ENT - Microbiology

Question 1

Is Sore throat usually:

Viral/Bacterial?

Answer 1

Viral (over 2/3rds)

Question 2

Which bacteria is the most common cause of sore throat?

Answer 2

Streptococcus pyogenes

aka. Group A Strep/ Group A beta haemolytic Strep

Question 3

What is the clinical name for a bacterial sore throat cause by Strep pyogenes?

Answer 3

Acute follicular tonsillitis

Question 4

What is the antibiotic treatment of bacterial sore throat?

Answer 4

Penicillin

Question 5

What are the complications of streptococcal sore throat?

Answer 5

Rheumatic fever

Glomerulonephritis

Question 6

What are the clinical features of Diptheria?

Answer 6

Severe sore throat

Grey white pseudomembrane in the posterior pharynx

Question 7

Which bacteria is seen in oral candida/thrush?

Answer 7

Candida albicans

Question 8

What is acute otitis media?

Answer 8

An Upper Respiratory infection involving the middle ear

Question 9

Which group of people most likely get acute otitis media? And how do they present?

Answer 9

Infants and children

Present with earache

Question 10

Are middle ear infections viral or bacterial?

Answer 10

Often viral with with bacterial secondary infection

Question 11

Common causative bacteria of middle ear infections? (4)

Answer 11

Streptococcus pneumoniae
Haemophilus influenzae
Streptococcus pyogenes
Moraxella

Question 12

When is the only time a swab sample is able to be obtained in middle ear infection?

Answer 12

If the ear drum is perforated

Question 13

What is the recommended treatment for middle ear infections?

Answer 13

Most self-limiting
First line = amoxicillin
Second line = erythromycin

Question 14

What clinical features suggest a secondary bacterial infection in acute sinusitis?

Answer 14

Severe pain
Tenderness over sinuses
Purulent nasal discharge

Question 15

How long does acute sinusitis last?

How long does chronic sinusitis last?

Answer 15

Acute = <4 weeks
Chronic = >4weeks

Question 16

What are the 3 types of Otitis externa?

Answer 16

Localised otitis externa
Acute diffuse otitis externa
Chronic diffuse otitis externa

Question 17

What are the bacterial causes of otitis externa?

Answer 17

Most commonly bacterial
Staphylococcus aureus
Pseudomonas aeruginosa

Question 18

Who commonly gets bacterial otitis externa?

Answer 18

Swimmers

Question 19

Name two final causes of otitis externa

Answer 19

Aspergillus niger

Candida albicans

Question 20

When should you swab an otitis externa?

Answer 20

If it is unresponsive to ‘aural toilet’ (wash out of the external ear)

Question 21

What is the fancy name for glandular fever?

Answer 21

Infectious mononucleosis

Question 22

What are the clinical symptoms of glandular fever?

Answer 22

Fever
Enlarged lymph nodes
Sore throat/pharyngitis/tonsillitis
Malaise/Lethargy

Question 23

What virus is responsible for glandular fever?

Answer 23

Epstein-Barr virus (EBV)

Question 24

Which Type of Herpes simplex virus causes oral lesions and when is it acquired?

Answer 24

Type 1 (HSV1)
Acquired in childhood

Question 25

What name is given to a severe HSV1 infection?

Answer 25

Primary gingivostomatitis

Question 26

Which type of HSV give rise to cold sores (oral herpes)?

Answer 26

Type 1

Question 27

What technique is used to confirm HSV in the lab?

Answer 27

PCR test of swab in viral transport medium (for Viral DNA detection)

Question 28

Herpangina is ulcers on the soft palate. What virus causes it and how is it diagnosed?

Answer 28

Virus = coxsackie virus
Diagnosis = clinically or PCR test of swab in viral transport medium (for viral DNA detection)

Question 29

What other disease dies coxsackie virus also cause?

Answer 29

Hand, foot and mouth disease

Question 30

Apthous ulcers are non-viral.

True or False?

Answer 30

True