
46
What is the treatment for giardiasis?
Metronidazole
47
Name the 3 different types of Helminths
Nematodes - roundworms Trematodes - flukes - fresh water exposure Cestodes - tapeworms - undercooked beef/pork
48
What is chagas disease caused by?
Kissing bug (triatome)
49
What does chagas disease cause?
Parasympathetic denervation affecting the colon and the oesophagus
50
What is the definition of an antibiotic?
A drug that kills or inhibits the growth of microorganisms
51
What is the definition of a resistant microorganism?
An organism which will not be inhibited by an antibiotic at clinically achievable concentrations
52
What is the definition of a susceptible microorganism?
An organism that is inhibited by antibiotics
53
What is the definition of a multi-drug resistant (MDR) organism?
Non-susceptibility to at least 1 agent in 3 or more antimicrobial categories
54
What is the definition of an extremely drug resistant (XDR) organism?
Non-susceptibility to at least 1 agent in all but 2 or fewer antimicrobial categories
55
What is the definition of a pan-drug resistant (PDR) organism?
Non-susceptibility to all agents in all antimicrobial categories
56
What is meant by "vertical transmission" of antimicrobial resistance?
A bacterium accumulated errors or mutations in its genome during replication Some of these give the ability to resist antibiotics
57
What is meant by "horizontal transmission" of antimicrobial resistance?
Resistant genes are swapped from one microbe to another
58
What are some causes of antimicrobial resistance?
Human or animal antimicrobial misuse or overuse | Prior hospitalisation or invasive procedures
59
What are some consequences of antimicrobial resistance?
Increased mortality and morbidity | Increased healthcare costs
60
What are some solutions for reducing antimicrobial resistance?
Preventing infections/spread of disease Improvement of antibiotic prescribing and use Development of new antimicrobials
61
How is Hepatitis A transmitted?
Faecal oral spread and poor hygiene/overcrowding
62
What is the clinical presentation of Hepatitis A?
Acute presentation only | Peak incidence in older children/young adults
63
What investigations confirm the diagnosis of Hepatitis A?
Clotted blood for serology - Hepatitis A IgM
64
How is the spread of Hepatitis A controlled?
Hygiene | Vaccine prophylaxis
65
How is Hepatitis B transmitted?
Sex Mother to child Blood to blood
66
What is the clinical presentation of Hepatitis B?
Acute and chronic infections
67
What investigations confirm the diagnosis of Hepatitis B?
Hep B surface antigen (HBsAg) - present in all infectious individuals - Present for more than 6 months is chronic Hepatitis B e antigen (HBeAg) - usually also present in highly infectious individuals Hep B DNA - usually also present in highly infectious individuals Hep B IgM - recently infected cases Anti-HBs - present in immunity
68
How is the spread of Hepatitis B controlled?
Minimize exposure - safe sex, safe needle exchange, prevention of needlestick injuries Pre-exposure vaccines Post-exposure prophylaxis
69
How is Hepatitis C transmitted?
Sex Mother to child Blood to blood
70
What is the clinical presentation of Hepatitis C?
75% of infected cases result in chronic infection
71
What investigations confirm the diagnosis of Hepatitis C?
HCV serology: - Negative - patient is unlikely to have HepC - Positive - patient has been infected HCV RNA assay: - Negative - past infection and no treatment needed - Positive - active infection
72
How is the spread of Hepatitis C controlled?
Minimize exposure | No vaccine
73
What is Hepatitis D?
An infection that is only found in individuals with a Hep B infection - exacerbated Hep B
74
Which hepatitis is Hepatitis E similar to in transmission and clinical presentation?
Hep A
75
Is there a vaccine for Hepatitis E?
No
76
Is spontaneous cure common in chronic Hep B infections?
Yes
77
Is spontaneous cure common in chronic Hep C infections?
No
78
What is the management of acute viral hepatitis?
Monitor for encephalopathy or resolution Immunisation of contacts Vaccinate against other infections if at risk
79
How long does a chronic hepatitis infection take to cause cirrhosis?
20 years
80
How long does a chronic hepatitis infection take to cause hepatocellular carcinoma?
30 years
81
What are the therapy options for chronic Hep B?
1. Suppressive antiviral drug e.g. entecavir, tenofovir - Safe but only causes suppression not cure 2. Peginteferon therapy - Sustained cure is possible but there's serious side effects
82
What are the therapy options of chronic Hep C?
Use of antivirals e.g. ledipasvir, sofosbuvir

Gastroenterology Year 1 (8 decks)

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