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Y3S1 NEURO > Infections of the Sensory System > Flashcards

Infections of the Sensory System Flashcards

1
Q

non specific ocular defences

A 
eyelids 
tears
ocular epithelium 
normal ocular bacterial flora 
mucin 
antibacterial factors 
macrophages and natural killer cells
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2
Q

specific ocular defences

A

eye-associated lymphoid tissue
langerhans cells - senitels (snitches)
t-lymphocytes
b-lymphocytes

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3
Q

where is the lacrimal gland

A

under the eyebrow

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4
Q

where are lysosomes found - they CLEAVE PETIDOGLYCANS this results in cell death

A

tears, saliva, mucous, they are also found int he granules of macrophages and neutrophils

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5
Q

lactoferrin

A

this binds to iron and starves the bacteria and fungi, it also breaks down RNA and DNA so has antiviral effects

  • tears
  • saliva
  • mucous
  • neutrophils
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6
Q

lysozyme and lactoferrin combined

A

they help to defeat gram negative bacteria

  1. lactoferrin alters the permeability of the lipopolysaccharide layer giving lysozyme access to the peptidoglycan layer
  2. thus is can cleave the petidoglycans and kill the cell
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7
Q

what are some natural bugs in the ocular biome

A
  • staphylococcus
  • streptococcus
  • propionibacterium
  • corynebacterium
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8
Q

what is the role of these naturally occurring bugs in the ocular biome

A
  • they competitively inhibit growth of pathogenic organisms

this is why the prescription of antibiotics is so careful as it can effect your natural biome and harm your host defence

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9
Q

name three common eye infections

A

conjunctivitis - adult and neonatal
Keratitis - viral and bacterial
Orbital Cellulitis - pre and post-septal

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10
Q

name two rarer eye infections

A
  • Endophthalmitis – Post-op and endogenous

* Retinochoroiditis – HIV/AIDS

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11
Q

Conjunctivitis

A
  • Viral common
  • Viral – adenovirus (rarer)
  • Bacterial common
  • Bacterial – trachoma
  • Neonatal

sticky watery pink and inflamed eyes, this is usually self limiting and rarely causes any serious damage

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12
Q

adenovirus caused infections

A
  • Bilateral,verysticky,red,painful
  • Enlargement of ipsilateral periauricular lymph node
  • Sore throat and cough - miserable
  • May have corneal involvement - Punctate keratitis
  • Symptomatic treatment – try to avoid topical steroids
  • Keratitis can last a long time
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13
Q

Bacterial Conjunctivitis

A
  • Discharge more yellow and thick
  • Will not typically go away unless given Abx

Cause
• Haemophilus influenzae
• Streptococcus pneumoniae
• Moraxella

Treatment
• Chloramphenicol
• Fusidic Acid

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14
Q

keratitis

A

can be bacterial or viral:
bacterial = often in rich countries CL related
viral = HSV and HZO

Trachoma - main infectious cause of work wide blindness

conguncitis
inflammation
scarring
trichiasis (eyelashes grow wrong way) / entropion (eyelid sits incorrectly)

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15
Q

keratitis

A

can be bacterial or viral:
bacterial = often in rich countries CL related
viral = HSV (often in run down patients) and HZO

Trachoma - main infectious cause of work wide blindness

conguncitis
inflammation
scarring
trichiasis (eyelashes grow wrong way) / entropion (eyelid sits incorrectly)

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16
Q

what is the most frequent and the most pathogenic ocular pathogen which can cause corneal perforation in just 72 hours.

A

Pseudomonas aeruginosa

17
Q

HSV Keratitis

A

• Often in ‘run down’ patients
• History of ‘cold sore’ on lips/nose in the past or recently
• Always unilateral – always same eye
• Painful, red, watery, photophobic
• Dendritic ulcer, can become geographic, new vessels, loss of sensation, scarring -
often recurrent
• Topical and oral aciclovir – often on oral low dose for months and years

18
Q

what causes trachoma

A

chlamydia trachomatis

19
Q

how do you treat river blindness

A

ivermectin treatment

20
Q

what is a carrier of toxoplasma and what foes is cause

A

cats

oral pyrimethamine, sulfadiazine and corticosteroids

21
Q

Endophthalmitis 1 in a 1000 risk

A

this is rare, but serious

develops after:

