26757701
Description
Flashcards by Jenna Paterson, updated more than 1 year ago
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Created by Jenna Paterson
about 4 years ago
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| Question | Answer |
| What are risk factors for C. Diff infection? | - Recent antibiotic use - Older age (>65 years) - Gastric acid suppression - Female gender - Certain underlying medical conditions e.g. IBD, cancer, kidney disease, diabetes - Recent hospitalisation - Previous GI surgery |
| What are potential complications of C. Diff infection? | Toxic megacolon Pseudomembranous colitis Perforation |
| What is toxic megacolon? | - Acute toxic colitis accompanied by dilatation of the colon - Involves non-obstructive dilatation >6cm and signs of systemic toxicity |
| What are signs of systemic toxicity seen in toxic megacolon? | - Fever - Tachycardia - Leukocytosis - Dehydration - Altered mental state - Electrolyte derangement - Hypotension |
| What would you suspect in someone with colonic dilatation but no signs of systemic toxicity? | Not toxic megacolon. May be Hirschsprung disease or pseudo obstruction. |
| How can you treat toxic megacolon? | - Reduce colon distension to prevent perforation - Correct any fluid/electrolyte disturbances -Treat precipitating factors (e.g. C. Diff infection) |
| Define pseudomembranous colitis | - Defined by the presence of 'pseudomembranes' on the mucosa of the colon or the small intestine. - Pseudomembranes = layer of acute inflammatory cells, caused by C. Diff toxin release causing mucosal inflammation and damage |
| What is defined as severe C. Diff infection? | Patient has severe C. Diff infection if they have one or more severity markers present: ○ WBC >15 ○ SCr >1.5 baseline ○ Suspicion of/confirmed pseudomembranous colitis, toxic megacolon or ileus ○ Evidence of severe colitis on AXR or CT ○ Temperature >38.5 |
| How should C. Diff infection be managed? | Antibiotics - oral metronidazole if no severity markers, oral vancomycin if severe CDI. IV fluids Analgesia VTE prophylaxis Correct electrolyte abnormalities Stop drugs such as PPIs, causative Abx, diuretics |
| What Abx are higher risk for development of CDI? | - Clindamycin - Co-amoxiclav - Ceftriaxone (cephalosporin) - Ciprofloxacin |
| What type of bacteria is C. Diff? | Anaerobic, gram +ve bacilli |
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