ENT Antibiotics and a lil bit of microbiology

Question 1

Which pathogen causes epiglottitis?

Answer 1

H. influenza

Question 2

Treatment of epiglottitis?

Answer 2

Ceftriaxone (IV)

Question 3

Commonest BACTERIAL cause of tonsillitis?

Answer 3

Group A beta haemolytic strep.

i.e. strep pyogenes

Question 4

Antibiotic choice for beta-haemolytic streptococci (group A, B, C & G) tonsillitis?

Answer 4

Penicillin

Question 5

Potential serious complications of streptococcal sore throat?

Answer 5

Rheumatic fever

Glomerulonephritis

Question 6

First line antibiotic choice in acute sinusitis and when would you prescribe antibiotics?

(also what’s second choice)

Answer 6

Penicillin V
Reserved for severe / deteriorating cases of >10 days duration.

Second line is doxycycline, but NOT IN CHILDREN.

Question 7

Common bacterial causes of otitis externa?

Answer 7

Staph aureus

Also pseudomonas aeruginosa

Question 8

Fungal causes of otitis externa?

Answer 8

Aspergillus niger

Candida albicans

Question 9

Management of otitis externa?

Answer 9

Bathe it

Swab to microbiology, and antibiotics for severe or persistent cases.
Base choice on microbiology results.

Question 10

When should you consider antibiotics in acute OTITIS MEDIA?

Answer 10

1) <2 years old and bilateral AOM
2) bulging membrane and marked multiple symptoms
3) otorrhoea

Question 11

First line antibiotic in acute otitis media?

Answer 11

Amoxicillin (5 days)

Clarithromycin if penicillin allergic

Question 12

What virus causes hand, food and mouth disease?

Answer 12

Coxackie viruses (enteroviruses)

Question 13

How is hand, foot and mouth disease diagnosed?

Answer 13

Clinically or PCR test of swab

Question 14

Bacterial cause of syphilis?

Answer 14

Treponema pallidum

Question 15

A patient presents with severe sore throat causing dysphagia associated with pyrexia, present for 3 days.

What’s the most suitable antibiotic choice?

Answer 15

Benzylpenicillin

Question 16

What’s the best antibiotic choice in a penicillin-allergic patient with pyrexia, nasal obstruction, nasal discharge and facial pain?

Answer 16

Doxycycline

acute sinusitis

Question 17

Patient presents with a 2 day history of worsening sore throat, now causing complete dysphagia, drooling and recent onset of stridor.

What’s the antibiotic of choice?

Answer 17

Cefriaxone

epiglottitis