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MD4001 Pathology > Infections of the sensory System > Flashcards

Infections of the sensory System Flashcards

1
Q

What are / name the basic ocular defense mechanisms

A
  • Eyelids
  • Lacrimal system
  • Conjunctiva
  • Cornea
  • Blood-ocular barrier
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2
Q

What are the common bacteria responsible for bacterial conjunctivitis?

A
  • Haemophilus influenzae
  • Streptococcus pneumoniae
  • Moraxella spp
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3
Q

What are some of the bacteria which can cause conjunctivitis in a neonate?

A
  • Neisseria gonorrhoeae
  • Escherichia coli
  • Staphylococcus aureus
  • Haemophilus influenza
  • Chlamydia trachomatis
    Also herpes simplex
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4
Q

Name a hospital aquired infection which can cause bacterial conjunctivitis?

A

Pseudomonas aeruginosa

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5
Q

WHat are the clinical features of bacterial conjunctivitis?

A
  • Hyperaemic red conjunctivae

- Mucopurulent discharge

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6
Q

How can samples be taken for conjunctivitis?

A
  • Conjunctival swabs
  • Corneal scrapings
    Lab diagnosis can be made through a culture or NAAT
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7
Q

What local antibiotics can be used to treat bacterial conjunctivitis?

A
  • Fusidic acid
  • Tetracycline
  • Chloromphenicol (most common)
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8
Q

What clinical features of conjunctivitis can differentiate bacterial from viral conjunctivitis?

A
  • Thick discharge = bacterial

- More watery = viral

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9
Q

What serotypes of adenovirus can cause conjunctivitis?

A

3, 4, 7, 8 and 10

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10
Q

What are some clinical features of conjunctivitis caused by adenovirus?

A
  • Purulent
  • Enlargement of ipsilateral periauricular lymph node
  • May have corneal involvement (punctate keratitis, subepithelial inflammatory infiltration)
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11
Q

How should an adenovirus infection (conjunctivitis) be treated?

A
  • Symptommatic treatment
  • Pain relief
  • Avoid use of topical steroids - may reduce immune response
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12
Q

What are the clinical features of a Varicella Zoster Virus infection of the eye (shingles)?

A
  • Affects opthalmic dermatome of 5th cranial nerve
  • Very painful (post-hepetic neuralgia)
  • Skin lesions
  • Anterior uveitis
  • Ocular perforation
  • Retinal involvement
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13
Q

What is VZV treated with?

A

Antivirals - aciclovir

- Possibly topical steroids in severe inflammation

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14
Q

Shingles is a chronic disease in what percentage of people?

A

25%

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15
Q

How is shingles prevented?

A

Through a live attenuated vaccine

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16
Q

What is the most common infectious cause of blindness in the developed world?

A

Herpes simplex Virus

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17
Q

What are the clinical features of HSV infection?

A
  • Dendritic shaped ulcer on surface of the eye
  • Unilateral almost always
  • Ulcerative blepharitis
  • Follicular conjunctivitis
  • Regional lymphadenopathy
  • Corneal involvement
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18
Q

What can HSV cause in the eye permenantly?

A

Corneal scarring

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19
Q

What is HSV treated with?

A

Aciclovir, avoid use of steroids

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20
Q

What parasite causes onchocerciasis (river blindness)?

A

Onchocera volvulus (transmitted via blackfly)

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21
Q

How is onchocera volulus (river blindness) treated?

A
  • Ivermectin and doxycycline

- Mass treatment of whole populations, insecticides for blackfly

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22
Q

How can chlamydia trachomatis cause blindness?

A
  • Chronic inflammation and scarring within eyelid causing it to turn in on eyeball
  • Eyelashes then rub against eyeball causing corneal scarring
  • Secondary infection can follow
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23
Q

What is used to treat chlamydia trachomatis?

A

Oral macrolides

- Azithromycin

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24
Q

What symptoms occur in chlamydia trachomatis?

A
  • 3-10 days post infection
  • Lacrimation
  • Mucoprulent discharge
  • Conjunctival involvement
  • Folicular hypertrophy
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25
Q

What is the SAFE camapign?

A

Aims to eradicate trachomatis

  • S: Surgery for inturned eyeballs
  • A: Antibiotics
  • F: Facial cleanliness
  • E: Environmental change - increase access to water and sanitation
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26
Q

What clinical sign is seen in AIDS in the eyes?

A
  • “Cotton wool spos”

- Infraction of retinal nerve fibre layer

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27
Q

What infection is responsible for the “cotton wool spots”?

A

Cytomegalovirus (as a result from AIDS)

28
Q

What is CMV in the eye treated with?

A

IV ganciclovir

- Maintain therapy to prevent relapse

29
Q

What is endopthalmitis?

A

Infection within eyeball itself

30
Q

What does endopthalmitis develop after?

A
  • Occular operation
  • Trauma
  • Inoculation of foreign body
  • Complication of systemic infection
31
Q

What is endopthalmitis treated with?

A

Bacterial causes treated by systemic antibiotics and early vitrectomy

32
Q

What is dental caries?

A
  • Tooth decay

- Damage to a tooth that can happen when decay-causing bacteria in your mouth make acids that attack the tooth’s surface

33
Q

What are the host defences of the respiratory tract?

A
  • Saliva
  • Mucus
  • Cilia (muco-ciliary escalator/elevator)
  • Nasal secretions
  • Antimicrobial peptides
34
Q

What are the common causative agents of the common cold?

