Microbiology

Question 1

What is the common bacterial causes of conjunctivitis in adults?

Answer 1

Staph aureus

Strep pneuomiae

Question 2

What is the common bacterial causes of conjunctivitis in children?

Answer 2

H flu

Question 3

What is different about bacterial conjunctivitis in neonates?

Answer 3

Must be referred to ophthalmology due to possibility of contraction during birth

Question 4

Which two bacteria is particularly worrying in a neonatal conjunctivitis?

Answer 4

N gonorrhoeae

Chlamydia trachomatis

Question 5

What are common symptoms of bacterial conjunctivitis?

Answer 5

Hazy vision
Sticky discharge- often at night
Pussy exudates
Redness
Gritty feeling

Question 6

What kind of swabs are taken for conjunctivitis?

Answer 6

Bacterial
Viral
Chlamydia

Question 7

What topical antibiotic is usually given?

Answer 7

Chloramphenical

Question 8

What are the pros/cons of drops vs ointments?

Answer 8

Drops need to be kept in fridge
Drops difficult to keep sterile
Ointment harder to apply but gives soothing effect

Question 9

When must chloramphenical be avoided?

Answer 9

If history of aplastic anaemia

Question 10

What are the signs of aplastic anaemia, clinically?

Answer 10

Anaemia
Low WBC
Low platelets

Question 11

If the eye gets worse on abx treatment in bacterial conjunctivitis what must be considered?

Answer 11

An allergy to chloramphenical

Question 12

What are the symptoms of adenoviral conjunctivitis?

Answer 12

Gritty feeling
Red eyes
watery discharge
Starts with URTI

Question 13

What is the treatment for adenoviral conjunctivitis?

Answer 13

Self resolving

But symptomatic treatment of antihistamine plus artificial tears

Question 14

What is important to remember with pink eye (adenovirus conjunctivitis) ?

Answer 14

It is contagious.

Spread by share of eyeliners

Question 15

Which other two viruses commonly cause conjunctivitis?

Answer 15

Herpes zoster

Herpes simplex

Question 16

In a patient with conjunctivitis and also urethritis/vaginitis, what must be considered?

Answer 16

Chlamydial infection

Question 17

How is chlamydial conjunctivitis treated?

Answer 17

Topical and oral azithromycin

Further STI screening

Question 18

What ethical dilemma might occur when testing for chlamydia?

Answer 18

Need to tell patient what you’re testing for and ask for contact number
Contact tracing if positive

Question 19

What sign is present in chlamydial conjunctivitis?

Answer 19

Wet rice grains in internal eyelid

Question 20

What is keratitis?

Answer 20

Inflammation of cornea

Question 21

What is a hypopyon?

Answer 21

Level of white blood cells seen in the iris

Question 22

What bacteria are to blame for keratitis?

Answer 22

Staph aureus
Strep pneumoniae
H flu
Staph epidermidis

Question 23

What is often seen in bacterial keratitis?

Answer 23

Ulcer

Question 24

What is the first step in treatment of bacterial keratitis?

Answer 24

Corneal scrape

Question 25

What does the treatment for bacterial keratitis consist of?

Answer 25

Admission. | Hourly drops

Question 26

What condition presents with a dendritic ulcer?

Answer 26

Herpetic keratitis

Question 27

What should never be given for herpetic keratitis?

Answer 27

Steroids. | Steroids can cause corneal melt

Question 28

What does recurrent herpetic keratitis result in?

Answer 28

Reduced corneal sensation

Question 29

What kind of viral keratitis can steroids be given for?

Answer 29

Adenoviral keratitis

Question 30

What sign may be seen in adenoviral keratitis?

Answer 30

Subepithelial infiltrates

Question 31

Who tends to get fungal keratitis?

Answer 31

Farmers or gardeners

Question 32

What is involved in fungal keratitis treatment?

Answer 32

``` Long treatment (6 months) Topical chlorhexadine ```

Question 33

What is associated with contact lenses and keratitis?

Answer 33

Acanthamoeba | P aeruginosa

Question 34

What is associated with orbital cellulitis?

Answer 34

Pain Proptosis Pyrexia Paranasal sinusitis

Question 35

Why is orbital cellulitis an urgent case?

Answer 35

Sight threatening | Requires hospitalisation.

Question 36

What tests need to be done for orbital cellulitis?

Answer 36

Microbiology swabs | CT scan to differentiate between preseptal and orbital

Question 37

What can cause orbital cellulitis?

Answer 37

Sinus infection | Superficial infection e.g. folliculitis or chalazion

Question 38

What is a chalazion?

Answer 38

Cyst in eyelid caused by a blocked gland

Question 39

What causes endophthalmitis?

Answer 39

Surgical complication or endogenous e.g. endocarditis

Question 40

What are the symptoms of endophthalmitis?

Answer 40

Acute Decreased vision Very red

Question 41

What is the most common cause of endophthalmitis?

Answer 41

Staph epidermidis

Question 42

What is the treatment of endopthalmitis?

Answer 42

Intravitreal vancomycin | Topical antibiotics

Question 43

What is chorioretinitis?

Answer 43

Inflammation of the choroid

Question 44

What causes chorioretinitis in patients with AIDs?

Answer 44

CMV

Question 45

What other organism can cause chorioretinitis?

Answer 45

Toxocara canis (worm)

Question 46

Where do toxocara normally live?

Answer 46

Cats and dogs | Cannot replicate in humans

Question 47

What test is done for toxocara?

Answer 47

Serology

Question 48

Why is chloramphenicol not used on babies?

Answer 48

Grey baby syndrome Hypotension Low tone Cardiovascular collapse

Question 49

What is dacrocystitis?

Answer 49

Infection of nasolacrimal sac, due to obstruction of the lacrimal gland

Question 50

What antibiotic should be given if staph aureus is organism?

Answer 50

Fusidic acid