  • intra-ocular operation e.g. cataract surgery
  • trauma with inoculation of foreign body
  • complication of systemic infection

treatment
- intraocular and systemic antibiotics +/- vitrectomy this is a surgical alternative

22
Q

Otitis Media

A

most common in small children and infants mainly caused by RSV

  • fever
  • diarrhoea
  • vomiting
  • headache
  • earache

may result in hearing difficulties and delayed learning development

23
Q

Sinusitis

A
  • Pathogen invasion of the air spaces associated with the URT
  • Middle ear
  • Outer ear
  • Sinuses
  • Blockage of the eustachian tube or sinuses
  • Mucosal swelling prevents muco-ciliary clearance of infection
  • Exacerbated by local accumulation of inflammatory bacterial products
24
Q

treatment of sinusitis

A 
ampicillin, amoxycillin 
oral cephalosporins (especially to deal with β-lactamase- producing organisms)
25
Q

what is the main cause of the common cold

A

rhinoviruses and its SEASONAL

26
Q

Acute Pharyngitis & Tonsillitis

A

virus causes mostly caused by the EBV and CMV

bacterial causes
• Streptococcus pyogenes

27
Q

Cytomegalovirus (CMV)

A
  • Transmission in body secretions and organ transplants
  • Usually asymptomatic or mild in healthy adults
  • Virus can reactivate and cause disease when cell- mediated immunity is compromised
  • Treatment with ganciclovir, foscarnet, cidofovir
28
Q

Epstein-Barr Virus (EBV): Glandular Fever

A

• Replicates in B lymphocytes

  • swollen tonsils and uvula
  • petechiae on the soft palate
  • white exudate

DO NOT TREAT WITH ANTIBIOTCS

  • Clinical features:
  • Fever
  • Headache
  • Malaise
  • Sore throat
  • Anorexia
  • Palatal petechiae
29
Q

complications of glandular fever

A
  • Burkitt’s lymphoma
  • Nasopharyngeal carcinoma
  • Guillain-Barré syndrome
30
Q

Tonsillitis

A
  • Caused by Streptococcus pyogenes
  • Clinical features:
  • Fever
  • Pain in throat
  • Enlargement of tonsils
  • Tonsillar lymphadenopathy
  • Susceptible to treatment with penicillin
  • Increasing resistance to erythromycin and tetracycline
31
Q

tonsillitis complications

A
  • Scarlet Fever
  • Caused by erythrogenic toxin from S. pyogenes
  • Peritonsillar abscess (“quinsy”)
  • Otitis media / sinusitis
  • Rheumatic heart disease
  • Glomerulonephritis
32
Q

Parotitis also known as mumps

A
  • Caused by the mumps virus
  • Clinical features:
  • Fever
  • Malaise
  • Headache
  • Anorexia
  • Trismus
  • Severe pain and swelling of parotid gland(s)
  • Primary sites of replication: URT & eye
33
Q

mumps treatment, prevention and complications

A

treatment:

  • mouth care
  • nutritional
  • analgesia

prevention:

  • acute immunisation
  • MMR

complications:

  • CNS involvement
  • Epididymo-orchitis
34
Q

Acute Epiglottitis

A

Diagnosis:
• Do not examine throat or take throat swabs as this will
precipitate complete obstruction of airway.
• Blood cultures to isolate H. influenzae
• Treatment:
• Life-threatening emergency
• Requires urgent endotracheal intubation
• Intravenous antibiotics (ceftriaxone or chloramphenicol)

35
Q

Diphtheria

A
  • Transmission through aerosol
  • Clinical features:
  • Sore throat
  • Fever
  • Formation of pseudomembrane
  • Lymphadenopathy
  • Oedema of anterior cervical tissue (bull- neck)
36
Q

diphtheria management

A
  • Treatment:
  • Prompt anti-toxin therapy administered intramuscularly • Concurrent antibiotics (penicillin or erythromycin)
  • Strict isolation
  • Prevention:
  • Childhood immunisation with toxoid vaccine
  • Booster doses given if travelling to endemic areas if >10 years have elapsed since primary vaccination
37
Q

Laryngitis & Tracheitis

A
  • Infections may spread down from the URT
  • Usually viral in origin
  • Parainfluenza virus
  • Respiratory Syncytial virus • Influenza vurus
  • Adenovirus
  • In adults: hoarseness; retrosternal pain
  • In children: dry cough; inspiratory stridor (croup)

Y3S1 NEURO (44 decks)

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