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ENT > Microbiology > Flashcards

Microbiology Flashcards

1
Q

When should a sore throat be considered a medical emergency?

A

when combined with stridor or respiratory difficulty

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2
Q

What are the causes of inflammation by non-infectious means?

A

uncommon but include physical irritation eg from GORD; chronic irritation from cigarette smoke; alcohol or hayfever

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3
Q

Who do acute throat infections most common affect?

A

those aged 5-10 a nd 15-25`

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4
Q

What are the complications of a sore throat?

A

otitis media; peri-tonsillar abscess (quinsy); parapharyngeal abscess and mastoiditis

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5
Q

What should be suspected if sore throad and lethargy persist into the second week in 15-25 yos?

A

infectious mononucleosis

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6
Q

What are the causes for referral or admission with a sore throat?

A

if throat cancer is suspected; pain on swalling/dysphagia for more than 3 weeks; red or red and white patches or ulceration or swelling of the oral/pharyngeal mucosa persists for more than 3 weeks

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7
Q

What score should be used to assist decision on whether to give an antibiotic?

A

Centor clinical prediction score

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8
Q

What are the components of the Centor score?

A

tonsillar exudate; tender anterior cervical lymph nodes; hx of fever; absence of cough

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9
Q

What is the most common cause of bacterial sore throad?

A

step. pyogenes

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10
Q

what is the treatment for strep. pyogenes?

A

penicillin

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11
Q

What is seen on microbiology of strep. pyogenes?

A

gram positive cocci in chain; beta-haemolysis (complete)

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12
Q

What are the late complications of strep. sore throat?

A

rheumatic fever; glomerulonephritis

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13
Q

What are the signs of rheumatic fever?

A

fever; arthritis and pancarditis

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14
Q

What are the signs of glomerulonephritis?

A

haematuria; albuminuria and oedema

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15
Q

When does rheumatic fever arise after strep throat?

A

3 week post

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16
Q

When does glomerulonephritis arise after a strep throat?

A

1-3 weeks post

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17
Q

What are the features of Diphtheria?

A

severe sore throat with a grey white (pseudo) membrane across the pharynx

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18
Q

How does the organims cause illness?

A

a potent exotoxin

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19
Q

Why is diphtheria so serious?

A

the exotoxin is cardiotoxic and neurotoxic

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20
Q

What is the vaccine for diptheria made from?

A

toxoid

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21
Q

What is the treatment for diphtheria?

A

antitoxin and supportive and penicillin/erythromycin

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22
Q

What are the signs of candida/thrush?

A

white patches on red, raw mucous membranes in throat/mouth

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23
Q

What is the treatment for candida?

A

nystatin

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24
Q

What is acute otitis media?

A

a URTI involving the middle ear by extension of infection up the eustachian tube

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25
Q

Who gets otitis media?

A

infants and children

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26
Q

What are infections ofr the middle ear often caused by?

A

viral with bacterial secondary infection

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27
Q

What are the most common bacteria causing infections of the middle ear?

A

haemophilus influenzae; strep. pneumoniae; strep. pyogenes

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28
Q

How can a sample be obtained for infections of the middle ear?

A

swab of pus if eardrum perforates, otherwise samples cant be obtained

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29
Q

What is the first line antibiotic for infections ofr the middle ear?

A

amoxicillin

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30
Q

What is second line antibiotic for middle ear infefctions?

A

erythromycin

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31
Q

What are the signs of acute sinusitis?

A

mild discomfort over frontal or maxillary sinuses due to congestion often seen with URTI

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32
Q

What would indicate a secondary bacterial infection with acute sinusitis?

A

severe pain and tenderness with purulent discharge

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33
Q

When should antibiotics be given with sinusitis?

A

for severe/deteriorating cases of more than 10 days

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34
Q

What is the first line antibiotic for sinusitis?

A

penicillin V

35
Q

What is the second line antibiotic for sinusitis?

A

doxycycline

36
Q

Who should doxycycline NOT be given to?

A

children

37
Q

What is otitis externa?

A

inflammation fo the outer ear canal

38
Q

What are the signs of otitis externa?

A

redness and swelling of the skin of the ear canal; itchiness; sore and painful; discharge or increased wav

39
Q

What is malignant otitis?

A

an extension of otitis externa in to the bone surrounding the ear canal which is fatal without treatment

40
Q

What bones does malignant otits affect?

A

mastoid and temporal bones

41
Q

What are the symptoms and signs of malignant otits?

