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Neuro Block 3 > Intro To Eye Infections > Flashcards

Intro To Eye Infections Flashcards

0
Q

What is Keratitis?

A

Inflammation of the cornea

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1
Q

What is Blepharitis?

A

Inflammation of the eyelid

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2
Q

What is Keratoconjuntivitis?

A

Inflammation of the eye and cornea

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3
Q

What is Uveitis?

A

Inflammation of the middle layer: iris, ciliary body, choroid

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4
Q

What is Chorioretinitis?

A

Inflammation of the choroid and retinal layers

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5
Q

What is Endophthalmitis?

A

Inflammation of the aqueous and vitreous humor

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6
Q

What is the route of most eye infections?

A

Trauma
Paranasal sinus transfer
Anatomical abnormality
Fewer tear production

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7
Q

What is chronic conjunctivitis and what is it associated with?

A

Inflammatory disease of the eyelid margin where too much oil is produced

Blepharitis

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8
Q

What is a stye/Hordeolum?

A

Localized inflammation often on lower lid due to bacterial growth in eyelash

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9
Q

What bacteria is associated with chronic conjunctivitis with Blepharitis?

A

Staphylococcus epidermidis

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10
Q

What is the treatment of chronic conjunctivitis with Blepharitis?

A

Erythromycin ointment

Keep the eye clean

Warm and compress the gland

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11
Q

What eye defense mechanisms do tears contain?

A

SlgA

Lysozyme

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12
Q

How does blinking act as a defense mechanism against infection?

A

Inhibits microbial attachment

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13
Q

How does the conjunctiva contribute to eye defense mechanisms?

A

Lymphocytes, plasma cells, neutrophils, and mast cells which produce antibodies and cytokines

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14
Q

What is conjunctivitis caused by?

A

Dilation and congestion of subepithelial vessels

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15
Q

What are some characteristics of conjunctivitis?

A

Discharge (clear or milky)
Irritation
Sensitivity to palpitation

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16
Q

What is the most common viral cause of conjunctivitis?

A

Adenovirus

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17
Q

What is the common cause of bilateral conjunctivitis?

A

Bacterial first, then viral

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18
Q

What is the discharge from conjunctivitis from both bacterial and viral infections like?

A

Bacterial - mucopurulent

Viral - mild, watery, “sleepers”

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19
Q

What conjunctivitis cause has association with ear infections?

A

Bacterial

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20
Q

What is a key symptom of allergic conjunctivitis?

A

Itchy eyes

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21
Q

What is the response of allergic rhinoconjunctivits?

A
  1. IgE response by B-cells
  2. IgE coats mast cells
  3. Mast cells release histamine
  4. Histamine causes inflammation
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22
Q

What is the most common cause of neonatal viral conjunctivitis?

A

HSV

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23
Q

What is symptomatic of viral conjunctivitis?

A

Watery

Previous infection

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24
Q

What are some characteristics of adenoviruses?

A 
Non-enveloped
dsDNA
Lytic on epithelium cells
Latent is lymphoid cells
Highly contagious through fomites in swimming pools
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25
Q

What is an example of adenovirus?

A

Coxsackie

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26
Q

What adenoviruses infect cells of the respiratory tract?

A

4 and 7

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27
Q

What adenoviruses are associated with conjunctivitis?

A

19 and 37

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28
Q

What adenoviruses are associated with enteric organ infections?

A

40, 41, and 42

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29
Q

How do you detect an adenovirus conjuntivitis?

A

AdenoPlus

Detects adenovirus hexon protein of the viral capsid

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30
Q

What are the top three bacterial causes of conjunctivitis?

A

Staph aureus
H. Influenze
Strep pneumoniae

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31
Q

What is the most common cause of adult conjunctivitis?

A

Staphylococcus aureus

32
Q

What is the treatment options for bacterial conjunctivitis?

A

Polytrim (trimethoprim + polymixin)

Moxifloxacin (fluoroquinolone drops)

33
Q

What is the mechanism of action of Moxifloxacin and fluoroquinolone?

A

Topo II and IV inhibitors

Both gram + and -

34
Q

What is the mechanism of action of trimethoprim?

A

inhibits dihydrofolatereductase selectively in bacteria

Bacteria static

35
Q

What is the mechanism of polymixin b and what is its spectrum?

A

Binds to LPS creating holes in the membran

36
Q

What is the cause of hyperacute bacterial conjunctivitis?

A

Neisseria gonorrhoeae (meningidis less often)

37
Q

What is a key symptom of a Neisseria conjunctivitis?

A

Copious amounts of yellow-green discharge (purulent)

Preauricular adenopathy

38
Q

How do you culture Nersseria gonorrhoaea?

A

Gram negative
Intracellular diplococci
Chocolate agar with vancomycin, colistin, nystatin, trimethoprim

39
Q

How do you treat Neisseria gonorrhoeae?

A

Promptly with systemic ceftriaxone (broad)
May augment with topical antibiotics

Otherwise progression to corneal ulceration and perforation

40
Q

What is ophthalmia neonatorum?

