Infections

Question 1

Define acute rhinosinusitis and pathogen responsible

Answer 1

Symptomatic inflammation of nasal cavity and paranasal sinuses lasting less than 4 weeks.
usually Viral infection associated with common cold - symptomatic treatment

Question 2

Name 3 clinical features of acute otitis media

Answer 2

• White, bulging tympanic membrane
• marked erythema along malleus
• air fluid level in anterosuperior portion of Tm

Question 3

Name 7 red flag signs for referral of conjunctivitis

Answer 3

• Reduce visual acuity
• ciliary flush - pattern of injection in which redness most pronounced in ring at limbus (transition zone between cornea and sclera)
• photophobia
• severe foreign body sensation preventing patient from keeping eye open
• corneal opacity
• fixed pupil
• severe headache with nausea

Question 4

When should bacterial conjunctivitis be diagnosed?

Answer 4

Only if thick purulent discharge that continues throughout day, can be seen at lid margins and corner eye
Usually unilateral

Question 5

When should viral conjunctivitis be diagnosed?

Answer 5

• Present as injection, mucous or serous discharge and burning, sandy, gritty feeling in 1 eye.
• second eye usually involved in 24 to 48 hours
• profuse tearing rather than discharge
• tarsal conjunctiva may have follicular or bumpy appearance. May be enlarged and tender periauricular node.
• usually symptoms worse 3-5 days, gradual resolution over 2 to 3 weeks.

Question 6

Define blepharitis

Answer 6

Chronic inflammation eyelids with intermittent acute exacerbations

Question 7

Cause of anterior blepharitis ? (2)

Answer 7

Staphylococcal colonisation or seborrhea

Question 8

Cause of posterior blepharitis ?

Answer 8

Meibomian gland dysfunction which affects tear composition

May be associated with rosacea or seborrheic dermatitis

Question 9

Define keratitis and population at risk and complication

Answer 9

Inflammation of cornea
Almost exclusively in contact lens wearers
May progress to corneal ulceration with hypopyon within 24 hours!

Question 10

Pathogens responsible for keratitis? (4)

Answer 10

Mostly bacteria: S aureus and pseudomonas aeruginosa
Herpes simplex virus
Adenovirus

Question 11

Name 4 diagnostic findings bacterial keratitis

Answer 11

• Corneal opacity or infiltrate! Typically round white spot
Associated with red eye, photophobia, foreign body sensation
Refer urgently!

Question 12

Define hordeolum and 2 types

Answer 12

Stye. Acute purulent inflammation of eyelid
May be sterile or infections: S aureus
Internal: inflammation meibomian gland just under conjunctival side eyelid
External: true Stye. From eyelash follicle or lid margin tear gland

Question 13

Treatment of hordeolum?

Answer 13

Warm compresses (stye)

Question 14

Complication hordeolum (stye)?

Answer 14

Chalazion (hardens- may need incision and curettage)

Question 15

Name 5 pathogens responsible for UTI and most common one

Answer 15

• E. coli most common
. Proteus
. Klebsiella
• enterobacter
• Staph less common

Question 16

Name 6 organisms commonly associated with pneumonia

Answer 16

• S pneumonia. (Gram positive )
• atypical: mycoplasma pneumonia, chlamydia pneumonia, legionella
• Resp viruses eg adenovirus
• h influenza
• aerobic gram negative bacilli eg klebsiella pneumonia
• S aureus

Question 17

What is pseudoephedrine used for?

Answer 17

Nasal decongestion

Sympathomimetic

Question 18

Name 3 helminth types and examples

Answer 18

• Nematodes: round worms
• cestodes: tapeworms
• trematodes: flukes

Question 19

Name 3 protozoan types and examples

Answer 19

• Sporozoa: malaria, toxoplasmosis, cryptosporidia
• rhizopods: amoebas
• flagellates: trichomonas

Question 20

Name 5 risk factors for severe or complicated influenza

Answer 20

• Extremes of age
• people younger than 19 receiving long term aspirin or salicylate containing medications
• immunocompromised
• pregnant and pp women up to 2 weeks pp
• rapid deterioration