Gastro: Pseudomembranous Colitis: Free MSRA Podcast

🎧MSRA PODCAST:Pseudomembranous Colitis — C. diff, Diarrhoea & Danger🔍 A focused, high-yield revision session breakingdown pseudomembranouscolitis — what it is, why it happens,how to diagnose and manage it, and the complications you need to know for theMSRA exam. 🧠Key Learning Points📌Definition• Pseudomembranous colitis is inflammation of the colon due to toxinsproduced by Clostridioides difficile (C.diff)• Named for pseudomembranes — yellow-white plaques offibrin, neutrophils, and dead cells on the colon lining🧠Not true membranes —inflammatory debris! 📌Cause / Aetiology✔️ Triggered by C. difficile infection, usually after antibioticdisruption of gut flora✔️ Toxins A and B damage the colonic epithelium,leading to inflammation, ulceration, and fluid secretion🧠Toxins A + B = A forActive inflammation, B for Barrier breakdown 📌Key Risk Factors🦠Recent antibiotics — especially broad-spectrum🏥Hospitalisation /long-term care👵Older age🛡️Immunosuppression (chemo, steroids, etc.)🦠Existing gutconditions (IBD)🧠Mnemonic: CFC =Clindamycin, Fluoroquinolones, Cephalosporins 📌DifferentialDiagnosis (DDx)• Infectious colitis: Salmonella, Shigella, E. coli, Campylobacter → Mnemonic: SSE• Ischaemic colitis• Inflammatory bowel disease (IBD)• Drug-induced colitis (e.g., NSAIDs) 📌Epidemiology• Major cause of nosocomial diarrhoea• 2% of general population may be asymptomatic carriers• Incidence risingdue to resistant strains and hospital transmission 📌Clinical Features⚠️Watery diarrhoea (may be bloody)⚠️Abdominal pain, cramping⚠️Fever, leukocytosis⚠️ Severe cases → toxic megacolon,perforation, sepsis🧠Think: Danger =Diarrhoea + Dehydration + Deadly complications 📌Investigations🧪Stool tests – Toxin A/B ELISA – PCR for C. diff DNA🔬Endoscopy (if needed): pseudomembranes visualised🧠Start with suspicion+ stool testing 📌Management1️⃣Stop the triggeringantibiotic (if safe)2️⃣Start anti-C. diffantibiotics: ✔️ Oral vancomycin(first-line) ✔️ Fidaxomicin ✔️Metronidazole (mild cases or alternative)3️⃣Supportive care: IV fluids, electrolytes, monitor fordeterioration🧠Antibiotics forantibiotic-associated disease – ironic but effective 📌Complications🚨Toxic megacolon🚨Perforation🚨Septic shock🚨Relapse (~25%)🧠Post-infectious IBSor chronic diarrhoea can persist 📌Prognosis• Good with prompttreatment• Recurrence rate ~25%• Severe cases carryhigh morbidity/mortality 📌Prevention Tips• Antibiotic stewardship – only when necessary• Infection control in healthcare settings• Future:manipulation of gut microbiome 📎PseudomembranousColitis MSRA Resources📝Gastro Course Home:https://www.passthemsra.com/courses/gastroenterology-for-the-msra/ Hashtags#MSRA #Cdiff#PseudomembranousColitis #MSRARevision #GastroMSRA #AntibioticStewardship#MSRAFlashcards #MSRAQuiz #NICEGuidelines #HighYieldRevision #MSRAPodcast