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ENT > ENT Microbiology > Flashcards

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
Q

What are the most common bacteria involved in AOM?

A

Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes

26
Q

What is acute sinusitis?

A

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
Q

What commonly causes otitis externa?

A 
Staphylococcus aureus 
Proteus spp.
Pseudomonas aeruginosa – seen in swimmers 
Aspergillus niger		
Candida albicans
28
Q

Define otitis externa.

A

Inflammation of the outer ear canal

29
Q

Waht is the typicla presentation of otitis externa?

A

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
Q

If the ear canal becomes blocked due to swelling or secretions in otitis externa what can be affected?

A

Hearing (conductive)

31
Q

What is the management of otitis externa?

A

Topical aural toilet – wash out ear properly
Swab reserved for unresponsive cases
Treat depending on culture results – topical clotrimazole for aspergilus niger

32
Q

What virus causes infective mononucleosis/glandular fever?

A

Epstein Barr Virus

EBV

33
Q

What are the 3 cardinal signs of infective mono?

A

Fever
Pharyngitis
Lymphadenopathy

34
Q

What other signs and symptoms can be present in infective mono?

A

Jaundice/ hepatitis, rash, leucocytosis, large numbers of atypical lymphocytes in blood film, splenomegaly (friable and prone to damage), palatal petechiae

35
Q

What should not be given in glandular fever and why?

A

Amoxicillin or ampicillin

Florid red rash occurs

36
Q

In terms of WBCs what happens in glandular fever?

A

Large number of atypical ymphocytes

37
Q

Give the compications of infective mononucleosis?

A

Anaemia, thrombocytopenia, splenic rupture, upper airway obstruction, increased risk of lymphoma esp. in immunosuppressed

38
Q

What is the treatment for infective mono?

A

Bed rest, Paracetamol, avoid sport, antivirals not clinically effective, corticosteroids may have some role in some complicated cases

39
Q

What types of Herpes SImpex virus cause oral and genita lesions?

A

Type 1 and Type 2

40
Q

What causes primary gingivostomatitis? Who does it occur in?

A

HSV Type 1

Disease of pre-school children

41
Q

Can anything be given for primary gingivostomatitis? How long can it take to recover?

A

Yes - acyclovir treatment

Up to 3 weeks to recover

42
Q

How does herpes simplex encephalitis present?

A 
Temporal lobe necrosis 
Fever 
altered mental state 
seizures 
CNVII palsy
43
Q

What causes herpangina?

A

Coxsackie virus

44
Q

How does herpanagina present and in whom?

A

Vesicles/ ulcers on soft palate

Pre-school children

45
Q

What causes hand, foot and mouth disease?

A

Coxsackie virus

46
Q

How is infective mononucleosis diagnosed?

A

+ve Monospot or Paul-Bunnell test
Atypical lymphocytes in blood
Low CRP (100 then bacterial)

ENT (4 decks)

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