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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
what are the pathogens that can cause viral microbial keratitis?
herpes virus | adenovirus
26
what can be seen in the eye in herpetic keratitis?
dendritic ulcer
27
how does a patient with herpetic keratitis present?
eye is extremely painful
28
what does recurrences of herpetic keratitis eventually lead to?
reduced corneal sensation
29
what medication should never be given in herpetic keratitis? and why?
steroids. can cause a corneal melt and perforation of the cornea
30
is adenoviral keratits usually unilateral or bilateral?
bilateral
31
what does adenoviral keratitis usually follow?
a URTI
32
is adenoviral keratitis contagious?
yes
33
why are topical antibiotics sometimes given in adenoviral keratitis?
to prevent secondary infection
34
when are steroids required in adenoviral keratitis?
if it becomes chronic
35
what can be seen in the eye in adenoviral keratitis?
subepithelial infiltrates
36
what pathogens can cause a keratitis in someone who wears contact lenses?
Acanthamoeba | pseudomonas auruginosa
37
what causes acanthamoeba keratitis?
when people wash their contact lenses in water
38
how long does a fungal keratitis with hypopyon develop over?
a few days- less acute than bacterial one
39
in what kind of occupation does a fungal keratitis usually happen?
in farmers
40
what is there usually a history of in fungal keratitis?
trauma from vegetation
41
how does someone with orbital cellulitis present?
very painful, red swollen area around orbit. proptosis and fever
42
what is orbital cellulitis often associated with?
paranasal sinusitis
43
what makes the pain worse in orbital cellulitis?
eye movements
44
what type of orbital cellulitis is easier to treat and less sight threatening?
when infection has come from focal orbital infection
45
pathogens which cause orbital cellulitis?
staphlococci, streptococci, coliforms, haemophilus influenzae, anaerobes
46
when would you do a CT scan in orbital cellulitis?
is there is any suggestion of restriction of muscles or optic nerve dysfunction
47
how is orbital cellulitis treated?
with broad spectrum antibiotics, abscess may require drainage
48
what normally causes endophthalmitis?
post-surgical
49
what is a rarer cause of endophthalmitits?
endogenous
50
how does endophthalmitis present?
acutely, very very very painful, very red eye, decreasing vision
51
how quickly is the sight lost in endophthalmitis if not treated?
within 48 hours
52
what pathogens usually cause endophthalmitits?
- commensals | - most common is staph epidermidis
53
in eye surgery, why are antibiotics drops given at the end of the surgery?
to try prevent endophthalmitis
54
what is the treatment for endophthalmitis?
intravitreal amikacin and vancomycin and topical antibiotics
55
pathogens in chorioretinitis?
- cytomegaly virus in AIDS - toxoplasma gondii - toxocara canis
56
what is the apperance of the retina in CMV retinitis in AIDS?
haemorrhagic
57
what do you get toxoplasmosis from?
tick bites
58
what other symtoms do you get with toxoplasmosis retinitis?
mild flu like illness
59
what happens when a immunocompetent has toxoplasmosis retinitis?
enters latent phase with cysts forming
60
what can be seen in the vitreous humour in toxoplasma retinitis?
inflammatory cells
61
how is toxoplasma retintis treated?
usually self limiting, only needs treated if vision is compromised
62
what is toxocara?
a parasite (roundwarm) that affects cats and dogs
63
why is toxocara retinitis often self limiting?
unable to replicate in humans and remains an immature form of the worm
64
what can happen in toxocara retinitis thst causes irreversible visual loss?
form granulomas
65
in what eye infection is corneal scrapes taken?
in bacterial keratitis
66
where is the culture taken from in endophthalmitis?
aqueous/vitreous humour
67
what test is done for toxoplasma and toxocara?
serology
68
what does chloramphenicol inhibit?
peptidyl transferase enzyme
69
what pathogens does chlorampenicol have a bacterocidal affect on?
strep and haemoophilus `
70
what affect does chloramphenicol have on staph?
bacterostatic
71
what is dacrocystitis?
stasis of tears draining, duct becomes blocked and infected
72
how is dacrocystitis treated?
systemic antibiotics
73
how does aciclovir inhibit DNA synthesis?
it is a base analogue, it mimics guanine
74
how is dendritic ulcers of the cornea treated?
with antivirals - aciclovir
75
what antibiotic is used to treat staph aureus conjuctivitits?
fusidic acid
76
what antibiotic is used to treat pseudomonas aeruginosa conjuctivitis?
gentamicin
77
how is chlamydial conjuctivitis treated?
topical oxytetracycline
78
what extra treatment may an adult with chlamydial conjuctivitis also need?
oral azithromycin for genital chlamydia infection
79
what does a 4-quinolone (ofloxacin) treat?
most gram neg bacterias including coliforms, pseudomonas aeruginosa, h.influenza
80
what is a 4-quinolone (oflocacin) not active against?
strep. pneumoniae
81
what will the combination of gentamicin and cefuroxime cover?
most gram positive and gram negative organisms

Ophthalmology Week 1 (6 decks)

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