Microbiology

Question 1

how does bacterial conjunctivitis present?

Answer 1

red, swollen and inflamed conjunctiva

sticky discharge

Question 2

if bacterial conjunctivitis is present in neonates in the first 28 days, what needs to be doen?

Answer 2

refer to ophthalmology

Question 3

what are three common causes of bacterial conjunctivitis in neonates?

Answer 3

s aureus
neisseria gonorrhoea
chlamydia trachomatis

Question 4

what are the three common causes of bacterial conjunctivitis?

Answer 4

staph aureus
strep pneumoniae
haemophilus influenzae (especially in children)

Question 5

how is bacterial conjunctivitis managed?

Answer 5

topical antibiotic - chloramphenicol

Question 6

when should chloramphenicol be avoided?

Answer 6

history of aplastic anaemia

allergy

Question 7

what three viruses can cause viral conjunctivitis?

Answer 7

adenovirus
herpes simplex
herpes zoster

Question 8

when can herpes zoster cause viral conjunctivitis?

Answer 8

if shingles is affecting the CN VI dermatome

Question 9

what is the most common cause of viral conjunctivitis?

Answer 9

adenovirus

Question 10

how does adenovirus viral conjunctivitis present?

Answer 10

profuse watery discharge

red eye

Question 11

what commonly precedes an adenoviral conjunctivitis?

Answer 11

URTI

Question 12

what history is usually present in chlamydial conjunctivitis?

Answer 12

chronic history of conjunctivitis that is unresponsive to treatments

Question 13

when should chlamydial conjunctivitis be suspected?

Answer 13

bilateral conjunctivitis in young adults

Question 14

what needs to be done if someone has chlamydial conjunctivitis?

Answer 14

contact tracing

Question 15

what complication can chlamydial conjunctivitis cause?

Answer 15

subtarsal scarring

Question 16

what is microbial keratitis?

Answer 16

infection of the cornea

Question 17

what should GP’s do when someone presents with keratitis?

Answer 17

refer to ophthalmology

Question 18

why is bacterial keratitis rare?

Answer 18

the cornea is good at resisting infection

Question 19

what can be seen in the eye in bacterial keratitis?

Answer 19

infiltrates

hypopyon

Question 20

what is a hypopyon?

Answer 20

a layer of white cells that have settled in the anterior chamber

Question 21

what can bacterial keratitis result in?

Answer 21

perforation of the cornea

Question 22

how is bacterial keratitis managed?

Answer 22

admission for hourly eye drops

Question 23

what causes herpetic keratitis?

Answer 23

herpes simplex virus

Question 24

when is herpetic keratitis painful?

Answer 24

the first time

if recurrent - reduced corneal sensation

Question 25

what is the characteristic appearance of herpetic keratitis?

Answer 25

a dendritic ulcer in the outer cornea

Question 26

how is herpetic keratitis managed?

Answer 26

topical antiviral = ganciclovir

Question 27

what should not be given in herpetic keratitis and why?

Answer 27

steroids can cause a corneal melt + perforation

Question 28

what will be present in herpetic keratitis due to herpes zoster?

Answer 28

multiple dendritic ulcers instead of just one

Question 29

what does adenoviral keratitis result in?

Answer 29

sub epithelial infiltrates that can impact vision

Question 30

when does adenoviral keratitis often occur?

Answer 30

after conjunctivitis or an URTI

Question 31

how is adenoviral keratitis managed?

Answer 31

tends to be self limiting | may need mild topical steroids if chronic

Question 32

is adenoviral keratitis usually unilateral or bilateral?

Answer 32

bilateral

Question 33

who is fungal keratitis seen in?

Answer 33

people who work outside | those with ocular surface diseases

Question 34

why is fungal keratitis often diagnosed late?

Answer 34

resembles bacterial keratitis

Question 35

how is fungal keratitis maanged?

Answer 35

topical antifungals - natamycin

Question 36

what causes acanthamoeba keratitis?

Answer 36

when contact lens wearers wash their lenses with water and parasites get o them

Question 37

what is seen in acanthamoeba keratitis?

Answer 37

a ring deposit in the cornea

Question 38

how is preseptal cellulitis managed?

Answer 38

systemic antibiotics

Question 39

how does orbital cellulitis present?

Answer 39

pain when moving the eye proptosis pyrexia

Question 40

what is proptosis?

Answer 40

protrusion of the eye

Question 41

what is orbital cellulitis often associated with?

Answer 41

paranasal sinusitis

Question 42

how can orbital cellulitis be sight threatening?

Answer 42

can compress the optic nerve

Question 43

what investigation is done in orbital cellulitis and why?

Answer 43

CT look for orbital abscesses

Question 44

when does orbital cellulitis often occur?

Answer 44

after an operation

Question 45

what is endophthalmitis?

Answer 45

an infection of the inside of the eye

Question 46

how does endophthalmitis present?

Answer 46

extreme pain decreasing vision red eye

Question 47

what causes endophthalmitis?

Answer 47

conjunctival commensals getting into the eye during surgery

Question 48

what is the most common causative organism of endophthalmitis?

Answer 48

staph epidermidis

Question 49

how is endophthalmitis managed?

Answer 49

intravitreal amikacin/vancomycin | topical antibiotics

Question 50

name two things that can cause chorioretinitis

Answer 50

toxoplasmosis | toxocara

Question 51

what is toxoplasmosis?

Answer 51

a protozoan infection with toxoplasmosis gondii

Question 52

how do people get toxoplasmosis?

Answer 52

congenital | acquired - contaminated soil, undercooked meat

Question 53

how is toxoplasmosis managed if sight threatening?

Answer 53

antibiotics and steroids