Microbiology

Question 1

Keratitis affects…

Answer 1

the cornea

Question 2

Endophthalmitis affects…

Answer 2

the whole globe

Question 3

Common causes of bacterial conjunctivitis in neonates

Answer 3

Staph aureus, neisseria gonorrhoeae, Chlamydia trachomatis

Question 4

Common causes of bacterial conjunctivitis in all ages

Answer 4

staph aureus, strep penumoniae, haemophilus influenza

Question 5

Common treatment for bacterial conjunctivitis

Answer 5

chloramphenicol drops or ointment (qds)

Question 6

How do you confirm bacterial conjunctivitis?

Answer 6

tissue swab from the fornix - you may wish to give an LA drop first

Question 7

Common causes of viral conjunctivitis (3)

Answer 7

Adenovirus, Herpes simplex, herpes zoster

Question 8

How might adenovirus conjunctivitis present?

Answer 8

watery, red eye following URTI

Question 9

Treatment for adenovirus conjunctivitis

Answer 9

cold compress should suffice, give antibacterial drops if worried about secondary infection

Question 10

Presentation of herpes zoster conjunctivitis

Answer 10

Hutchisons sign, red eye and spots on nose

Question 11

Treatment of herpes zoster conjunctivitis

Answer 11

anti-virals such as acyclovir

Question 12

Complication of herpes zoster ophthalmicus

Answer 12

post-herpetic neuralgia

Question 13

What is hutchisons sign?

Answer 13

vesicles on the side of the nose which precede herpes zoster ophthalmicus

Question 14

Common presentation of chlamydial conjunctivitis

Answer 14

often chronic history which is unresponsive to treatment, suspect if bilateral conjunctivitis in young adults

Question 15

Clinical sign of chlamydial conjunctivitis

Answer 15

rice grains in eyelids which can cause chronic follicular scarring of the lid

Question 16

What is a hypopyon?

Answer 16

an obvious fluid level in the anterior segment of the anterior chamber

Question 17

Bacterial keratitis treatment

Answer 17

hourly eye drops for at least 48 hours and daily review

Question 18

Presentation of herpes viral keratitis

Answer 18

Dendritic ulcers with a very painful eye which can be recurrent. Pain is less each time but vision will deteriorate

Question 19

Treatment of viral keratitis

Answer 19

Zovirax

Question 20

Must be avoided with viral keratitis

Answer 20

Steroids - may cause a corneal melt

Question 21

Presentation of adenoviral keratitis

Answer 21

Usually after URTI, subepithelail infiltrates but self-limiting. Can be contagious

Question 22

Orbital cellulitis presentation

Answer 22

Painful and swelling around the eye. May be pyrexial. Proptosis may occur. Well defined redness around the orbit

Question 23

Treatment of orbital cellulitis

Answer 23

broad spectrum antibiotic and monitor closely. Abcess may require draining

Question 24

Cause of endophthalmitis

Answer 24

post-surgical or endogenous

Question 25

Presentation of endophthalmitis

Answer 25

VERY painful, with decreasing vision and very red eye - sight threatening

Question 26

Treatment of endophthalmitis

Answer 26

Intravitreal antibiotics and topical antibiotics

Question 27

Toxoplasma gondii

Answer 27

protozoan infection. 10% have it in latent form. From cats and raw meat

Question 28

Cautions for Chloramphenicol

Answer 28

Aplastic anemia; grey baby syndrome

Question 29

Alternative antibiotic if chloramphenicol not an option?

Answer 29

Ofloxacin

Question 30

Common contaminant of eyedrops after 4 weeks

Answer 30

Pseudomonas