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Ophthalmology Week 1 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

what is keratitis?

A

inflammation of the cornea

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2
Q

what is it called when the entire globe is infected?

A

endophthalmitis

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3
Q

what are the 3 pathogens in bacterial conjuctivitis of neonates?

A

staph aureus
neisseria gonorrhoeae
chlamydia trachomatis

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4
Q

main causes of bacterial conjuctivitis in other age groups (not neonates)?

A

staph aureus
strep pneumoniae
haemophilus influenza

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5
Q

in what age group is Haemophilus influenza conjuctivitis most common?

A

in children

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6
Q

how can a patient with bacterial conjuctivitis present?

A

red eye, vision may be hazy, sticky discharge, eyelids often stick together

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7
Q

what topical antibiotic is usually used in bacterial conjuctivitis?

A

chloramphenical

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8
Q

in which 2 ways can topical chloramphenical be given?

A

drops or ointment

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9
Q

when should you avoid giving chlorampenical?

A

if there is a history of aplastic anaemia or allergy

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10
Q

what should you be thinking about if symptoms of bacterial conjuctivitits worsens after giving chlorampenical?

A

allergy

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11
Q

how many drops of cholampenical are needed per day to treat bacterial conjuctivitis?

A

4 times daily

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12
Q

what is different in a viral conjuctivitits compared to a bacterial conjuctivitis?

A

watery discharge not a sticky pussy discharge

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13
Q

3 most common causes of viral conjuctivitis?

A

adenovirus
herpes simplex
herpes zoster

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14
Q

what can be seen around the eye in herpex simplex conjuctivitis?

A

little white spots

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15
Q

what is Hutchinson’s sign?

A

vesicles on the tip or side of nose which represents herpes zoster affecting ophthalmic branch of trigeminal nerve

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16
Q

what should you consider in a young person with bilateral conjuctivtis that is unresponsive to treatment?

A

chlamydial conjuctivitis

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17
Q

what other symptoms might someone with chlamydial conjuctivitis have?

A

urethritis or vaginitis

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18
Q

how is chlamydial conjuctivitis diagnosed?

A

chlamydial swab

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19
Q

if chlamydial conjuctivitits is not treated, what can develop on the upper inner eyelid?

A

follicles

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20
Q

if follicles develop in chlamydial conjuctivitis, what can this lead to?

A

subtarsal scarring

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21
Q

when is a hypopyon seen?

A

in bacterial keratitis

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22
Q

what is a hypopyon and what does it look like?

A

white because it is filled with inflammatory exudate and u can see a white fluid level in the anterior chamber of the eye

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23
Q

what should you do if someone presents with a bacterial keratitis with hypopyon and why?

A

refer them to ophthalmology urgently as they can lose their eye

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24
Q

how is a bacterial keratitis treated?

A

need admission for hourly drops, daily review

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25
Q

what are the pathogens that can cause viral microbial keratitis?

A

herpes virus

adenovirus

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26
Q

what can be seen in the eye in herpetic keratitis?

A

dendritic ulcer

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27
Q

how does a patient with herpetic keratitis present?

A

eye is extremely painful

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28
Q

what does recurrences of herpetic keratitis eventually lead to?

A

reduced corneal sensation

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29
Q

what medication should never be given in herpetic keratitis? and why?

A

steroids. can cause a corneal melt and perforation of the cornea

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30
Q

is adenoviral keratits usually unilateral or bilateral?

A

bilateral

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31
Q

what does adenoviral keratitis usually follow?

A

a URTI

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32
Q

is adenoviral keratitis contagious?

A

yes

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33
Q

why are topical antibiotics sometimes given in adenoviral keratitis?

A

to prevent secondary infection

34
Q

when are steroids required in adenoviral keratitis?

A

if it becomes chronic

35
Q

what can be seen in the eye in adenoviral keratitis?

A

subepithelial infiltrates

36
Q

what pathogens can cause a keratitis in someone who wears contact lenses?

A

Acanthamoeba

pseudomonas auruginosa

37
Q

what causes acanthamoeba keratitis?

A

when people wash their contact lenses in water

38
Q

how long does a fungal keratitis with hypopyon develop over?

A

a few days- less acute than bacterial one

39
Q

in what kind of occupation does a fungal keratitis usually happen?

A

in farmers

40
Q

what is there usually a history of in fungal keratitis?