A

Conjunctivitis or Keratoconjuntivitis occurring within the first four weeks of birth

41
Q

What causes ophthalmia neonatorum?

A

N. Gonorrhoeae, C. Trachomatis, Staph, Strep,

E. Coli, H. Influenzae, or H. Simplex

42
Q

How do you prevent ophthalmia neonatorum?

A

Prophylactic erythromycin ointment

Culture and smear for diagnosis

43
Q

How do macrolides like erythromycin and azithromycin?

A

Bind the 50S subunit (23s specifically) of RNA polymerase

44
Q

How do you treat Chlamydia?

A

Macrolides like erythromycin and azithromycin

Systemic

45
Q

Want are some adverse side effects of macrolides?

A

GI discomfort
Hepatic failure
Prolonged QT interval
Inhibits cyt P450

46
Q

What do stereotypes D-K of Chlamydia trachomatis cause?

A

Inclusion conjunctivitis

47
Q

What do stereotypes A-C of Chlamydia trachomatis cause?

A

Trachoma

48
Q

What is the leading cause of blindness world wide?

A

Trachoma

By Chlamydia trachomatis since there is no long lasting immunity scarring the cornea further

49
Q

How do you diagnosis Chlamydia trachomatis?

A

A fluorescent antibody

50
Q

What do you see on a microscope with chlamydia trachomatis?

A

Intracellular basophils inclusion bodies

51
Q

What is a common coinfection of chlamydia trachomatis?

A

N. Gonorrhoeae

52
Q

How do you treat chlamydia trachomatis?

A

Systemic azithromycin

Also treat sexual partners
World wide prophylactic

53
Q

What are the two different forms of chlamydia trachomatis?

A

Elementary body - enters the epithelial cells converts to…

Reticulate bodies - which replicates using binary frisson

54
Q

Which form of chlamydia trachomatis has a rigid outer membrane?

A

The elementary bodies that need protection from the extra cellular enviornment

55
Q

How does HSV-1 Keratoconjuntivitis present?

A

Similar to adenovirsuses but more pain

Rare you have a blue eyeball presentation with scarring

56
Q

How do you treat HSV-1 Keratoconjuntivitis?

A

Systemic acyclovir

If corneal involvement treat with topical trifluridine

Consider prophylactic treatment with erythromycin to prevent bacterial superinfection

57
Q

What is Trifluridine?

A

A pyrimidine analog

Uses host kinases

Used when acyclovir resistant

58
Q

What are some symptoms of Keratitis?

A

More likely to have vision defects
Photophobia
Pain (lots of nerve endings)
Foreign body sensation

59
Q

What is viral keratitis caused by?

A

HSV-1
Adenovirus
VZV

60
Q

What are some bacterial causes of keratitis?

A

Staph, strep, pseudomonas

61
Q

What increases your susceptibility for keratitis?

A

Trauma,
drying of the epithelial
Hypoxia

62
Q

What are some other causes of keratitis?

A

Acanthamoeba

Fungal in warm environments

63
Q

How do you treat bacterial and viral keratitis?

A

Bacterial - Moxifloxacin eye drops

Viral - trifluridine and acyclovir

64
Q

What are some characteristics of pseudomonas aeroginsoa?

A

Gram negative
Aerobic rod
Flagella

Everywhere
Oppertunistic
Naturally resistant to many antibiotics and disinfectants due to ability to form biofilms

65
Q

What is a virulence factor of pseudomonas that inhibits mitochondrial enzymes disrupting ciliary beating in keratitis?

A

The blue pigment pyocyanin

66
Q

What virulence factors does pseudomonas have?

A

Adherence factors
Cytotoxins like elastase and alkaline protease that destroy the corneal epithelium

Host immune response leads to scarring

67
Q

What are two form of parasites?

A

Cyst

Tropozoic (infection)

68
Q

What are amoebas like and treated?

A

Yeast

Azoles

69
Q

What are some causes of uveitis?

A

Herpes, zoster

70
Q

What does toxoplasma usually cause?

A

Visual defects
Chorioretinitis
Congenital

71
Q

What infectious organism for Chorioretinitis and really all other eye infection will you worry about in immunocompromized patients (HIV)?

A

Toxo and CMV

72
Q

What parasitic worms should you worry about that cause Chorioretinitis (and blindness)?

A

Toxocara canis

Onchocerra volvulus - river blindness

Both transmitted through sand flies

73
Q

What do you see with CMV retinitis?

A

Brush fire retina

74
Q

What do you use to diagnosis toxo?

A

IgM serology

75
Q

How do you treat toxoplasma?

A

Pyrimethahamine and sulfadiazine that inhibit production of pyrimidines

also trimethoprim

76
Q

What is Endophthalmitis and what are some common characteristics?

A 
Inflam of the humors (blockage)
Rare
Pain, redness, decreased vision
Bacteria and fungi
Common after cataract surgery with Oppertunistic infection
Blood spread
77
Q

What is the common treatment for Endophthalmitis?

A

Fluoroquinolone or vancomycin injected into the eye

Neuro Block 3 (17 decks)

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