inf & imm > Week 2 GI & ENT > Flashcards

Week 2 GI & ENT Flashcards

(37 cards)

Study These Flashcards
1
Q

What are the common GIT infections?

A
  • Bacterial gastroenteritis
  • Viral/Parasitic gastroenteritis
  • Amoebiasis
  • Giardiasis
  • Toxic megacolon
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2
Q

What are the common intra-abdominal infections?

A
  • Peritonitis
  • Cholecytitis
  • Diverticulitis
  • Intra-abdominal, liver or pancreatic abscess
  • Peptic ulcer disease
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3
Q

What are the common ENT infections? (10)

A
  • Pharyngitis
  • Diphtheria
  • Epiglottitis
  • Otitis externa
  • Otitis media
  • Mastoiditis
  • Sinusitis
  • Conjunctivitis
  • Keratitis
  • Endophthalmitis
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4
Q

What are the common organisms causing bacterial GE?

A
  • Salmonella spp (mostly S enteriditis, S typhi & S paratyphi)
  • Shigella spp
  • Campylobacter jejuni
  • Vibrio spp
  • Clostridium difficile
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5
Q

How are the common Salmonella spp transmitted and what GI infection do they cause?

A

Causes bacterial GE

Salmonella enteriditis
- Most common
- Transmitted through food
- Usually self-limiting

Salmonella typhi (typhoid fever) & Salmonella paratyphi
- Causes more dangerous manifestations
- P.t. transmitted by water
- P.p transmitted from person-to-person (eg ingestion of fecal-contaminated food/water)
- Must be treated with antibiotics
- Not endemic in Singapore

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6
Q

How is shigella spp transmitted and what GI infection does it normally cause?

A
  • Can cause bacterial GE
  • Transmitted from person-to-person
  • Disease is usually self-limiting
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7
Q

How is Campylobacter jejuni transmitted and what GI infection does it normally cause?

A
  • Can cause bacterial GE
  • Transmitted through food (mostly chicken)
  • Usually self-limiting
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8
Q

How is Vibrio spp transmitted and what GI infection does it normally cause?

A
  • Can cause bacterial GE
  • Transmitted through raw seafood
  • Usually self-limiting

Note: Vibrio cholera
- Causes the most serious effects, and can cause death
- Transmitted through water
- Common indicator is “rice water stool”

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9
Q

How is Clostridium difficile transmitted and what GI infection does it normally cause?

A
  • Can cause bacterial GE
  • Starts off with antibiotic exposure and then transmitted person-to-person
  • Especially common in hospital environments
  • Treatment involves stopping the current antibiotic and replacing it with one that targets the GI
  • Dangerous as it can lead to colitis, toxic megacolon or death
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10
Q

What is haemolytic uraemic syndrome?

A
  • Serious condition affecting the kidneys
  • Caused by EHEC/E.coli strain 0157
  • Transmitted through contaminated food or water
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11
Q

What samples and tests do you send for to test for Salmonella spp, Shigella spp, Vibrio spp and Campylobacter causing bacterial GE?

A
  • Stool sample
  • Culture and sensitivity test
  • TAT 24-48 hours
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12
Q

What samples and tests do you send to test for C. difficile causing bacterial GE?

A
  • Stool
  • C. diff toxin test
  • C&S not done as C. diff is hard to grow
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13
Q

What are the common viruses that cause viral GE?

A
  • Norovirus
  • Rotavirus
  • Adenovirus

note: all these viruses are common in children and in nurseries

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14
Q

How is Norovirus transmitted and what GI infection can it cause?

A
  • Viral GE
  • Can lead to uncontrolled diarrhea and vomiting (easily spread in hospitals)
  • Transmitted through contaminated food/shellfish/water and fecal-contaminated sources
  • Usually self-limiting
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15
Q

How are Rotavirus and Adenovirus transmitted and what GI infection can it cause?

A
  • Viral GE
  • Commonly causes paediatric diarrhea
  • Transmitted person-to-person
  • Usually self-limiting
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16
Q

What samples and tests do you send to test for rotavirus, adenovirus and norovirus causing viral GE?

Study These Flashcards
A
  • Stool sample
  • Enzyme immunoassay (EIA) test and/or
  • Polymerase chain reaction (PCR) test
  • C&S not done as viral cultures takes too long to grow
17
Q

Cause and diagnosis of Amoebiasis?

Study These Flashcards
A
  • By Entamoeba histolytica parasite

Diagnosis through
- Microscopy of stool specimens (to visualise parasite)
- Blood serology if systemic infection is suspected

Systemic infection
- More dangerous
- Usually abscess in the liver
- Pus will look like anchovy sauce

18
Q

Cause and diagnosis of giardiasis?

Study These Flashcards
A
  • Giardia parasite (G. intestanalis, lambia, duodenalis)
  • Diagnosis through stool microscopy
19
Q

Cause and diagnosis of toxic megacolon?

