Eye & Ear Flashcards

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1
Q

Enumerate the defense mechanisms of the eye

A
  1. Eyelashes prevent the entry of foreign material
  2. They blink 15 to 20 times per minute so secretions of lacrimal glands & goblet cells can wash away bacteria
  3. Lysozymes & IgA
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2
Q

Mention the routes of infection of eye

A
  1. Direct contact esp with trauma, contact lenses, fomites, hands…etc
  2. Infection through the blood e.g. CMV or nervous system e.g. HSV
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3
Q

Infection of eyelid margins causes……while that of eyelid glands or follicles causes…..

A

Blepharitis
Sties

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4
Q

The general symptoms of eyelid infections

A

Irritation, redness, burning sensation, occasional itching

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5
Q

List the causative agents of conjunctivitis

A

Bac: S.aureus, S.pneumoniae, H.influenza, Moraxella, N.gonorrhea, C.trachomatis
Viruses: adenovirus, Enterovirus 70, Coxsackie virus A24, HSV-1, systemic infections, COVID-19

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6
Q

Mention the important virulence factors

A
  1. Cell-associated: protein A (binds Fc portion of Ig), clumping factor (bound coagulase), capsula (polysaccharide.
  2. Enzymes: free coagulase, beta lactamase
  3. Toxins: Alpha toxin (hemolytic), P-V leukocidin
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7
Q

Virulence factors of N.gororrhea

A
  1. Pili
  2. IgA protease
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8
Q

Describe the structure of:
1. Adenovirus
2. Enterivirus 70 & Coxsackie virus A24
3. HSV-1

A
  1. Non-enveloped ds-DNA
  2. Non-enveloped ss-RNA
  3. Enveloped ds-DNA
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9
Q

Describe the ocular diseases caused by adenovirus and their C/P

A

-Non-specific follicular conjunctivitis
-Acute pharyngoconjunctival fever in children having triad of fever, pharyngitis & conjunctivitis (swimming pool conjunctivitis)

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10
Q

Ocular disease caused by Enterivirus 70 & Coxsackie virus A24 is…..

A

Acute severe hemorrhagic conjunctivitis

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11
Q

N.gonorrhea & C.trachomatis may result from……

A

Autoinoculation from a genital infection (via hands & fomites)

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12
Q

Describe clinical manifestations of conjunctivitis

A

Red eye with excessive lacrimation, purulent sticky discharge in case of bacterial & watery discharge in case of viral infection. May start in one eye & spread to the other.

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13
Q

List the causative agents of neonatal conjunctivitis in order of frequency

A
  1. C.trachomatis
  2. N.gonorrhea
  3. S.aureus
  4. S.pneumoniae
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14
Q

Mention preventive measures of neonatal conjunctivitis

A

Application of erythromycin eye drops or oinment immediately after delivery plays imp role in prevention of gonococcal infections. Oral erythromycin is preferred in chlamidial conjunctivitis prevention

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15
Q

All chlamidiae share…..detected by….., they also posses immunotype-specific proteins fetected by……

A

Group-specific lipopolysaccharide antigen, complement fixation test
Immunofluoresecnce

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16
Q

…….types of C.trachomatis cause trachoma, while…..cause genital infections that when transmitted to the eye cause….

A

A,B,C
D-K
Inclusion conjunctivitis

17
Q

C.trachomatis has….serotypes

A

15

18
Q

C.trachomatis target cells are…..

A

Cells of conjunctiva

19
Q

Describe replication cycle of C.trachomatis

A

The cycle begins when extracellular, metabolically inert, “spore-like” elementary body enters the cell and reorgamizes into a larger metabolically actove reticulate body. This replicates within the inclusion body by binary fission which gives rise to elementary bodies released from cell.

20
Q

Infants born to infected mothers develop……..

A

Mucopurulent neonatal inclusion conjunctivitis

21
Q

Features that set inclusion conjunctivitis apart from glaucoma

A

The cornea is not affected, usually affects lower eyelid. Recovery is the rule.

22
Q

What is Reiter’s syndrome

A

An autoimmune disease caused by Abs against C.trachomatis cross-reacting with antigens on cells of joints, uveal tract, urethra.

23
Q

The best lab diagnosis for C.trachomatis infectoon are…

A

Nucleic acid amplification tests such as PCR

24
Q

Describe pharma. treatment of trachoma

A
  1. Newborns: tetracycline or erythromycin cream for 10-14 days
  2. Adults: oral tetracycline,doxycycline or erythromycin for 3-6 weeks
25
Q

Mention a fungus causing keratitis

A

Fusarium solani

26
Q

Enumerate important virulence factors of P.aeruginosa

A
  1. Produces exotoxin A which inactivates elongation factor-2.
  2. Pili and capsule are virulence factors that mediate attachment and inhibit phagocytosis respectively.
27
Q

HSV reactivation in…..can cause dentritic ulcer

A

Ophthalmic division of trigeminal ganglia

28
Q

Adenovirus serotype…..cause conjunctivitis while serotype…..cause EKC

A

3
8 & 19

29
Q

Describe treatment of viral keratoconjujctivitis

A

Topical and oral acyclovir are used in treatment of HSV
Oral acyclovir is used in treatment of herpes zostet ophthalmicus

30
Q

Mention diagnostic specimen of eye infections and tests

A

Conjunctival swab/corneal scrapings
Bacterial: inoculation on blood and chocolate agar with 5-10% CO2. Isolated colonies are identified by Gram stained films and biochemical tests.
For viral infection: PCR

31
Q

……causes chorioretinitis in AIDS patients

A

CMV

32
Q

Mention 2 viruses causing neonatal ocular and manifestation and describe the symptoms

A

CMV, Rubella
Cataract, microphthalmia,severe chorioretinitis

33
Q

Acute localized otitis externa is caused by….while diffuse type is caused by…..and related to…..

A

S.aureus
P.aeruginosa
Maceration

34
Q

Malignant otitis externa is caused by…..and seen in…..

A

P.aeruginosa and anaerobes
DM patienta

35
Q

The most common bacterial pathogen causing otitis media is….

A

S.pneumoniae

36
Q

Enumerate viral pathogens causing otitis media and describe their structure

A
  1. RSV: belongs to paramyxovirus family. Non segmented -sense/ssRNA
  2. Coronaviruses: enveloped +sense/ssRNA. Helical nucleocaspid
  3. Rhinovirus (most common): picronavirus, +sense/ssRNA.
37
Q

GR: Follow up is important in otitis media

A

As residual fluid may lead to chronicity, resulting in hearing impairment.