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ENT Week 1 2017/18 > 7: Microbiology > Flashcards

7: Microbiology Flashcards

1
Q

A sore throat with stridor or respiratory distress is an indication for what?

A

Admission

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2
Q

Why shouldn’t you examine an inflamed throat?

A

Could make inflammation (i.e epiglottitis) worse and constrict throat

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3
Q

What throat infections cause pain at the back of the mouth?

A

Acute pharyngitis

Tonsilitis

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4
Q

What tends to cause throat infections?

A

Viruses

Bacteria

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5
Q

In which groups do acute throat infections usually occur?

A

Younger people (< 25 years)

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6
Q

Acute throat infections are often complicated by which diseases?

A

Otitis media

Quinsy

Parapharyngeal abscess

Mastoiditis

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7
Q

What is the course of most acute throat infections?

A

Resolve within 1 week - self-limiting

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8
Q

Should acute throat infections be swabbed?

A

Not routinely

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9
Q

What should you suspect if a sore throat and lethargy last more than 2 weeks in a young person?

A

Glandular fever

(infectious mononucleosis)

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10
Q

If someone has a persistent sore throat and a neck mass, what should you suspect?

A

Pharyngeal cancer

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11
Q

Which score is used to predict which acute throat infection patients would actually benefit from antibiotics?

A

Centor clinical prediction score

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12
Q

The vast majority of sore throats (do / do not) require antibiotics.

Why?

A

do not

viral

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13
Q

What are the most common bacterial causes of sore throat?

A

GAS

Strep. pyogenes

gram +ve chains

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14
Q

How would a Strep. pyogenes throat infection be treated?

A

Penicillin

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15
Q

What are rare complications of GAS throat infections causing:

a) fever, arthritis
b) acute renal failure?

A

a) Rheumatic fever

b) Glomerulonephritis

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16
Q

Which organism produces a grey white membrane across the throat which is an exotoxin?

What is the disease called?

A

Corynebacterium diptheriae

Diptheria

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17
Q

What is the classical feature of diptheria?

A

Pseudomembrane

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18
Q

Is diptheria common in the UK?

A

No

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19
Q

What sort of vaccine is given for diptheria?

A

Inactivated vaccine

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20
Q

How is diptheria treated?

A

Supportive therapy

Diptheria antitoxin

Penicillin

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21
Q

What causes oral thrush?

A

Candida

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22
Q

What does oral thrush look like?

A

White patches on inflamed membranes in throat and mouth

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23
Q

How is oral thrush treated?

A

Nystatin (anti-fungal)

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24
Q

What is acute otitis media?

What is the main symptom?

A

Middle ear infection

Earache

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25
Q

What commonly causes otitis media?

A

Most are VIRAL

Bacterial - Strep. pneumoniae, H. influenzae, Strep. pyogenes

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26
Q

In which situation only can you obtain a swab of pus in otitis media?

A

Perforation of tympanic membrane

which is obviously really bad

27
Q

How is otitis media treated?

A

Supportive (viral)

Bacterial: amoxicillin > erythromycin

28
Q

What is acute sinusitis?

A

Mild discomfort over sinuses often seen in URTI

29
Q

When is acute sinusitis treated?

A

Secondary bacterial infection

Severe pain

30
Q

How is secondary bacterial sinusitis treated?

A

Penicillin IV

Doxycyline BUT NOT IN CHILDREN

31
Q

What is otitis externa?

A

Inflammation of external acoustic meatus (ear canal)

32
Q

What are the symptoms of otitis externa?

A

Inflammation of ear canal

Pain

Itch

Discharge

Loss of hearing

33
Q

What is malignant otitis externa?

A

Otitis externa which has turned into an osteomyelitis of mastoid and temporal bones

34
Q

Which bacteria usually causes malignant otitis externa?

A

Pseudomonas aeurginosa

35
Q

Which cranial nerve can be damaged by malignant otitis externa?

A

CN VII

Facial nerve palsy

36
Q

What bacteria cause otitis externa?

A

Staph. aureus

Pseudomonas

37
Q

People who ___ a lot can get otitis externa.

A

swim

38
Q

What is infectious mononucleosis?

Who gets it?

A

Glandular fever

Young adults

39
Q

What are the symptoms of infectious mononucleosis?

A

Fever

Enlarged lymph nodes

Sore throat (throat infection, pharyngitis, tonsilits)

Malaise, lethargy (lacking energy)

40
Q

What sign on histology is pathognomic of glandular fever?

A

Atypical T lymphocytes:

massive

blue stipled cytoplasm

smaller nucleus than normal (should take up the whole cell)

41
Q

What is the course of glandular fever?

A

3+ week duration but self-limiting

42
Q

What are haematological complications of glandular fever?

A

Haemolytic anaemia

Thromocytopenia

production of autoantibodies against RBCs and platelets

Splenic rupture

43
Q

What can enlarged tonsils cause in severe glandular fever?

A

Upper airway obstruction

44
Q

People who have had glandular fever are at increased risk of which blood cancer?

A

Lymphoma

45
Q

Which virus causes glandular fever?

A

Epstein Barr virus (EBV)

46
Q

What happens to patients

a) in early childhood
b) > 10 years old

who are exposed to EBV?

A

a) Rarely mono

b) Often mono

47
Q

How is glandular fever treated?

A

Bed rest

Avoid sport

Paracetamol

48
Q

Are antivirals given for glandular fever?

A

No, not effective

49
Q

What drug can be given for complications of glandular fever?

A

Steroids

50
Q

What investigations confirm EBV infection in glandular fever?

A

EBV IgM (early infection)

Specific antibody tests (e.g monospot)

Blood films (for increased numbers of lymphocytes)

LFTs (for jaundice)

51
Q

What should be checked in pregnant women with glandular fever?

A

Causal organism

(because CMV, toxoplasma can cause birth defects)

52
Q

If someone has glandular fever and tests negative for EBV, what important virus should they be tested for?

A

HIV

53
Q

Which type of HSV causes mouth ulcers?

A

HSV Type 1

54
Q

What disseminated skin infection are people with HSV1 susceptible to?

A

Eczema herpeticum

55
Q

How does HSV1 infection present on

a) primary infection
b) reactivation?

A

a) Gingivostomatitis

b) Cold sores

56
Q

What are people given if they suffer from recurrent mouth ulcers due to HSV1 infection?

A

Aciclovir

57
Q

Genital herpes is caused by both HSV1 and ___.

A

HSV2

58
Q

What is herpetic whitlow?

Who tended to get them?

A

Cold sores on fingers due to contact with HSV1 mouth ulcers

Dentists

59
Q

How is HSV infection confirmed in the lab?

A

Viral PCR

60
Q

What is the name for viral infection causing vesicles and ulcers on the back of the throat?

What organisms cause it?

A

Herpangina

Coxsackie virus

61
Q

What viral infection causes lesions on the hands, feet and mouth?

What causes it?

A

Hand, foot and mouth disease

Coxsackie virus

62
Q

What are apthous ulcers?

A

Mouth ulcers which aren’t associated with infection

i.e they’re inflammatory

63
Q

What organism causes syphilis?

A

Treponema pallidum

64
Q

What is the painless ulcer caused by primary syphilis infection?

A

Chancre

ENT Week 1 2017/18 (10 decks)

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