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ophthalmology > Micro > Flashcards

Micro Flashcards

1
Q

Main causes of bacterial conjunctivitis in neonates

A

Staph aureus
Neisseria gonorrhoeae
Chlamydia trochamitis

Pt will have sticky eye for first 28 days (from birth canal -> sexually transmitted)

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2
Q

Main causes of bacterial conjunctivitis in non-neonates (all other ages)

A

Staph aureus
Strep pneumoniae
Haemophilus influenzae (esp. kids)

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3
Q

Treatment of bacterial conjunctivits

A

Self limiting in 14 days

If wanted to clear up faster:
Topical antibiotic (usually chloramphenicol)
Beware of allergy or aplastic anaemia

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4
Q

Main causes of viral conjunctivits

A

Adenovirus
Herpes simplex
Herpes zoster (inc. ophthalmicus)

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5
Q

History of chlamydial conjunctivitis

A

Unresponsive to treatment
Often bilateral conjunctivitis in young adult
May have vaginitis/urethritis symptoms

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6
Q

Bacterial keratitis associations

A

Contact lens wear
Corneal pathology
Will common have a hypopyon (build up of white cells in anterior chamber)

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7
Q

Treatment of bacterial keratitis

A

Hourly eye drops for 48 hours (day + night)
(antibiotic depending on pathogen)

4th generation quinolone (eg ofloxacin) will treat most gram negatives including coliforms and pseudomonas aeruginosa. (will not treat step pneumonia)

Gentamicin and cefuroxime combo will treat most gram negative and positive organisms

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8
Q

Treatment of herpetic keratitis

A

If recurrent give topical acyclovir

DO NOT GIVE STEROIDS - may cause corneal melt and perforation

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9
Q

Adenoviral keratitis history

A

Bilateral
Follows URTI usually
Contact with infected person (contagious)
Affects vision

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10
Q

Treatment of adenoviral keratitis

A

Give antibiotics to prevent a secondary infection

If the disease becomes chronic give steroids to speed up recovery

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11
Q

Common causes of fungal keratitis

A

Acanthamoeba

Pseudomonas aeruginosa

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12
Q

Common history of fungal keratitis

A

Contact lens use
Trauma preceding incident
Non-healing (slow to heal)

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13
Q

History of orbital cellulitis

A

Paranasal sinusitis
Pain (especially on moving eye)
Proptosis
Pyrexial

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14
Q

Orbital cellulitis management

A

Broad spectrum antibiotics (vancomycin + cefotaxime (add metronidazole if intracranial extension suspected))
Abscess drainage if necessary
Scan if there is suggestion of muscle restriction or optic nerve dysfunction

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15
Q

History of endophthalmitis

A

Recent surgery
Very painful and very red eye
Decreased vision

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16
Q

Most common endophthalmitis organism and treatment

A 
Staph epidermidis (conjunctival commensal)
Treatment is intra-vitreal amikacin and vancomycin + topical antibiotic
17
Q

Common causes of chorioretinits

A 
Cytomegalovirus (CMV) in AIDS
Toxoplasma gondii (toxoplasmosis)
toxocara canis (worm)
18
Q

How does someone get toxocara canis and what are the issues associated

A

Through contact with an infected cat or dog

May form granulomas which can cause irreversible vision loss

19
Q

Mode of action of chloramphenicol

A

Inhibits peptidyl transferase enzyme
Bacterocidal effect in strep. and haemophilus
Bacterostatic effect in staph

20
Q

Side effects of chloramphenicol

A

Potential allergy
1:40,000 cases causes irreversible aplastic anaemia
Grey baby syndrome

21
Q

How do penicillins and cephalosporins work

A

Contain a B-lactam ring which inhibits enzyme in bacteria which produces the cell wall

22
Q

How do quinolones work and give examples

A

Levofloxacin, ofloxacin, ciprofloxacin etc.
Work by inhibiting DNA gyrase which is repsonsible for compressing bacterial DNA into supercoils. Therefore the coils decompress and bacteria die

23
Q

How does aciclovir work?

A

Mimics guanine inhibiting viral DNA synthesis

24
Q

Treatment of chlamydial conjunctivitis

A

Topical oxytetracycline

If genital infection in adults also: oral azithromycin too

25
Q

What bacteria will chloramphenicol typically not treat

A

Pseudomonas aeruginosa

26
Q

Treatment of pseudomonas aeruginosa conjunctivits

A

Gentamicin

27
Q

Treatment of staph aureus conjunctivitis

A

Fusidic acid

28
Q

Treatment of gram negatives and coliforms

A

Gentamicin

ophthalmology (1 decks)

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