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ENTJaz > ENT microbiology > Flashcards

ENT microbiology Flashcards

1
Q

if have sore throat and stridor = absolute indication for __

avoid ___

A

hospital admission

dont examine throat

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2
Q

pain at back of mouth can be __/__ usually caused by viral (or bacterial) infection

A

pharyngitis and tonsillitis

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3
Q

complications of a tonsillitis/pharyngitis =

A

otitis media (most common)
quinsy
parapharyngeal abscess
mastoiditis

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4
Q

viral + bacterial causes of tonsillitis/pharyngitis

A 
cold/flu usually
strep
HIV
gonococcal pharyngitis
diphtheria
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5
Q

if >=2wk sore throat and 15-25yo suspect

A

mono

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6
Q

treatment of pharyngitis/tonsillitis =

A

paracetamol/ibuprofen
warm salty water
if bacterial = phenoxymethylpenicillin

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7
Q

a high centor score increases the likelihood of __ being the causative organism of tonsillitis

A

srtep pyogenes

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8
Q

late complications of strep throat =

A 
rheumatic fever (3wks after sore throat)
glomerulonephritis (1-3wk post sore throat)
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9
Q

severe sore throat with pseusomembrane across pharynx =
exotoxin is __+__ toxic
increasing incidence in ___

A

diphtheria
neuro and cardiotoxic
Russia

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10
Q

treatment of diptheria

A

antitoxin

supportive penicillin/ erythromycin

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11
Q

thrush organism -

appearance =

A

candida albicans

white patches on red raw mucous membranes

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12
Q

treatment of thrush

A

nystatin

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13
Q

acute otitis media usually occurs in __+__ due to a ___ spreading through the ___ to the middle ear

A

infants and kids
URTI
eustachian tube

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14
Q

cause of otitis media is usually __

with a secondary ___ infection - org.s =

A

viral

bacterial - H influ, Strep. pneumoniae, strep pyogenes

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15
Q

can only swab pus in acute otitis media if __

A

eardrum is perforated

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16
Q

treatment for acute otitis media =

A

80% resolve themselves in 4 days

Abx = amoxicillin (erythromycin if allergy)

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17
Q

discomfort over frontal/maxillary sinus in patients with a viral URTI =

A

acute sinusitis

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18
Q

severe pain and tenderness in acute sinusitis suggests __

A

2ndry bacterial infection

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19
Q

treatment for acute sinusitis

A

only Abx if >10 days and severe/deteriorating
1st line = penicillin V
2nd = doxycyline (NOT IN KIDS)

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20
Q

s+s of otitis externa =

A 
red and swollen skin of ear canal
maybe itchy
may become sore and painful
may have discharge/increased wax
hearing may be affected
21
Q

malignant otitis externa = extends to __+__ and possibly __+__

A

mastoid and temporal bone

skull and meninges

22
Q

s+s of malignant otitis externa

A 
pain
headache v severe
granulation tissue at bone-cartilage junction
exposed bone in ear canal
CNVII palsy
23
Q

investigations for malignant otitis externa =

A

PV, CRP, image, biopsy, culture

24
Q

usual organism of malignant otitis externa

A

pseudomonas aeruginosa

25
Q

risk factors for malignant otitis externa =

A

diabetes

head and neck radiotherapy

26
Q

causative organisms of otitis externa =

A 
aspergillus niger
candida albicans
S. aureus
proteus spp
Pseudomonas aeruginosa (more likely to cause malignant OE)
27
Q

treatment for otitis externa -

A 
topical aural toilet
if severe/resistant = culture => gentamicin 0.3% drops or
topical clotrimazole (= canasten - for aspergillus niger)
28
Q

triad seen in infective mononucleosis

A

fever
pharyngitis
lymphadenopathy

29
Q

signs and symptoms of infective mononucleosis

A 
hepatitis/jaundice
rash
leucocytosis
atypical lymphocytes (large and irregular)
splenomegaly
palatal petechiae
30
Q

duration of fever pharyngitis and lymphadenopathy in mono

A

fever and pharyngitis = 2-4 wks

lymphadenopathy = 4wks

31
Q

complications of mono =

A

anaemia (AI and related to steroids)
thrombocytopaenia
upper airway obstruction
increased lymphoma risk

32
Q

causative agent of mono

establishes itself in __ cells

A

EBV

epithelial

33
Q

treatment for mono =

A

bed rest
no sport for 6 wks
paracetamol
steroids if haem anaemia/ upper airway obstruction

34
Q

lab confirmation of mono =

A

EBV IgM
heterophile antibody - Paul-Bunnell and monospot tests
FBC and film
LFTs

35
Q

similar illnesses to mono

A

CMV (no heterophile Ig and fewer atypical lymphocytes)
toxoplasmosis
primary HIV -seroconversion illness, also have diarrhoea

36
Q

HSV__ is acquired in kids and causes oral lesions

infection is through ___

A

1

salivary contact

37
Q

primary gingivostomatitis is caused by ___ and affects ___
s+s =
Rx =
time to recovery =

A 
HSV
pre-schoolers
systemic upset
lips buccal mucosa and hard palate 1-2mm vesicles, ulcers
fever
local lymphadenopathy
aciclovir
around 3wks
38
Q

latency of HSV1 is in ___ and reactivation leads to __

A

CN V

cold sores

39
Q

herpetic whitlow =

A

tip of finger infection with HSV

40
Q

confirmation of presence of HSV is by

A

PCR

41
Q

herpangina is caused by ___
manifests as __
usually affects ___
Ix =

A

coxsackie (enterovirus)
vesicle/ulcers on soft palate
pre-schoolers
PCR

42
Q

Hand foot and mouth is caused by ___

A

coxsackie (enterovirus)

43
Q

appearance of aphthous ulcers =

A

recurring and painful

round/ovoid and inflammatory halo

44
Q

recurrent oral ulcers caused by systemic disease =

A 
Behcets
coeliac
IBD
Reiters
drugs
pemphigus
pemphigoid
45
Q

painless indurated ulcer =

A

primary syphilis - chancre

46
Q

why PO amoxicillin over penicillin in acute OM

A

better oral absorption (also covers more organisms)

47
Q

in hospital this test is done to confirm mono as it is the most specific

A

clotted blood for IgM

48
Q

systemic antifungal =

A

IV ampotericin

49
Q

___ given for strep throat not amoxicillin because ___

A

penicillin

not worried about H. influenza so don’t need the broader spectrum

ENTJaz (6 decks)

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