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DAST 7 Exam 2 > Eye Infections - 5Qs > Flashcards

Eye Infections - 5Qs Flashcards

1
Q

Def. bacterial conjunctivitis

A

Inflammation of conjunctiva due to bacterial inf

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2
Q

List possible etiology of bacterial conjunctivitis (BC)

A 
Mechanical / irritative/ toxic
Allergic
Infectious (bacterial and virus)
Immune mediated
Neoplastic

MAIIN

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3
Q

What are the most common bacterial pathogens resp 4 BC in neonates?

A 
C. Trachomatis
H. Influenzae
Staphylococcus aureus
Streptococcus Pnuemoniae
N. gonorrhoeae

C HSSN

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4
Q

What are the most common bacterial pathogens resp 4 BC in children?

A

H. Influenzae
S. aureus
S. pneumoniae

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5
Q

What are the most common bacterial pathogens resp 4 BC in adults?

A

H. Influenzae
S. aureus
S. pneumoniae
Coagulase-negative staph org

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6
Q

Name risk factors for BC wrt

  • eye
  • inf
  • sex
A

Disorders of the tear ducts, eyelids, or tear film

Adjacent inf e.g. Dacryocystitis

Sexual abuse and sex with multiple persons - gonococcal and chlamydia inf

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7
Q

What’s the clinical presentation of C. trachomatis in neonates?

A

Conjunctival inj (dilation of conjunctival vessels) and eyelid edema

Purulent unilateral or bilateral ocular discharge one week after delivery from a chlamydia-infected mother

50% of neonates have chlamydia pnuemoniae

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8
Q

What’s the clinical presentation of N. gonorrhea in neonates?

A

Hyperacute inf

Rapid onset of conjunctival inf and eyelid edema

Eyes glued shut

Corneal involvement and perforation

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9
Q

What’s the clinical presentation of H. influenzae in children?

A

Xtics by concurrent upper respiratory tract inf and conjunctivitis otitis syndrome

75% of children

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10
Q

What’s the clinical presentation of S. pneumoniae in children?

A

Xtics by conjunctivitis-otitis syndrome

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11
Q

What’s the clinical presentation of staphylococci aureus in adults?

A

Associated with chronic blepharo-conjunctivitis

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12
Q

List complications BC.

A

Corneal scarring and perforation

Loss of vision

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13
Q

List diagnosis for BC

A

Comprehensive medical eye exam (Main)

Conjunctival cultures

Smears for cytology and stains (gram, giemsa)

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14
Q

When is Conjunctival cultures indicated?

A

Suspected infectious neonatal conjunctivitis

Recurrent or severe purulent conjunctivitis

Non-responding conjunctivitis

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15
Q

When is Smears for cytology and stains (gram, giemsa) indicated?

A

Suspected infectious neonatal conjunctivitis

Chronic or recurrent conjunctivitis

Suspected gonococcal conjunctivitis

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16
Q

What pathogens cuz BC that need to be treated systematically?

A

N. gonorrhoeae

C. trachomatis

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17
Q

When is topical tx preferred in BC?

A

Non-chlamydial and non- gonorrhoeae causes of BC

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18
Q

What medication should be avoided in BC?

A

Corticosteroids - may worsen herpetic keratitis

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19
Q

What’s the 1st line for BC caused by N. gonorrhoeae in neonates, children and adults?

A

Ceftriaxone

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20
Q

What’s the 1st line for BC caused by C. trachomatis in neonates and children < 45kg?

A

Erythromycin/ ethylsuccinate (EES, Ery-Tab, Erythrocin)

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21
Q

What’s the 1st line for BC caused by C. trachomatis in children > 45kg but < 8yr, children >= 8yr and adults?

A

Azithromycin (Zithromax)

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22
Q

List topical tx options for BC.

A

Bacitracin ung

Ciprofloxacin ung

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23
Q

What pt education is applicable to BC?

A

No contact lenses

Avoid rubbing and touching eyes to spread inf

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24
Q

What is the etiology of Viral Conjunctivitis (VC)

A

Adenoviral

Herpes Simplex Virus (HSV)

Varicella Zoster Virus (VZV)

Molluscum contagiosum

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25
Q

Name risk factors for VC?

A

Blepharitis (eyelid inflammation)

Poor hand hygiene

Other causes of ocular surface inflammation

Dry eye

B- POD

26
Q

What are the clinical presentations of Adenoviral?

