ENT microbiology Flashcards
sore throat
- most commonly caused by what?
- most common causative organism in bacterial tonsillitis- describe
- treatment of bac tonsillitis
- complications (3)
- late complications (2)
- viral
- Strep pyogenes (Group A strep) Gram + cocci in chains
-use centaur criteria, if greater than 3 then:
oral penicillin, clarithromycin if allergic
-peritonsillar abscess
sinusitis or ottitis media
scarlet fever
-rheumatic fever (fever + arthritis + pericarditis)
Glomerulonephritis (haematuria + albuminuria + oedema)
Diptheria
- causative organism
- presentation
- complications
- treatment
- Corynebacterium diptheriae
- severe sore throat and grey white membrane across pharynx
- produces cardiotoxin and neurotoxin so risk of reps arrest
- vaccine or antitoxin + supportive + penicillin + erythromycin
Oral thrush
- causative organism
- presentation
- treatment
- candida albicans
- white patches on red/raw mucus membranes
- Nystatin suspension topically
Acute Otitis media
- What is it
- presentation
- causative organisms
- investigations
- treatment
- URTI involving the middle ear via the eustachian tube
- generally childhood, severe earache with pressure in ears, may cause perforation and discharge
- viral, if bacterial then haemophilus influenza, strep pneumoniae & strep pyogenes
- swab the pus if perforated
- immediate antibiotic treatment if bilateral or in
Acute sinusitis
- presentation (viral and bacterial)
- causative organisms
- treatment
- viral: mild discomfort over frontal or maxillary sinuses due to congestion with UR viral infection
bacterial: severe pain and purulent nasal discharge
-viral or haemophilus influenza, strep pneumoniae & strep pyogenes
-uncomplicated then should resolve in 14 days
complicated- penicillin 1st line the doxycycline
Otitis externa
- what is it
- presentation (4)
- causative organisms
- treatment
-inflammation of the outer ear
-redness and swelling of the outer ear skin and ear canal
may be itchy
can be sore and painful
may be discharge
-bacterial (staph aureus, proteus spp, pseudomonas aeruginosa)
fungal (Aspergillus Niger, candida albicans
- swab and treat dependant on culture
e. g. topical clotrimazole, topical gentamicin if pseudomonas
Infectious Mononucleosis
- presentation (triad + 6)
- Complications (4)
- causative organism
- treatment (3)
- lab confirmation (4)
- similar illness caused by viruses (3)
-young adults
triad: fever, lymphadenopathy, sore throat: pharyngitis
+tonsilltis, malaise/lethargy, jaundice/hepatitis, rash, lymphocytosis/atypical lymphocytes, splenomegaly, palatal petachiae
- anaemia & thombocytopenia,splenic rupture, upper airway obstruction, increased risk of lymphoma if immnosuppressed
- EBV
-bed rest & paracetamol
avoid sport
antivirals not effective, corticosteroids if complicated
-EBV IgM
heterophile antibody- paul-Bunnel test
FBC and blood film
also LFTs
-cytomegalovirus
toxoplasmosis
Primary HIV
name 2 viral causes of ulceration
Herpes simplex virus
Coxsackie virus
Herpes simplex virus
- type 1 presentation (6)
- treatment
- where does the virus lie latent
- reactivation causes what? (stimuli and treatment)
- what occurs when enters at nail?
- investigations
- HSV encephalitis- what is it?
childhood, primary gigivostomatitis
systemic upset, vesicles progressing to ulcers on the lips, bucal mucosa and hard palate
drool means the ulcers can be anywhere on body
fever and lymphadenopathy
- aciclovir
- Sensory nerve cell ganglia
-Cold sores
stress/immunosuppression
aciclovir
- Herpetic Whitlow
- swab and PCR
- massive temporal lobe necrosis + fever and change mental state
Herpangina
- what is it
- causative organism
- investigations
- vesicles on the soft palate, progress to ulcers
- coxsackie virus
- PCR
Hand foot and mouth disease
- causative organism
- presentation
- diagnosis
- coxsackie virus
- often children, sore throat progressing to ulceration in mouth, also get skin involvement: small raised erythematous lesions similar to chicken pox
- PCR
Apthous ulcers
- what are they?
- associated with systemic disease (5)
-recurring painful mouth ulcers, confined t mouth with no systemic disease, last less than 3 wks
-Behcet's disease ABD/coeliac Reiter's disease Drug reactions skin disease
Primary syphilis
-signs
-painless chancre (indurated ulcer) on the lips or genitals
