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Ophthalmology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What are the causal organisms in bacterial conjunctivitis in neonates?

A

Staph aureus, neisseria gonorrhoeae, chlamydia trachomatis-refer all to ophthalmology

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2
Q

What are the causal organisms in bacterial conjunctivitis in adults and children?

A

S. aureus, strep pneumonia, haemophilus influenzae (esp. children)

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3
Q

What is the treatment of bacterial conjuctivitis?

A

Swab
Topical antibiotic-usually chloramphenical qds
Drops vs ointment

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4
Q

When should you avoid chloramphenicol in bacterial conjuctivitis?

A

If pt has histry of aplastic anaemia or allergy

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5
Q

What are the pathogens that can cause viral conjuctivitis?

A

Adenovirus, herpes simplex, herpes zoster

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6
Q

How will herpes simplex conjunctivitis present?

A

Grouped painful vesicles below eye. Redness, pain around eye

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7
Q

What is herpes zoster ophthalmicus?

A

Subtype of shingles associated with CNV1

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8
Q

What is the history of a patient with chlamydial conjunctivitis?

A

Often chronic history, Unresponsive to treatments. Suspect in bilateral conjunctivitis in young adults. May/may not have symptoms of urethritis/vaginitis.

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9
Q

What does a case of chlamydial conjunctivitis require?

A

Contact tracing

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10
Q

What is the appearance of chlamydial conjunctivitis?

A

Usually unilateral red eye with purulent discharge, predominant follicular conjunctivitis

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11
Q

What type of pathogens can cause microbial keratitis?

A

Bacterial, viral, fungi

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12
Q

What will bacterial keratitis present with?

A

Hypopyon

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13
Q

Do bacterial keratitis pts require admission?

A

Yes-hourly drops and daily review

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14
Q

What is usually associated with bacterial keratitis?

A

Other corneal pathology or contact lens wear

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15
Q

What will herpetic keratitis present with?

A

Dendritic ulcer

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16
Q

What do recurrences of herpetic keratitis result in?

A

Reduced corneal sensation

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17
Q

What can happen if herpetic keratitis is treated with steroids?

A

Cause a corneal melt and perforation of the cornea

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18
Q

What will adenoviral keratitis present with?

A

Subepithelial infiltrates

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19
Q

What are the clinical features of adenoviral keratitis?

A

Bilateral, usually follows URTI. Contagious, may affect vision

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20
Q

What is the treatment of adenoviral keratitis?

A

Topical AB to prevent secondary infection. Can require steroids to speed up recovery if becomes chronic

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21
Q

What organisms can cause keratitis due to contact lenses?

A

Acanthamoeba, pseudomonas aeruginosa

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22
Q

What will fungal keratitis present with?

A

Hypopyon

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23
Q

What kind of history will a fungal keratitis have?

A

More indolent than microbial keratitis. Usually history of trauma from vegetation

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24
Q

How will orbital cellulitis present with?

A

Painful-especially on eye movement. Proptosis, often associated paransal sinusitis, pyrexial

25
Q

Can orbital cellulitis affect sight?

A

Yes-sight threatening

26
Q

How are orbital abscesses identified in orbital cellulitis?

A

CT

27
Q

Where can an orbital cellulitis have spread from?

A

Direct extension from sinus, extension from focal orbital infection (infected chalazion, dacryocystiitis)

28
Q

What must be differentiated between in orbital cellulitis?

A

Preseptal and orbital

29
Q

What organisms can cause orbital cellulitis?

A

Staph, strep, coliforms, haemophilus influenzae, anaerobes

30
Q

When should a scan always happen in orbital cellulitis?

A

If any suggestion of restriction of muscles or optic nerve dysfunction

31
Q

What is the treatment for orbital cellulitis?

A

Broad spectrum AB, sometimes abscess drainage

32
Q

What is endophthalmitis?

A

Infection inside of the eye-post surgical or endogenous

33
Q

How will endophthalmitis present?

A

Very painful, with decreasing vision. Very red eye, threat to sight

34
Q

What organisms cause endophthalmitis?

A

Often conjunctival commensals-most common staph epidermidis

35
Q

What is the treatment for endophthalmitis?

A

Intravitreal amikacin and vancomycin and topical antibiotics

36
Q

What can cause chorioretinitis?

A

CMV in AIDS, toxoplasma gondii, toxocara canis (worm)

37
Q

How will toxoplasmosis present?

A

Mild flu like illness, rarely causes further problems. In immunocompromised patients it enters latent phase with cysts forming

38
Q

Can toxoplasmosis reactivate?

A

Yes

39
Q

What treatment is required in sight threatening toxoplasmosis?

A

Systemic treatment

40
Q

What is toxocara caused by?

A

Toxocara canis-parasitic nemotode (roundworm)

41
Q

What can toxocara form?

A

Granulomas which can cause irreversible visual loss

42
Q

What is the difference between toxocara in cats/dogs and humans?

A

Affects cats/dogs, unable to replicate in humans-remains in immature form of worm

43
Q

Rather than swabs what is used in bacterial keratitis diagnosed?

A

Corneal scrapes

44
Q

What should be used in diagnosis of endophthalmitis?

A

Aqueous/vitreous culture

45
Q

How does chloramphenicol act?

A

Inhibits peptidyl transferase enzyme (therefore stops bacterial protein synthesis)

46
Q

What is the effect of chloramphenicol on strep, haemophilus and staph?

A

Bacterocidal for strep and haemophilus, bacterostatic for staph

47
Q

What are the side effects of chloramphenicol?

A

Allergy, irreversible aplastic anaemia, grey baby syndrome

48
Q

What is dacrocystitis?

A

An infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac.

49
Q

What is a common contaminant of bottles?

A

Pseudomonas

50
Q

What are antivirals used for?

A

Dendritic ulcers of the cornea-do not use steroid drops

51
Q

What can chloramphenicol be used for?

A

Most bacteria in conjuctivitis except Pseudomonas aeruginosa

52
Q

What bacterial conjunctivitis is fusidic acid used to treat?

A

S. aureus

53
Q

What bacterial conjunctivis can gentamicin be used for?

A

Most Gram -ve bacteria including coliforms, Pseudomonas aeruginosa

54
Q

What is used to treat chlamydial conjunctivitis?

A

Topical oxytetracycline (adults may also need oral azithromycin for genital infection)

55
Q

What bacterial keratitis is A 4-quinolone (Ofloxacin) used to treat?

A

Most Gram -ve bacteria including coliforms, Pseudomonas aeruginosa, Haemophilus influenza.

56
Q

What bacterial keratitis can gentamicin and cefuroxime be used to ttreat?

A

Combination will treat most Gram +ve and Gram -ve organisms

57
Q

How will a patient with adenoviral conjunctivitis present?

A

Redeye, itchy eyes. May give history of recent exposure to an individual with red eye, or history of recent symptoms of URTI. The eye infection may be unilateral or bilateral.

58
Q

What should be used in diagnosis for acanthamoeba?

A

Microscopy/culture

59
Q

What should be used in diagnosis for toxoplasma and toxocara?

A

Serology

Ophthalmology (11 decks)

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