Microbiology

Question 1

what is conjunctivitis

Answer 1

inflammation of the conjunctiva

Question 2

what does keratitis affect

Answer 2

cornea

Question 3

what does endophthalmitis affect?

Answer 3

the entire globe

Question 4

what does cellulitis affect

Answer 4

the skin surrounding the eye

Question 5

in what age group is bacterial conjunctivitis worry

Answer 5

neonates

Question 6

what is the common bacterial causes of conjunctivitis in children

Answer 6

staph aureus, neisseria gonorrhoea and chlamydia trachomatis

Question 7

should you refer neonates who have bacterial conjunctivitis?

Answer 7

100% refer to ophthalmology

Question 8

what are the bacteria that commonly affect all ages in bacterial conjunctivitis

Answer 8

staph aureus, strep pneumonia, haemophilias influenzae

Question 9

what are signs of bacterial conjunctivitis

Answer 9

conjunctiva is red and swollen, itchy eyes which may lacrimal. Discharge- sticky

Question 10

how do you treat bacterial conjunctivitis

Answer 10

swab
Chloramphenicol
drops or ointments?

Question 11

What should you be careful about chloramphenicol

Answer 11

if history of plastic anaemia or allergy

Question 12

what does adenoviral conjunctivitis look like

Answer 12

red, irritated eyes, watery discharge and scratch complaint with enlarged lymph nodes- URTI

Question 13

What causes little white dots to appear in outer corner of lower lid

Answer 13

herpes simplex

Question 14

what nerve can herpes zoster affect

Answer 14

trigeminal

Question 15

what is the hutchinson- Robinson sign

Answer 15

spots at end of nose

Question 16

in what age does chlamydial conjunctivitis occur in

Answer 16

young adults

Question 17

is chlamydial conjunctivitis responsive to treatment?

Answer 17

no

Question 18

In bilateral conjunctivitis what condition should you suspect

Answer 18

chlamydial conjunctivitis

Question 19

what other symptoms are associated with chlamydial conjunctivitis

Answer 19

urethritis, vaginitis

Question 20

what are symptoms of chlamydial conjunctivitis

Answer 20

watery, red eyes, sensitive to light

Question 21

what would be present on the inside of upper lids in chlamydial conjunctivitis

Answer 21

little follicles

Question 22

what would you find in a bacterial keratitis

Answer 22

hypopyon, white layer with round circle

Question 23

what do you do when someone presents with a white layer at the bottom of their eye

Answer 23

urgent eye app to ophthalmologist

Question 24

what factors can cause bacterial keratitis

Answer 24

contact lens wear or other patholgies

Question 25

what can cause viral keratitis

Answer 25

herpes and adenovirus

Question 26

what would a dendrites ulcer be found in

Answer 26

herpetic keratitis- white ulcer outline

Question 27

is herpetic keratitis painful

Answer 27

YES

Question 28

what happens in recurrent herpetic keratitis

Answer 28

reduced corneal sensation

Question 29

IMPORTANT: what happens if you treat cornea with steroids

Answer 29

corneal melt and perforation of cornea

Question 30

How does adenoviral keratitis usually come about

Answer 30

after URTI

Question 31

what can you give for adenoviral keratitis

Answer 31

topical antibiotic to prevent secondary infection and steroids to speed up recovery

Question 32

what is an important sign in adenoviral keratitis

Answer 32

sub epithelial infiltrates

Question 33

what can acanthamoeba cause

Answer 33

keratitis due to contact lens

Question 34

fungal keratitis can be caused by which commensal

Answer 34

candida and aspergillus

Question 35

which occupations can lead to a diagnosis of fungal keratitis

Answer 35

history of trauma from vegetation i.e. woodcutting, metal chipping

Question 36

What are symptoms of orbital cellulitis

Answer 36

pain, proptosis, paranasal sinuses, pyrexial and sight threatening

Question 37

how is orbital cellulitis spread

Answer 37

through paranasal sinuses

Question 38

how should you manage a patient with orbital cellultitis

Answer 38

CT- ENT and ophthalmic opinion. Antibiotics and surgery

Question 39

what are the organisms that can cause orbital cellulitis

Answer 39

staph, strep, coliforms, haemophilus influenzae

Question 40

what is endophthalmitis

Answer 40

infection on the inside of the eye

Question 41

what is the usual cause for endophthalmitiis

Answer 41

post surgery

Question 42

is endophthalmitis painful?

Answer 42

YESSSSSS

Question 43

what is th most common commensal for endophthalmitiis

Answer 43

staph epidermidis

Question 44

how do you treat endophthalmitis

Answer 44

intravitreal amikacin and vancomycin and topical antibiotics

Question 45

what is chorioretinitis

Answer 45

inflammation of the choroid

Question 46

what are the organisms that can cause chorioretinitis

Answer 46

CMV in AIDS, toxoplasmosis gondii and toxocara canis

Question 47

how do you get a toxoplasmosis infection?

Answer 47

through tick bites

Question 48

who is toxocara canis affected by

Answer 48

cats or dogs

Question 49

can toxocara replicate in humans

Answer 49

naaah

Question 50

how can toxocara cause blindlness

Answer 50

form granulomas which canc cause visual loss

Question 51

what type of investigations are used in eye infections

Answer 51

swabs- viral, bacterial and chlamydial (make patient aware). Corneal scrapes in keratitis aqueous and vitreous for culture in endophthamitis microscopy/ culture for acanthamoeba serology for toxocara and toxoplasma

Question 52

what is the most commonly used topical antibiotic

Answer 52

chloramphenicol

Question 53

what are the side effects of chloramphenicol

Answer 53

allergy, aplastic anaemia and grey baby syndrome

Question 54

what is acyclovir used for

Answer 54

dendritic ulcers of cornea

Question 55

what should be used int he treatment of chlamydial conjunctiviits

Answer 55

topical oxytetracycline

Question 56

what combination of antibiotics will treat both gram positive and gram negative organisms

Answer 56

gentamicin and cefuroxime