A
  • Rhinoviruses (40%) (>100 serotypes)
  • Coronaviruses (30%) (>3 serotypes)
  • Coxsackie virus A
  • Echovirus
  • Parainfluenza virus
35
Q

What are the common viral causative agents responsible for acute pharyngitis and tonsilitis?

A
  • Epstein-Barr Virus (EBV)
  • Cytomegalovirus (CMV)
  • Herpes simplex virus type I
  • Rhinovirus
  • Coronavirus
  • Adenovirus
36
Q

What are the common bacterial causitive agents responsible for acute pharyngitis and tonsilitis?

A
  • Streptococcus pyogenes
  • Haemophilus influenzae
  • Corynebacterium diptheriae
37
Q

What cells do EBVs replicate in?

A

B lymphocytes

38
Q

What are the clinical features of EBV?

A
  • Swollen tonsills and uvula
  • Petechiae on the soft palate
  • White exudate
  • Fever
  • Headache
  • Malaise
  • Sore throat
  • Anorexia
  • Palatal petechiae
  • Cervical lymphadenopathy
  • Spelnomegaly
  • Mild hepatitis
39
Q

What can happen if glandular fever is treated with amoxicillin or ampicillin?

A

Painful rash can develop (therefore they are to be AVOIDED)

40
Q

What are some of the complications of glandular fever?

A
  • Burkitt’s lymphoma (with malaria) (B cell lymphoma)
  • Nasopharyngeal carcinoma
  • Guillain-Barre syndrome
41
Q

What should be avoided after glandular fever?

A

Contact sports or heavy lifting should be avoided during forst month of illness and until any splenomegaly has resolved

42
Q

What is are the clinical features of strep pyogenes tonsilitis?

A
  • Fever
  • Pain in throat
  • Enlargement of tonsils
  • Tonsilar lymphadenopathy
43
Q

What is strep pyogenes tonsilitis treated with?

A

Penicillin (increasing resistance to erythromycin and tetracycline)

44
Q

What is a complication of strep pyogenes infection?

A
  • Scarlet fever (erythrogenic txin from the bacteria)
  • Peritonsillar abscess (quinsy)
  • Ottis media / sinusitis
  • Rheumatic heart disease
  • Glomerulonephritis
45
Q

What is parotits caused by?

A

Mumps

46
Q

What are the primary sites of replication of mumps?

A

URT and eye

47
Q

What are the complications of mumps?

A
  • CNS involvement

- Epidymo-orchitis (~30% infected after puberty)

48
Q

What is Acute epiglottitis caused by?

A

Haemophilus influenza

49
Q

What percentage of healthy people have H influenza present in nasopharynx?

A

75%

50
Q

How can acute epiglottitis be prevented?

A

Hib vaccine (88% reduction in england and wales since 1992)

51
Q

What are the clinical features of acute epiglottitis?

A
  • High fever
  • Massive oedema of the epiglottis
  • Severe airflow obstruction resulting in breathing difficulties
  • Bacteraemia
52
Q

How is acute epiglottitis diagnosed?

A
  • Blood cultures to isolate H. influenzae

- DO NOT examine throat or take throat swabs as this willl precipitaate complete obstruction of airway

53
Q

How is acute epiglottitis treated?

A
  • Life-threatening emergency
  • Requires urgent endotracheal intubation
  • IV Ceftriaxone or chloramphenicol
54
Q

What bug causes diptheria?

A

Corynebacterium diptheriae

55
Q

WHat are the clinical features of diptheria?

A 
Childhood disease (usually)
Oedema of anterior cervical tissue (bull-neck)
- Sore throat 
- Fever 
- Formation of pseudomembrane 
- Lymphadenopathy
56
Q

What is diptheria treated with?

A
  • Prompt anti-toxin therapy administered IM
  • Concurrent antibiotics (penicillin or erythromycin)
  • Strict isolation
57
Q

What are common causes of laryngitis and tracheitis?

A
  • Parainfluenza virus
  • Respiratory Syncytial virus
  • Influenza
  • Adenovirus
    Usually viral - spread down from URT
58
Q

What are the symptoms of laryngitis and tracheitis?

A
  • Adults: hoarsness; retrosternal pain

- Children; Dry cough; inspiratory stridor (croup)

59
Q

What are some of the complicaions of otitis and sinusitis?

A
  • Blockage of eustachian tube or sinuses
  • Mucosal swelling prevents muco-ciliary clearence of infection
  • Exacerbated by local accumulation of inflammatory products
60
Q

Wat are the main causitive agents of ottitis and sinusitis?

A
  • Respiratory syncytial virus (RSV)
  • Mumps virus
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Baceteroides fragilis
61
Q

When is otitis media most common?

A

Infants and small children

62
Q

What are the most common bugs responsible for otitis media?

A

50% viral in origin - mainly RSV
Also S. pneumoniae and H influenzae
Thick discharge linked to bacterial infection

63
Q

What are the clinical features of otitis media?

A
  • Fever
  • Diarrhoea and vomitting
  • Buldging ear drum and dilated vesels
  • Fluid in middle ear (glue ear)
64
Q

What are some complications of Otitis media?

A
  • May lead to chronic suppurative otitis media

- May result in hearing difficulties and delayed learning development

65
Q

What are common infectious agents in otitis externa?

A

Similar microbiota to skin

  • Staphylococcus aureus
  • Candida albicans
  • Pseudomonas aeruginosa
66
Q

What is otitis externa treated with?

A

Antibiotic ear drops containing polymyxin

MD4001 Pathology (18 decks)

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