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ENT > microbio > Flashcards

microbio Flashcards

1
Q

what are the two types of herpes simplex virus?

A

HSV-1

HSV-2

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2
Q

what is HSV-1 more associated with?

A

orofacial disease

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3
Q

what is HSV-2 more associated with?

A

genital disease

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4
Q

when is herpes simplex virus more commonly aquired?

A

in childhood

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5
Q

how is herpes simplex virus transmitted?

A

via infected oral secretions during close contact

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6
Q

what can cause primary gingivostamitis?

A

HSV-1

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7
Q

who is most ocmmonly affected by primary gingivostomatitis?

A

pre-school children

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8
Q

how does primary gingivostomatitis present?

A
  • systemic upset (fever, malaise, headaches)
  • painful oral ulcers
  • local lymphadenopathy
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9
Q

what is treatment for primary gingivostomatitis?

A
  • aciclovir treatment

- may take up to 3 weeks to recover

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10
Q

what is treatment for a cold sore?

A

aciclovir therapy

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11
Q

what is herpetic whitlow?

A
  • HSV infection of the finger

- can occur by inoculation of the virus through a break in the skin

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12
Q

True/False

HSV-1 can cause encephalitis

A

True

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13
Q

what investigations are done to detect HSV-1?

A

swab of lesion and do a PCR

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14
Q

what is herpangina?

A

vesicles/ulcers on soft palate caused by enterovirus (especially Coxsackie virus)

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14
Q

what is herpangina?

A

vesicles/ulcers on soft palate caused by enterovirus (especially Coxsackie virus)

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15
Q

how is Herpangina diagnosed?

A

either clinically or by PCR

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16
Q

what causes hand, mouth and foot disease?

A

Coxsackie virus

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17
Q

how is hand, foot and mouth disease?

A

PCR or clinically

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18
Q

how does hand, foot and mouth present?

A

ulcers in hand, foot or mouth

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19
Q

can syphilis cause ulcers?

A

yes it can give you mouth ulcers

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20
Q

what are apthous ulcers?

A

non viral, self limiting, recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos

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21
Q

can apthous ulcers present outwith of the mouth?

A

no- are confined to the mouth

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22
Q

how long do apthous ulcers last?

A

usually <3 weeks

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23
Q

what is Behcets disease?

A

-a rare inflammatory disease of the blood vessels that causes recurrent oral ulcers, genital ulcers, uveitis, painful/swollen joints and headaches

24
Q

what is acute pharyngitis?

A

inflammation of the part oft he throat behind the soft palate

25
Q

most common causes of throat infections?

A

-viral or bacterial

26
Q

what should be suspected if a sore throat is associated with lethargy into second week?

A

glandular fever

27
Q

what are most common complications of pharingitis and tonsilitis?

A
  • otitis media (most common)
  • peritonsillar abscess
  • parapharyngeal abscess
  • lemierre syndrome
28
Q

when to refer a patient with sore throat urgently?

A
  • stridor
  • breathing difficulty
  • clinical dehydration
  • systemically unwell
29
Q

what is the most common bacterial cause of a sore throat?

A

Streptococcus pyogenes (group A strep/ Group A beta Haemolytic strep)

30
Q

treatment for sore throat cause by streptococcus pyogenes ?

A

penicillin

31
Q

what are complications of strep pyogenes?

A
  • rheumatic fever (3 weeks post sore throat)

- glomerulonephritis (1-3 weeks post sore throat)

32
Q

what scores/criteria have been made to try differentiate bacterial vs viral infections?

A

CENTOR criteria- increasing score increases likelihood of bacterial infection

Fever PAIN criteria- higher score increases likelihood of bacterial infection

33
Q

what feverPAIN score would indicate prescribing antibiotics?

A

4 or more

34
Q

what is diptheria?

A
  • highly contagious infection caused by gram positive bacillus Corynebacterium diptheriae
  • causes fever, sore throat, swollen glands, difficulty breathing or swallowing and a thick grey-white coating may cover back of throat, nose and tongue
35
Q

what causes diptheria?

A

gram positive bacilli

corynebacterium diptheriae

36
Q

what is treatment for diptheria?

A
  • antitoxin and supportive
  • penicillin/ eryhtomycin

There is also a vaccine!

37
Q

what is infectious mononucleosis?

A

glandular fever

38
Q

what causes infectious mononucleosis?

A

epstein barr virus

39
Q

how does infectious mononucleosis present?

A

common:

  • fever
  • enlarged lymph nodes
  • sore throat, tonsilitis, pharyngitis
  • malaise
  • lethargy

rare:

  • jaundice/hepatitis
  • leucocytosis
  • splenomegaly
  • palatal petechiae
40
Q

how is infectious mononucleosis diagnosed?

A

labratory conformation

Epstein-Barr virus IgM

Heterophile antibody (Paul-Bunnell test, Monospot test)

Blood count and film

Liver function test

41
Q

treatment for infectious mononucleosis?

A
  • bed rest
  • paracetamol
  • avoid sport for 6 weeks
  • corticosteroids may have a role in some complicated cases
42
Q

how does candida/thrush present?

A

-white patches on red, raw mucous membranes in throat/mouth

43
Q

what is the treatment for candida/thrush?

A

nystatin or fluclonazole

44
Q

what is acute otitis media?

A
  • an upper respiratory infection involving the middle ear by extension of the Eustachian tube
  • more common in children as they have a shorter and more horizontal eustachian tube
45
Q

how does acute otitis media present?

A

earache

46
Q

what are most common bacteria that cause an ear infection? (otitis media)

A
  • Haemophilius influenzae
  • streptococcus pneumoniae
  • streptococcus pyogenes
47
Q

how are infections of the middle ear (otitis media) diagnosed?

A

swab of pus if eardrum perforates

48
Q

what is the treatment for otitis media?

A

80% resolve in 4 days without antibiotics
First line- amoxicillin
second line- erythromycin

49
Q

what is otitis externa?

A

-inflammation of the outer ear canal

50
Q

how does otitis externa present?

A
  • redness and swelling of the skin of the ear canal
  • may be itchy
  • can be sore and painful
  • there may be discharge or increased amounts of ear wax
  • if canal becomes blocked by swelling or secretions, hearing can be affected
51
Q

what are common bacterial causes of otitis externa?

A
  • staphylococcus aureus
  • proteus spp
  • pseudomonas aeruginosa
52
Q

what are common causes of fungal otitis externa?

A

Aspergillus niger

Candida albicans

53
Q

what is treatment of otitis externa?

A
  • topical clotrimazole

- gentamicin 0.3% drops

54
Q

what is malignant otitis?

A
  • is an extension of otitis externa into the bone surrounding the ear canal
  • without treatment is a fatal condition
  • osteomyelitis will progressively involve the skull and meninges
55
Q

what are symptoms of malignant otitis?

A
  • pain and headache
  • granulation tissue at bone-cartilage junction of ear canal
  • exposed bone in ear canal
  • facial nerve palsy
56
Q

what are the investigations for malignant otitis?

A
  • plasma viscosity/C reactive protein
  • radiological imagin
  • biopsy and culture to demonstrate the extent of the osteitis and its cause
57
Q

what is treatment for acute sinusitis?

A

average length of illness is 2.5 weeks

  • antibiotics for severe/deteriorating cases of >10 days duration
  • 1st line= phenoxymethylpenicillin
  • 2nd=doxycycline (NOT IN CHILDREN)

ENT (33 decks)

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