A

trauma from vegetation

41
Q

how does someone with orbital cellulitis present?

A

very painful, red swollen area around orbit. proptosis and fever

42
Q

what is orbital cellulitis often associated with?

A

paranasal sinusitis

43
Q

what makes the pain worse in orbital cellulitis?

A

eye movements

44
Q

what type of orbital cellulitis is easier to treat and less sight threatening?

A

when infection has come from focal orbital infection

45
Q

pathogens which cause orbital cellulitis?

A

staphlococci, streptococci, coliforms, haemophilus influenzae, anaerobes

46
Q

when would you do a CT scan in orbital cellulitis?

A

is there is any suggestion of restriction of muscles or optic nerve dysfunction

47
Q

how is orbital cellulitis treated?

A

with broad spectrum antibiotics, abscess may require drainage

48
Q

what normally causes endophthalmitis?

A

post-surgical

49
Q

what is a rarer cause of endophthalmitits?

A

endogenous

50
Q

how does endophthalmitis present?

A

acutely, very very very painful, very red eye, decreasing vision

51
Q

how quickly is the sight lost in endophthalmitis if not treated?

A

within 48 hours

52
Q

what pathogens usually cause endophthalmitits?

A
  • commensals

- most common is staph epidermidis

53
Q

in eye surgery, why are antibiotics drops given at the end of the surgery?

A

to try prevent endophthalmitis

54
Q

what is the treatment for endophthalmitis?

A

intravitreal amikacin and vancomycin and topical antibiotics

55
Q

pathogens in chorioretinitis?

A
  • cytomegaly virus in AIDS
  • toxoplasma gondii
  • toxocara canis
56
Q

what is the apperance of the retina in CMV retinitis in AIDS?

A

haemorrhagic

57
Q

what do you get toxoplasmosis from?

A

tick bites

58
Q

what other symtoms do you get with toxoplasmosis retinitis?

A

mild flu like illness

59
Q

what happens when a immunocompetent has toxoplasmosis retinitis?

A

enters latent phase with cysts forming

60
Q

what can be seen in the vitreous humour in toxoplasma retinitis?

A

inflammatory cells

61
Q

how is toxoplasma retintis treated?

A

usually self limiting, only needs treated if vision is compromised

62
Q

what is toxocara?

A

a parasite (roundwarm) that affects cats and dogs

63
Q

why is toxocara retinitis often self limiting?

A

unable to replicate in humans and remains an immature form of the worm

64
Q

what can happen in toxocara retinitis thst causes irreversible visual loss?

A

form granulomas

65
Q

in what eye infection is corneal scrapes taken?

A

in bacterial keratitis

66
Q

where is the culture taken from in endophthalmitis?

A

aqueous/vitreous humour

67
Q

what test is done for toxoplasma and toxocara?

A

serology

68
Q

what does chloramphenicol inhibit?

A

peptidyl transferase enzyme

69
Q

what pathogens does chlorampenicol have a bacterocidal affect on?

A

strep and haemoophilus `

70
Q

what affect does chloramphenicol have on staph?

A

bacterostatic

71
Q

what is dacrocystitis?

A

stasis of tears draining, duct becomes blocked and infected

72
Q

how is dacrocystitis treated?

A

systemic antibiotics

73
Q

how does aciclovir inhibit DNA synthesis?

A

it is a base analogue, it mimics guanine

74
Q

how is dendritic ulcers of the cornea treated?

A

with antivirals - aciclovir

75
Q

what antibiotic is used to treat staph aureus conjuctivitits?

A

fusidic acid

76
Q

what antibiotic is used to treat pseudomonas aeruginosa conjuctivitis?

A

gentamicin

77
Q

how is chlamydial conjuctivitis treated?

A

topical oxytetracycline

78
Q

what extra treatment may an adult with chlamydial conjuctivitis also need?

A

oral azithromycin for genital chlamydia infection

79
Q

what does a 4-quinolone (ofloxacin) treat?

A

most gram neg bacterias including coliforms, pseudomonas aeruginosa, h.influenza

80
Q

what is a 4-quinolone (oflocacin) not active against?

A

strep. pneumoniae

81
Q

what will the combination of gentamicin and cefuroxime cover?

A

most gram positive and gram negative organisms

Ophthalmology Week 1 (6 decks)

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