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ENT > microbiology > Flashcards

microbiology Flashcards

1
Q

how many types of herpes simplex virus is there

A

2

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2
Q

type 1 herpes simplex features

A
  • occurs in childhood
  • HSV1 is cause of oral lesions
  • transmitted via infected oral secretions during close contact
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3
Q

what is primary gingivostomatitis

A
  • due to HSV1
  • disease of pre school children
  • primary infection
  • lips, buccal mucosa, hard palate
  • ulcers
  • local lymphadenopathy
  • 3 weeks to recover
  • fever
  • spread beyond mouth
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4
Q

what is used to treat primary gingivostomatitis

A

aciclovir

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5
Q

what causes the cold sores in herpes

A

reactivation from nerves causes active infection

-various stimuli (stress, trauma etc)

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6
Q

what is herpetic whitlow

A

infection of the finger from herpes virus

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7
Q

what is herpes simplex encephalitis

A

complication of herpes

-can cause temporal lobe necrosis

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8
Q

clinical manifestations of herpes

A
  • primary infection
  • asymptomatic
  • oral
  • genital
  • cutaneous
  • ocular
  • neurologic syndromes
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9
Q

what is herpangina

A

characterised by fever and vesicles/ulcers on soft palate

coxsackie virus

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10
Q

what virus causes hand foot and mouth disease

A

coxsackie viruses

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11
Q

what are apthous ulcers

A

non-viral

-recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos

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12
Q

what is bechet’s disease

A
  • recurrent oral ulcers
  • genital ulcers
  • uveitis
  • common in middle east and asia
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13
Q

what should be suspected if sore throat and lethargy persist into second week if person is 15-25yrs

A

mononucleosis/glandular fever

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14
Q

when should you refer immediately in a sore throat patient

A
  • stridor
  • breathing difficulty
  • clinical dehydration
  • systemically unwell
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15
Q

what is the most common bacterial cause of a sore throat

A

streptococcus pyrogenes

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16
Q

treatment for strep pyrogenes

A

penicillin

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17
Q

clinical presentation of strep pyrogenes

A

acute follicular tonsillitis

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18
Q

complications of strep pyrogenes

A
  • rheumatic fever

- glomerulonephritis

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19
Q

what is the centor criteria for a group A haemolytic strep

A
  • tonsillar exudate
  • tender anterior cervical lymph nodes
  • history of fever
  • absence of cough
20
Q

fever PAIN criteria for group A beta haemolytic strep

A 
FEVER last 24 hours
Purulence
Attend rapidly 
very Inflamed tonsils
No cough

one point each

21
Q

if a patient has a fever pain score of 0 or 1 what happens

A

no antibiotic

22
Q

if fever pain is 2 or 3 what happens

A

consider no antibiotic or a back up antibiotic prescription

23
Q

if feverPAIN 4 or 5 what happens

A

consider immediate antibiotic or back-up antibiotic prescription

24
Q

what is diptheria

A

a serious infection caused by strains of bacteria called Corynebacterium diphtheriae

25
Q

symptoms of diptheria

A

severe sore throat with a grey white membrane across the pharynx
the organism produces a potent exotoxin which is cardiotoxic and neurotoxic

26
Q

treatment for diptheria

A
  • antitoxin and supportive

- penicillin/erythromycin

27
Q

symptoms of glandular fever (infective mononucleosis)

A
  • young adults
  • fever
  • enlarged lymph nodes
  • sore throat
  • pharyngitis
  • tonsilitis
  • malaise
  • lethargy
  • jaundice
  • rash
  • splenomegaly
28
Q

complications of glandular fever

A
  • anaemia, thrombocytopenia
  • splenic rupture
  • upper airway obstruction
  • increased risk of lymphoma
29
Q

what virus causes glandular fever

A

epstein-barr

30
Q

treatment for glandular fever

A
  • bed rest
  • paracetamol
  • avoid sport
  • antivirals NOT clinically effective
31
Q

clinical presentation of candida/thrush

A

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

32
Q

treatment for candida

A

nystatin - 1ml four times daily for 7 days or until 48 hours after infection has cleared

or

miconazole 2% oral gel four times daily and continue up to 7 days after infection has cleared

or

fluconazole 50mg daily for 7 days

33
Q

most common bacteria for infections of the middle ear

A
  • haemophilus influenzae
  • streptococcus pneumoniae
  • streptococcus pyrogenes
34
Q

treatment for infections of middle ear

A

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

35
Q

what is otitis externa

A

inflammation of the outer ear

36
Q

symptoms of otitis externa

A
  • redness and swelling of the skin of the ear canal
  • may be itchy
  • can become sore and painful
  • may be discharge and increased ear wax
  • hearing could be affected by canal blockage
37
Q

bacterial causes of otitis externa

A
  • staphylococcus aureus
  • proteus spp
  • pseudomonas aeruginosa
38
Q

fungal causes of otitis externa

A
  • aspergillus niger

- candida albicans

39
Q

management of otitis externa

A
  • topical aural toilet (clearing the canal)
  • keep ears clean and dry
  • avoid damage to external ear canal
  • only swab and prescribe antibiotics for unresponsive or severe cases)
40
Q

what is malignant otitis externa

A

an extension of otitis into the bone surrounding the ear canal

41
Q

symptoms and signs of malignant otitis

A
  • pain and headache
  • granulation tissue at bone
  • exposed bone in the ear canal
  • facial nerve palsy
42
Q

investigations for malignant otitis

A
  • plasma viscosity/C-reactive protein
  • radiological imaging
  • biopsy and culture to test extent of osteitis
43
Q

risk factors for malignant otitis

A

diabetes and radiotherapy to head and neck

44
Q

presentation of acute sinusitis

A

mild discomfort over frontal or maxillary sinuses due to congestion seen in patients with upper respiratory viral infections

45
Q

what indicates secondary bacterial infection in acute sinusitis

A

severe pain and tenderness with purulent nasal discharge

46
Q

treatment for acute sinusitis

A

usually resolves in 2.5 weeks
for severe/deteriorating cases:
-1st line phenoxymethylpenicillin
-2nd line doxycycline (not in children)

ENT (26 decks)

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