ENT infections

Question 1

what are oppourtunistic pathogens?

Answer 1

Opportunistic pathogen are members of the normal commensal bacteria that can cause disease when they find themselves in the wrong place

Most human infections are caused by opportunist pathogens

Question 2

What is otitis externa (swimmers ear) and how can it be difined?

Answer 2

Localsied otitis externa

diffuse ottis externa

<3 weeks- acute

>3 week chronic

Question 3

what are the signs and symptoms of otitis externa

Answer 3

signs

• ear canal/external ear- red and swollen
• discharge
• swelling
• inflammed ear drum

symptoms

• itch
• sevre ear pain
• pain whene ar is moved
• tenderness when moving the ear

Question 4

describe incidence of otitis externa

Answer 4

1% diagnosed each year

peak inciden at 7-12 years

prevalence increases at the end of summer

Question 5

what is occuring here?

Answer 5

localised otits media

Localised foliculutis- can progress to become a furnucle

extremely painful

Question 6

What is this?

Answer 6

more reddening and swelling

inflamamtion of the skin and subdermis of the external ear canl

can expan to external ear canal and the tympanic emebrane

Question 7

what is this

Answer 7

Malignnat otits externa

infection that spreads deeply to the tissues and bones of the external ear

Question 8

what is this? and what is the most likely causativer agent?

Answer 8

Fungal otitis Externa

Aspergillus species or Canddia albicans

cans see the spores/sprouting bodies

Question 9

what is the most common causative bacteria agent of localised Acute otitis externa

Answer 9

• Staphylococcus aureus

Question 10

what is generally the causative agent of acute diffuseotitis externa ?

Answer 10

Staphylococcus aures

and

Pseudomonas aeruginosa

Question 11

what is the Treatment for Localised and diffuse acute otttis externa (bacteria cause)

Answer 11

evidence shows Abx rarely need

only give for those at high risk or severe infection

Flucloxacillin

Question 12

Treatment for fungal infections in chronic otits externa?

Answer 12

clotrimazole 1% solution

acetic acid 2% spray

Question 13

what is acute Otits media

Answer 13

Acute otitis Media is inflammation in the middle ear with effusion and accompanied by a rapid onset of symptoms and signs of an ear infection

Question 14

symptoms of acute otitis media?

Answer 14

• ear pain
• dulled hearing- present for a few days
• fever
• ittitabel babay
• performated ear drum

Question 15

Prevalence of otits media?

Answer 15

mostly in young children- less common ina adults

1/2 million PC consultations per anum

Question 16

what is happening on the right image?

Answer 16

acute otitis media in 3 year old- swollen tympanic membrane

Question 17

what are the most common bacteria causes of acute Otitis Media

Answer 17

• streptococcus Pyrogenes
• Morezxella catarhallis
• streptococcus pneumoniae
• haemophillis influenzae

Question 18

Viral pathogens associated with Otitis Media?

Answer 18

RSV, rhinovirus, adenovirs, Influenza virus

Question 19

describe the treatment and management of AOM

Answer 19

• specialists if sevre or below 3 months
• if systetmically unwell
  
  • 5-7 day of amoxicillin
  • hosptial if worse
• generally most improve within 24 hours (60% of children) with AOM

Question 20

what is Otitis media with effusion (glue ear)

Answer 20

Similar to AOm but not acute inflaamtion

low grade chronic bacteria or viral infection

80% by age of 10

generally resolves within 6-10 weeks

Question 21

what is happening in the belwo image

Answer 21

otitis media with effusion- Glue ear

Question 22

describe the occurence of Otitis media and Measles

Answer 22

measles common cause of Profounf hearing loss in areas with low vaccination.

typically bilateral- modertae to prodund Sensorineural Hearing loss may follow Measles Encephalitis

bacterial infection associated to measles infection may also cause hearing loss

Question 23

What is difference between Labrythinthis and Vestibular neuritis? what do they cause

Answer 23

same thing- inteerchangabel

cause- sudden , spontaneous, sevre and often incpasciitng vertigo and nausa (vomiting frequently)

infection of inner ear

Question 24

causes of Labyrinthis/ VN

Answer 24

mostly viral and generally URTI though

HSV1 reactivation in the vestibular ganglion may be a cause

bacterial labyrinthinits more serious

Question 25

what is Sinusitis

Answer 25

Sinusitis is define as symptomatic inflammation of the paranasal sinuses

Acute sinusitis refers to sinusitis that completely resolves within 12 weeks

reccurent (4 or more ananula episdoes) or chornic ( more than 12 weeks

Question 26

what is acute sinusitis caused by?

Answer 26

normally caused by viral URTI

rhinovirus, RSV< parainfluenxa, influenza- rarely bacterial

if bacterial

Streptococcus pneumonia

Haemophilus influenza

Moraxella catarhallis

Staphylococcus aureus

Question 27

Treatment for sinusitis

Answer 27

• majority no Abx
• high risk or systemically unwell—–>phenoxymethylpenicllin

Question 28

what is this ?

Answer 28

pus exudate and swollen- tonsilitis/ acute pharyngitis

cause of sore throats- acute upper respiraotry tract infection affects mucosa of the throst

Question 29

what are the most common causes of sore throats in adults, childre, children bewlo 5

Answer 29

virus- 85-95% of throat infections adults

virus- 705 in children aged 15-16

virus 95% cases under 5

rhinovirus

coronavirus

parainfluenza virus

influenza type A and B

Question 30

what is the most common cause of bacterial sore throat?

Answer 30

Group A BH strep (GAHBS)

Question 31

rare causes of sore throat to consider

Answer 31

epstein bar- (gglandular fever)

Haemophilus influenza type b — can cause epiglottitis

Rare, vaccination

Candida albicans — causes pharyngitis.

Neisseria gonorrhoeae — can cause gonococcal pharyngitis

Question 32

Treatment ofr viral sore throat?

Answer 32

generally viral infection (can be bacterial) resolve within 2 weeks, self-limiting

spontaneosu reolve in 3 days in 40% of people

by 1 week 85% are symptom free

Fever pain score for antibitoics- Fever, purelnce, attend rapdily,s everely infallmed tonsi, no cough or coryza

likelihood of siolating strept- 4-5 prescrtibe AB

Question 33

common cause of Qunisy/peritosillar abscess

Answer 33

streptoccocus pyrogens

Staph aurea

haemophilus ifluenza

Question 34

what is this?

Answer 34

qunisy

Question 35

what is this and how is it detected? who is it seen in

Answer 35

inflammation of the epiglottis

stridor in chilren ()nosiey breathing ) emergency

usuall age 2-5 years- becoming rarer

Question 36

main causes of epilgotitis

Answer 36

β-haemolytic streptococci (groups A, B, and C)

Staphylococcus aureus

Streptococcus pneumoniae