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Ophthalmology Week 1 2017/18 > 4: Microbiology > Flashcards

4: Microbiology Flashcards

1
Q

What is conjunctivitis?

A

Infectious inflammation of the conjunctiva

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2
Q

What is keratitis?

A

Infectious inflammation of the cornea

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3
Q

What is endophthalmitis?

A

Infectious inflammation of the entire eye

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4
Q

What is chorioretinitis?

A

Inflammation of the choroid and retina (back of the eye)

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5
Q

What is dacrocystitis?

A

Infectious inflammation of the lacrimal SAC

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6
Q

Which microbes cause conjunctivits?

A

Bacteria

Viruses

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7
Q

How can you tell the difference between bacterial and viral conjunctivitis?

A

Bacterial - loads of pus

Viral - watery

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8
Q

What are the symptoms of conjunctivitis?

A

Red eye

Itchy, gritty, watery eye

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9
Q

All neonates with conjunctivitis should be referred to who?

A

Ophthalmology

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10
Q

Which bacteria can cause conjunctivitis?

A

Staph aureus

Strep pneumoniae

H. influenzae (especially in children)

Chlamydia trachomatis

Neisseria gonorrhoeae

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11
Q

Which bacteria causes bacterial conjunctivitis especially in children?

A

H. influenzae

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12
Q

Which STI can cause bacterial conjunctivits which is chronic, unresponsive to previous treatment and accompanied by urethritis or vaginitis?

A

Chlamydia trachomatis

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13
Q

What must you do if you diagnose chlamydial conjunctivitis?

A

Alert people the patient has been in contact with

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14
Q

What are some additional features of chlamydial conjunctivitis compared to normal bacterial conjunctivitis?

A

Follicles under eyelid - “rice grain pattern”

Subtarsal scarring if left untreated

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15
Q

How is bacterial conjunctivitis investigated?

A

Swab

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16
Q

How is bacterial conjunctivitis treated?

A

Topical antibiotics

Chloramphenicol drops (4x a day)

Oxytetracycline (for chlamydia)

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17
Q

Which viruses can cause conjunctivitis?

A

Adenovirus

Herpes simplex virus

Herpes zoster virus

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18
Q

What is the difference between bacterial and viral conjunctivitis?

A

Bacterial - pus

Viral - watery

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19
Q

What may you see along conjunctivitis in someone with herpes simplex infection?

A

Cold sores

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20
Q

Which virus reactivates in elderly people and can cause a painful rash in the dermatomes for CN V?

A

Herpes zoster virus

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21
Q

What is the technical name for shingles affecting the forehead and eye area?

A

Ophthalmic zoster

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22
Q

How is viral conjunctivitis investigated?

A

Swab

23
Q

How is ophthalmic zoster treated?

A

Oral antivirals

Aciclovir

(add on antibiotics if at risk of secondary infection)

24
Q

What can ophthalmic zoster cause if untreated?

A

Vision loss

Post-herpetic neuralgia

25
Q

Which microbes can cause a keratitis?

A

Bacteria

Viruses

Fungi

26
Q

What does a bacterial keratitis look like?

A

Red eye

Hypopyon

27
Q

What is a hypopyon?

A

Exudate in anterior chamber at iridocorneal angle

Seen in bacterial keratitis

28
Q

What name is given to a collection of pus in the anterior chamber as seen in bacterial keratitis?

A

Hypopyon

29
Q

Which Gram negative bacillus is a common cause of keratitis in people who wear contact lenses?

A

Pseudomonas

30
Q

How is bacterial keratitis treated?

A

Topical antibiotics

HOURLY chloramphenicol drops

ofloxacin

31
Q

How would you treat Pseudomonas conjunctivitis?

A

Gentamicin

32
Q

What is a pathognomic sign of viral keratitis due to herpes infection?

A

Dendritic ulcer

White ulcer with loads of projections

33
Q

Viral keratitis is very ___ for the patient.

A

painful

34
Q

What is seen in the cornea in viral keratitis caused by adenovirus?

A

Subepithelial infiltrates

Little white specks

35
Q

Adenovirus keratitis is usually (unilateral / bilateral).

A

bilateral

36
Q

What are the classic features of

a) herpes
b) adenovirus

keratitis?

A

a) Dendritic ulcer

b) Subepithelial infiltrates

37
Q

How is viral keratitis treated?

A

Topical antivirals

e.g aciclovir

(add on topical antibiotics to prevent secondary infection)

38
Q

What should you suspect in a patient with red eye with a hypopyon and a history of farming / trauma from vegetation?

A

Fungal keratitis​

39
Q

What should you suspect in a patient with a fever, painful eye movements and massive orbital swelling?

A

Orbital cellulitis

40
Q

What is abnormal protrusion of the eye called?

A

Proptosis

41
Q

How is orbital cellulitis investigated?

A

CT head

For abscesses

42
Q

How is orbital cellulitis treated?

A

Broad spectrum antibiotics

ofloxacin, gentamin, cephalosporins…

43
Q

What is a “devastating”, painful infection of the whole eye which is commonly caused by surgery?

A

Endophthlamitis

44
Q

Endophthalmitis is commonly caused by commensal organisms.

What is an example?

How do they get into the eye?

A

Staph epidermidis

During surgery

45
Q

How is endophthalmitis investigated?

A

Aqueous / vitreous fluid sample

seeing as it affects the whole eye

46
Q

How is endophthalmitis treated?

A

Intravitreal antibiotics

Injected directly into the eye - amikacin, cephalosporins, vancomycin

47
Q

What commonly causes chorioretinitis - infective inflammation of the retina?

A

Parasites

Cytomegalovirus in AIDS patients

48
Q

What does the retina look like on fundoscopy of someone with chorioretinitis?

A

Pizza

49
Q

What can be seen in the retina of someone with chorioretinitis?

A

Pizza

Parasites

Scar tissue

50
Q

How is parasite infection of the eye investigated?

A

Serology (antibodies)

51
Q

What investigations would you do for

a) orbital cellulitis
b) conjunctivitis
c) keratitis
d) endophthalmitis
e) parasitic chorioretinitis?

A

a) CT head

b) Swab

c) Corneal scrapes

d) Aqueous or vitreous fluid sample

e) Serology

52
Q

How would you treat

a) uncomplicated bacterial conjunctivitis
b) chlamydial conjunctivitis
c) Pseudomonas conjunctivitis?

A

a) Chloramphenicol drops

b) Oxytetracycline drops

c) Gentamicin drops

53
Q

How would you treat

a) viral conjunctivitis
b) viral keratitis
c) orbital cellulitis
d) fungal keratitis
e) endophthalmitis?

A

a) Topical antivirals (plus prophylactic antibiotics)

b) ““

c) Broad spectrum antibiotics (ofloxacin, gentamicin, cephs)

d) Topical antifungals

e) Intravitreal antibiotics (amikacin, cephs, vancomycin…)

Ophthalmology Week 1 2017/18 (10 decks)

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