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ENT Microbiology Flashcards

1
Q

What is the most common cause of a sore throat and what should be given?

A

> 2/3rds are viral

No antibiotics given

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2
Q

What is the most comon cause of a sore throat cauing acute tonsillitis?

A

Strep pyogenes

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3
Q

What are the complications of a stretococcal sore throat?

A 
Peritonsillar abscess (Quinsy) 
Sinusitis/ Otitis media 
Scarlet fever 
Rheumatic fever - late complication 
Post-Strep GN - late complication
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4
Q

What causes diptheria?

A

Corynebacterium diptheriae

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5
Q

What is the clinical picture of someone with Diptheria?

A

Severe sore throat with a grey white membrane across the pharynx
Organism produces a potent exotoxin which is cardiotoxic and neurotoxic

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6
Q

What is the treatment for diptheria?

A

antitoxin and supportive measures and penicillin/ erythromycin

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7
Q

What organism causes oral thrush?

A

Candida albicans

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8
Q

How does thrush present?

A

White patches on red. raw mucous membranes in throat and mouth

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9
Q

What shoud be given for oral thrush?

A

Nystatin and review if antibiotic use if required (what they are on)

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10
Q

What are the risk factors for oral thrush?

A 
Oral or Inhaled steroids
Oral antibiotics 
Inflant or elderly 
Immunosuppressed
Wearing dentures 
Diabetes 
Undergoing chemotherapy or radiotherapy
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11
Q

What causes acute otitis media?

A

Upper respiratory infection involving the middle ear by extension of infection up the eustachian tube

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12
Q

What is the clinical picture of acute otitis media?

A

Intensely painful ear
May have fever
Buldging tympanic membrane on otoscope

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13
Q

What are the most common bacterial causes of acute otitis media?

A

Haemophilus influenzae
Streptococus pneumoniae
Streptococcus pyogenes

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14
Q

What % of AOM resolve spontaneously?

A

80% resolve within 4 days without AB

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15
Q

When should immediate AB be considered? Which ones should be given?

A

Bilateral AOM in

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16
Q

What else can be performed for AOM?

A

Myringotomy - send fluid for culture

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17
Q

What is otitis media with effusion?

A

OME
“glue ear”
Fluid often thick sticky glue accumulates in the middle ear behind an intact drum as the ET is blocked

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18
Q

What maye be seen on otoscopy in OME?

A

Fluid level/menisci

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19
Q

What are the complications of glue ear?

A

Speech may be dealyed

Behavioural problems

20
Q

What treatments can be used for OME?

A

Grommet insertion or hearing aid

21
Q

What causes acute otitis media?

A
  1. Organisms invade the mucous membrane causing inflammation, oedema, exudate and later pus
  2. Oedema closes the Eustachian tube, preventing aeration and drainage
  3. Pressure from the pus rises, causing the drum to bulge and perforate
  4. Most cases resolve completely. A small number cause complications or persistent perforation.
22
Q

What is chronic otitis media?

A

Eardrum is perforated ad failed to heal so ongoing infection

23
Q

What can cause chronic otitis media?

A

Late or inadequate treatment of AOM
Upper airway sepsis
Lowered resistance (malnutrition anaemia, immunological impairment)

24
Q

What treatment is required for chronic otitis media?

A

Myringoplasty - repairs ear drum and restores hearing loss

25
What are the most common bacteria involved in AOM?
Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes
26
What is acute sinusitis?
Mild discomfort over frontal or maxillary sinuses due to congestion often seen in patients with upper respiratory viral infections. However, severe pain and tenderness with purulent nasal discharge indicates secondary bacterial infection
27
What commonly causes otitis externa?
``` Staphylococcus aureus Proteus spp. Pseudomonas aeruginosa – seen in swimmers Aspergillus niger Candida albicans ```
28
Define otitis externa.
Inflammation of the outer ear canal
29
Waht is the typicla presentation of otitis externa?
Redness and swelling of he skin of the ear canal May be itchy Can become sore May be discharge, or increased amounts of ear wax
30
If the ear canal becomes blocked due to swelling or secretions in otitis externa what can be affected?
Hearing (conductive)
31
What is the management of otitis externa?
Topical aural toilet – wash out ear properly Swab reserved for unresponsive cases Treat depending on culture results – topical clotrimazole for aspergilus niger
32
What virus causes infective mononucleosis/glandular fever?
Epstein Barr Virus | EBV
33
What are the 3 cardinal signs of infective mono?
Fever Pharyngitis Lymphadenopathy
34
What other signs and symptoms can be present in infective mono?
Jaundice/ hepatitis, rash, leucocytosis, large numbers of atypical lymphocytes in blood film, splenomegaly (friable and prone to damage), palatal petechiae
35
What should not be given in glandular fever and why?
Amoxicillin or ampicillin | Florid red rash occurs
36
In terms of WBCs what happens in glandular fever?
Large number of atypical ymphocytes
37
Give the compications of infective mononucleosis?
Anaemia, thrombocytopenia, splenic rupture, upper airway obstruction, increased risk of lymphoma esp. in immunosuppressed
38
What is the treatment for infective mono?
Bed rest, Paracetamol, avoid sport, antivirals not clinically effective, corticosteroids may have some role in some complicated cases
39
What types of Herpes SImpex virus cause oral and genita lesions?
Type 1 and Type 2
40
What causes primary gingivostomatitis? Who does it occur in?
HSV Type 1 | Disease of pre-school children
41
Can anything be given for primary gingivostomatitis? How long can it take to recover?
Yes - acyclovir treatment | Up to 3 weeks to recover
42
How does herpes simplex encephalitis present?
``` Temporal lobe necrosis Fever altered mental state seizures CNVII palsy ```
43
What causes herpangina?
Coxsackie virus
44
How does herpanagina present and in whom?
Vesicles/ ulcers on soft palate | Pre-school children
45
What causes hand, foot and mouth disease?
Coxsackie virus
46
How is infective mononucleosis diagnosed?
+ve Monospot or Paul-Bunnell test Atypical lymphocytes in blood Low CRP (100 then bacterial)

ENT (4 decks)

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