Study These Flashcards
A
  • Microbe cause: C. difficile
  • PP cause: Inflammatory bowel disease, ischemic colitis, medicinal drugs, other inflammatory conditions
  • Common in elderly due to use of many antibiotics

Impending signs:
- Distended abdomen but no diarrhea/output
- Antibiotics alone is not enough to treat

20
Q

Brief on the other intra-abdominal infections and what microbes can cause them?

Study These Flashcards
A
  • Cholecystitis (infl of gallbladder) leading to cholangitis (infl of bile duct)
  • Diverticulitis (infl of intestines)
  • Abscesses

Caused by:
- Coliforms (eg E. coli, Klebsiella, Enterobacter)
- Anaerobes
- Enterococci
- P. aeruginosa
- Candida

21
Q

What is the pathophysiology of peritonitis?

Study These Flashcards
A
  • Usually due to the perforation of intestines, gallbladder or other organs within the abdomen and spills over into the sterile peritoneum
  • May also be due to C. diff toxins

Primary:
- Liver disease -> ascites -> spontaneous bacterial peritonitis

Secondary:
- Associated with peritoneal dialysis

22
Q

What pathogens can cause peritonitis?

Study These Flashcards
A

Primary:
- Coliforms
- Pseudomonas aeruginosa
- Anaerobes
- Enterococci
- Candida

Secondary:
- Primary +
- Coagulase-negative Staphylococcus (Skin flora)
- Staph aureus
- Other environmental bacteria (due to foreign object)

23
Q

Cause and pathophysiology of peptic ulcer disease?

Study These Flashcards
A
  • Helicobacter pylori
  • Bacteria can survive due to urease production (neutralises stomach acid)
  • Chronic condition may lead to stomach cancer
  • Gastric biopsy may be needed if repeated courses of Abx does not work
24
Q

What is the most common first line of antibiotics?

25
Why should frequent use of Ciproflaxin be discouraged?
- One of the few Abx that can be used to treat UTI caused by Pseudomonas aeruginosa - If px is resistant to Ciproflaxin, IV Abx needs to be started
26
What are the common pathogens causing Pharyngitis? (IMPT)
1) Viruses - Most common - eg Rhinovirus, Adenovirus, Parainfluenza, EBV - Disease is usually self-limiting 2) Group A Streptococcus - especially Streptococcus pyogenes - necessary to treat with antibiotics to prevent complications, can give Abx prophylaxis also - eg rheumatic fever/heart disease, glomerulonephritis, tonsillar abscess 3) Corynebacterium diphtheria - Fatal due to airway obstruction and/or arrhythmia from exotoxins - Common in countries w poor vaccination rates 4) Neisseria gonorrhea 5) Fusobacterium necrophorum
27
What are the causes of Diphtheria and their signs?
- Corynebacterium diphtheriae - Transmitted through infected droplets or surfaces - Incubated for 2-5 days and infectious until at least 14 days of Abx therapy - s/s include "bull/thick" neck appearance, thick pseudomembrane in the tonsils, sore throat, fever - Arrythmias, myocarditis and heart blocks can occur if toxins are involved - Toxigenic strains also cause the pseudomembranes and nerve toxicity - Non-toxigenic strains merely colonise the airway
28
What is the diagnosis, treatment and prevention of Diphtheria?
Diagnosis: - Culture from nasopharyngeal swab Treatment: - Abx (Erythromycin, Penicillin) - Antitoxin Prevention: - Vaccination - Abx prophylaxis
29
Epiglottitis?
- Haemophilus influenzae type B - Infected epiglottis - s/s drooling, difficulty swallowing, airway obstruction and difficulty breathing - Do not take throat swab
30
Normal Otitis externa? (OE)
- Staph aureus and Pseudomonas aeruginosa - Infected external auditory canal - Due to water trapped in ear, or heavy use of hearing aids/ear phones - Treatment with antibiotic ear drops
31
Malignant Otitis externa
- Mostly due to pseudomonas aeruginosa - Seen in diabetics or immunocompromised - More serious as infection may invade the bone, blood vessels and nerves - Treatment is for at least 6 weeks and IV Abx
32
Otitis media? (OM)
- Usually viral but - Common bacteria include Streptococcus pneumoniae and Haemophilus influenza - Obstruction of eustachian tube - Treat with antibiotics is due to bacteria - Complication may include mastoiditis leading to brain abscess
33
Mastoiditis?
Mastoiditis is an infection of your mastoid bone, the large bone behind your ear.
34
What pathogens commonly cause Sinusitis?
- Streptococcus pneumoniae - Haemophilus influenzae
35
Causes and s/s of Conjunctivitis? (IMPT)
- Mostly viral: ~ Adenovirus ~ Enterovirus - Bacteria: ~ Staph aureus ~ Strep pneumoniae ~ Pseudomonas aeruginosa (contact lens) - s/s: ~ Thick purulent exudate if bacterial in origins ~ Red eyes ~ Usually in children
36
Causes and s/s of Keratitis?
- Mostly bacterial ~ Similar to conjunctivitis ~ coliforms ~ Group A Strep s/s: - May lead to blindness - Not so much discharge, more watery eyes
37
Causes of Endophthalmitis?
- Staph aureus - Streptococcus - Candida
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