microbio

Question 1

what are the two types of herpes simplex virus?

Answer 1

HSV-1

HSV-2

Question 2

what is HSV-1 more associated with?

Answer 2

orofacial disease

Question 3

what is HSV-2 more associated with?

Answer 3

genital disease

Question 4

when is herpes simplex virus more commonly aquired?

Answer 4

in childhood

Question 5

how is herpes simplex virus transmitted?

Answer 5

via infected oral secretions during close contact

Question 6

what can cause primary gingivostamitis?

Answer 6

HSV-1

Question 7

who is most ocmmonly affected by primary gingivostomatitis?

Answer 7

pre-school children

Question 8

how does primary gingivostomatitis present?

Answer 8

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

Question 9

what is treatment for primary gingivostomatitis?

Answer 9

• aciclovir treatment

- may take up to 3 weeks to recover

Question 10

what is treatment for a cold sore?

Answer 10

aciclovir therapy

Question 11

what is herpetic whitlow?

Answer 11

• HSV infection of the finger

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

Question 12

True/False

HSV-1 can cause encephalitis

Answer 12

True

Question 13

what investigations are done to detect HSV-1?

Answer 13

swab of lesion and do a PCR

Question 14

what is herpangina?

Answer 14

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

Question 14

what is herpangina?

Answer 14

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

Question 15

how is Herpangina diagnosed?

Answer 15

either clinically or by PCR

Question 16

what causes hand, mouth and foot disease?

Answer 16

Coxsackie virus

Question 17

how is hand, foot and mouth disease?

Answer 17

PCR or clinically

Question 18

how does hand, foot and mouth present?

Answer 18

ulcers in hand, foot or mouth

Question 19

can syphilis cause ulcers?

Answer 19

yes it can give you mouth ulcers

Question 20

what are apthous ulcers?

Answer 20

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

Question 21

can apthous ulcers present outwith of the mouth?

Answer 21

no- are confined to the mouth

Question 22

how long do apthous ulcers last?

Answer 22

usually <3 weeks

Question 23

what is Behcets disease?

Answer 23

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

Question 24

what is acute pharyngitis?

Answer 24

inflammation of the part oft he throat behind the soft palate

Question 25

most common causes of throat infections?

Answer 25

-viral or bacterial

Question 26

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

Answer 26

glandular fever

Question 27

what are most common complications of pharingitis and tonsilitis?

Answer 27

- otitis media (most common) - peritonsillar abscess - parapharyngeal abscess - lemierre syndrome

Question 28

when to refer a patient with sore throat urgently?

Answer 28

- stridor - breathing difficulty - clinical dehydration - systemically unwell

Question 29

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

Answer 29

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

Question 30

treatment for sore throat cause by streptococcus pyogenes ?

Answer 30

penicillin

Question 31

what are complications of strep pyogenes?

Answer 31

- rheumatic fever (3 weeks post sore throat) | - glomerulonephritis (1-3 weeks post sore throat)

Question 32

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

Answer 32

CENTOR criteria- increasing score increases likelihood of bacterial infection Fever PAIN criteria- higher score increases likelihood of bacterial infection

Question 33

what feverPAIN score would indicate prescribing antibiotics?

Answer 33

4 or more

Question 34

what is diptheria?

Answer 34

- 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

Question 35

what causes diptheria?

Answer 35

gram positive bacilli corynebacterium diptheriae

Question 36

what is treatment for diptheria?

Answer 36

- antitoxin and supportive - penicillin/ eryhtomycin There is also a vaccine!

Question 37

what is infectious mononucleosis?

Answer 37

glandular fever

Question 38

what causes infectious mononucleosis?

Answer 38

epstein barr virus

Question 39

how does infectious mononucleosis present?

Answer 39

common: - fever - enlarged lymph nodes - sore throat, tonsilitis, pharyngitis - malaise - lethargy rare: - jaundice/hepatitis - leucocytosis - splenomegaly - palatal petechiae

Question 40

how is infectious mononucleosis diagnosed?

Answer 40

labratory conformation Epstein-Barr virus IgM Heterophile antibody (Paul-Bunnell test, Monospot test) Blood count and film Liver function test

Question 41

treatment for infectious mononucleosis?

Answer 41

- bed rest - paracetamol - avoid sport for 6 weeks - corticosteroids may have a role in some complicated cases

Question 42

how does candida/thrush present?

Answer 42

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

Question 43

what is the treatment for candida/thrush?

Answer 43

nystatin or fluclonazole

Question 44

what is acute otitis media?

Answer 44

- 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

Question 45

how does acute otitis media present?

Answer 45

earache

Question 46

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

Answer 46

- Haemophilius influenzae - streptococcus pneumoniae - streptococcus pyogenes

Question 47

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

Answer 47

swab of pus if eardrum perforates

Question 48

what is the treatment for otitis media?

Answer 48

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

Question 49

what is otitis externa?

Answer 49

-inflammation of the outer ear canal

Question 50

how does otitis externa present?

Answer 50

- 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

Question 51

what are common bacterial causes of otitis externa?

Answer 51

- staphylococcus aureus - proteus spp - pseudomonas aeruginosa

Question 52

what are common causes of fungal otitis externa?

Answer 52

Aspergillus niger | Candida albicans

Question 53

what is treatment of otitis externa?

Answer 53

- topical clotrimazole | - gentamicin 0.3% drops

Question 54

what is malignant otitis?

Answer 54

- 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

Question 55

what are symptoms of malignant otitis?

Answer 55

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

Question 56

what are the investigations for malignant otitis?

Answer 56

- plasma viscosity/C reactive protein - radiological imagin - biopsy and culture to demonstrate the extent of the osteitis and its cause

Question 57

what is treatment for acute sinusitis?

Answer 57

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)