A

ABRUPT onset

Lymphadenopathy, petechial, and subconjuntival hemorrhages

27
Q

What are the clinical presentations of HSV?

A

Unilateral conjunctival inj, watery discharge

Vesicular rash or ulceration of eyelids

28
Q

What are the clinical presentations of VZV?

A

Unilateral or bilateral conjunctival inj, watery discharge

Vesicular rash or ulceration of eyelids

29
Q

What are the clinical presentation of Molluscum contagiosum?

A

Unilateral or bilateral

Shiny dome-shaped lesion of eyelid

30
Q

What are the complications of VC?

A

Scarring, infiltrates and necrosis

Perforation

Uveitis

Keratitis

Loss of vision

31
Q

How do you diagnose VC?

A

Comprehensive medical eye evaluation

Culture NOT routinely done in VC

32
Q

What should be avoided in the treatment of VC?

A

Topical AB and topical corticosteroids

33
Q

How do you treat VC caused by Adenoviral?

A

No effective tx

34
Q

What may be considered in Adenoviral?

A

Sx control e.g.

Artificial tears
Topical antihistamine
Cold compresses

35
Q

How do you treat VC caused by Molluscum contagiosum?

A

Req Surgical removal of lesions

36
Q

How do you treat VC caused by HSV?

A

Trifluridine 1% solution (Viroptic)

Acyclovir (Zovirax)

37
Q

How do you treat VC caused by VZV?

A

Acyclovir (Zovirax)

38
Q

What’s the pt education for VC?

A

Same as BC

39
Q

Define Blepharitis.

A

Sty in the eye (inflammation of eyelid)

40
Q

What’s the etiology of Blepharitis?

A

Staphylococcus epidermidis
S. aureus
Seborrheic
Meibomian gland dysfunction (MGD).

41
Q

Name risk factors for Blepharitis.

A

Rosacea (main RF)

Aqueous tear deficiency

Isotretinion (Accutane)

Contact lens associated conjunctivitis

42
Q

What’s the clinical presentation of Blepahritis caused by staphylococcus?

A

Scaling crusting of the eyelid

Loss and misdirection of eyelashes, eyelid scarring

Conjunctival injection, tear deficiency, corneal involvement

43
Q

What’s the main complication of Blepharitis?

A

Keratitis

44
Q

How do you diagnose Blepharitis?

A

Same as VC.

45
Q

When is culture indicated in Blepharitis?

A

Recurrent B with severe inflammation

Hx of non-response to AB

46
Q

What’s the preferred tx for B?

A

Topical AB e.g.

Bacitracin or Erythromycin X 1 week

47
Q

What’s the recommended tx for chronic MGD Blepharitis?

A

Doxycycline

Monocycline

48
Q

When is the recommend tx for chronic MGD Blepharitis contra-indicated?

A

Pregnancy
Lactation
Children < 10yr

49
Q

Name the 4 main pathogens responsible for Bacterial Keratitis.

A

Gram tve cocci

Gram tve bacilli

Gram - ve bacilli

Gram -ve coccobacilli

50
Q

What’s the clinical presentation of Bacterial keratitis?

A

Eye redness, pain and swelling
Ocular tearing or discharge
Increased light sensitivity
Blurry vision

51
Q

What the complication of BK?

A

Corneal scarring, irregularities, perforation

Endophthalmitis

Loss of vision

52
Q

How’s BK diagnosed?

A

Comprehensive medical eye exam

53
Q

When’s culture and smears needed for BK?

A

Large extensive corneal infiltrate

Chronic or non-responsiveness keratitis

Atypical clinical presentation

Unusual hx

Sight-threatening or severe keratitis

54
Q

When’s corneal biopsy indicated?

A

Non-responsive and has negative cultures

55
Q

What is the preferred route of tx for BK?

A

Topical AB eyedrops or ointment

56
Q

What’s the preferred tx for BK caused by no m.o. Identified or multiple m.o. identified? And Gram tve cocci

A

Cefazolin

57
Q

What’s the preferred tx for BK caused by gram tve bacilli - Mycobacterium species?

A

Amikacin

58
Q

What’s the preferred tx for BK caused by gram - ve rods?

A

Tobramycin or Gentamicin

59
Q

What’s the preferred tx for BK caused by gram -ve cocci?

A

Ceftriaxone

60
Q

What AB is reserved for if all else fails in BK tx?

A

Topical corticosteroids

DAST 7 Exam 2 (9 decks)

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