A

pain and hedache, more severe than clinical signs would suggest; granulation tissue at bone-cartilage junction of ear canal; exposed bone in the ear canal; facial nerve palsy

42
Q

What is facial nerve palsy?

A

drooping face on the side of the lesion

43
Q

What are the investigations for malignant otitis?

A

PV; CRP; imagin; biopsy and culture

44
Q

What is the most common bacteria in malignant otitis?

A

pseudomonas

45
Q

What are the risk factors for malignant otitis?

A

DM; PMH of radiotherapy

46
Q

What are the bacterial causes of otitis externa?

A

staph. aureus; proteus; pseudomonas; aspergillus; candida

47
Q

What is the treatment for otitis externa?

A

topical aural toilet

48
Q

When should a swab and prescription be done for otitis externa?

A

unresponsive and severe cases

49
Q

What might you prescribe for otitis externa depending on the culture results?

A

topical clotramizole or gentamicin drops

50
Q

What is the classic triad seen in infectious mononucleosis?

A

fever; pharyngitis and lymphadenpathy

51
Q

What are other signs of glandular fever?

A

jaundice/hepatitis; rash; leucocytosis; presence of stypical lymphocytes in blood film; splenomegaly; palatal petechiae

52
Q

What antibiotic results in a rash with glandular fever?

A

ampicillin or amoxicillin

53
Q

What do the atypical lymphocytes seen with glandular fever look like?

A

activated cytotoxic T lymphocytes- larger, irregular nucleus and high level of ribosomes

54
Q

What are complications of glandular ever?

A

anaemia; thrombocytopania; splenic rupture; upper airway obstrucition; increased risk of lymphoma esp. in immunosuppressed

55
Q

What should be avoided following glandular fever and why?

A

avoid sports for 6 weeks- splenic rupture

56
Q

What virus causes glandular fever?

A

EBV

57
Q

What are the 2 phases of primary infection with EBV?

A

early childhood- rarely results in glandular fever; in over 10s often causes

58
Q

What is the therapy for glandular fever?

A

ebd rest; avoid sport; paracetamol

59
Q

How is glandular fever comfrimed in the lab?

A

EBV IgM; monospot- heterophile antibody; blood count and film; LFTs

60
Q

How can you differentiate between EBV and CMV which cause very similar disease??

A

no heterophile antibody and fewer atypical lymphocytes

61
Q

When is type 1 HSV typically acquired?

A

childhood

62
Q

What does type 1 HSV cause?

A

oral lesions

63
Q

How is HSV transferred?

A

salivary contact

64
Q

What disease can occur with primary infection of HSV type 1?

A

primary gingivostomatitis

65
Q

What are the signs of primary gingivostomatitis?

A

systemic upset-fever, local lymphadenopathy; lips, buccal mucosa, hard palate affected with vesicles and ulcers

66
Q

How is primary gingivostomatitis treated?

A

aciclovir

67
Q

Where is herpes held latent?

A

inactive form of virus in sensory nerve cells of trigeminal ganglia (nerve that serves the area of the mouth)

68
Q

Does aciclovir prevent latency?

A

no

69
Q

What is the percentage of people that get clinical reoccurences with HSV1?

A

half

70
Q

What would recurrent intra-oral lesions indicate?

A

Rarely cause by HSV so likely to be something else

71
Q

What is herpetic whitlow?

A

HSV infected in fingers

72
Q

How is HSV confirmed in the lab?

A

swab of lesion and viral DNA detected by PCR

73
Q

What is a complication of HSV in the CNS?

A

herpes simplex encephalitis

74
Q

What causes herpangina?

A

coxsackie virus-enterovirus

75
Q

What are the signs of herpangina?

A

vesicles/ulcers on soft palate

76
Q

What patient group gets herpangina?

A

children

77
Q

What virus causes hand, foot and mouth disease?

A

coxsakcie virus

78
Q

What are apthous ulcers?

A

recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos- each ulcer lasts less than 3 weeks; absence of systemic disease

79
Q

What causes apthous ulcers?

A

non-viral, self limiting

80
Q

What is the triad seen with Behcets disease?

A

recurrent oral ulcers; genital ulcers and uceitis

81
Q

Where is Behcets most common?

A

middle east and asia

82
Q

What is the triad foudn with Reiters ?

A

Noninfectious urethritis
Arthritis
Conjunctivitis

83
Q

What are the cahracteritics of a chancre?

A

painless indurated ulcer at site of entry of Treponema pallidum

84
Q

What is a chancre a sign of?

A

syphilis

ENT (13 decks)

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