Microbiology

Question 1

Name 4 types of conjunctivitis

Answer 1

Bacterial
Viral
Chlamydial
Allergic

Question 2

Bacterial conjunctivitis - clinical features

Answer 2

Red eye
Lots of pus
Sticky discharge 
Gritty sensation
Vision is unaffected

Question 3

Bacterial conjunctivitis - unilateral or bilateral

Answer 3

Starts unilateral and becomes bilateral

Question 4

Bacterial conjunctivitis - papillae or follicles

Answer 4

Papillae

Question 5

Bacterial conjunctivitis - investigations

Answer 5

Local anaesthetic then take swab from tissue inside fornix

Question 6

Bacterial conjunctivitis - management

Answer 6

Self limiting but topical antibiotics clear it faster

Question 7

Bacterial conjunctivitis - example of topical antibiotics used (and side effects)

Answer 7

Chloramphenical

- patient may develop worsening of symptoms with this treatment. If this occurs then the patient may be allergic to it.

Question 8

Bacterial conjunctivitis - what does chloramphenicol not treat

Answer 8

Pseudomonas aeruuginosa (treat with gentamicin)

Question 9

Chlamydial conjunctivitis - clinical features

Answer 9

Chronic history
Red eye
Painless
May have symptoms of urethritis, vaginitis

Question 10

Chlamydial conjunctivitis - Definition

Answer 10

Chronic unilateral follicular conjunctivitis

Question 11

Chlamydial conjunctivitis - examination

Answer 11

Follicles - looks like rice grains

Question 12

Chlamydial conjunctivitis - management

Answer 12

Usually unresponsive

Topical oxytetracycline

Question 13

Viral conjunctivitis - clinical features

Answer 13

Watery eyes
Pink eyes
Bottom eyelid is affected

Question 14

Viral conjunctivitis - examination

Answer 14

Red velvety appearance of conjunctiva

Follicles (look like rice grains on conjunctiva)

Question 15

Viral conjunctivitis - causes

Answer 15

Adenovirus
Herpes simplex
Herpes zoster

Question 16

Keratitis

Answer 16

Inflammation of the cornea

Question 17

Bacterial keratitis - clinical features

Answer 17

Painful eye
Red eye around limbus
Reduced vision
Hypopyon

Question 18

Bacterial keratitis - examination

Answer 18

Abnormal corneal reflection

Question 19

Bacterial keratitis - investigations

Answer 19

Corneal scrape

Question 20

Bacterial keratitis - management

Answer 20

Hourly drops (day and night)
Ofloxacin 
Gentamicin and Cefuroxime (if ofloxacin doesn't work)

Question 21

Hypopyon

Answer 21

Fluid level of pus in the anterior chamber

Question 22

Viral keratitis - example

Answer 22

Herpetic keratitis which causes dendritic ulcer

Question 23

Viral keratitis - clinical features

Answer 23

Very painful 
Red eye around limbus 
Recurrent - every time pt gets an episode the pain lessens due to reduced corneal sensation 
Profuse lacrimation 
Vision may be reduced

Question 24

Viral keratitis - dendritic ulcer

Answer 24

Located in the cornea
It is white and thin
Has many branches like a tree

Question 25

Viral keratitis - investigations

Answer 25

Fluroscene dye and then shine blue light

Question 26

Viral keratitis - management

Answer 26

Antivirals eg zovirax (aciclovir)

Question 27

Viral keratitis - which medication do you NOT use and why?

Answer 27

Steroids | - this can result in a geographical ulcer which can burst causing perforation of the cornea

Question 28

Adenovirus keratitis - cause

Answer 28

Usually occurs after a URTI

Question 29

Adenovirus keratitis - clinical features

Answer 29

Small white sub-epithelial infiltrates on the cornea | Bilateral

Question 30

Adenovirus keratitis - management

Answer 30

Self limiting | May give topical antibiotics to prevent secondary infection

Question 31

Fungal keratitis - clinical features

Answer 31

Chronic history | Not really sore

Question 32

Autoimmune keratitis - clinical features

Answer 32

Loss of the peripheral aspect of the cornea

Question 33

Endopathlmitis - definition

Answer 33

Infection of the inside of the eye | Affects the entire globe

Question 34

Endopthalmitis - causative organisms

Answer 34

Often commensals - e.g. staph epidermidis

Question 35

Endopthalmitis - clinical features

Answer 35

Very painful Decreasing vision Very red eye

Question 36

Endopthalmitis - investigations

Answer 36

Culture of aqueous humour or vitreous body

Question 37

Endopthalmitis - management

Answer 37

Inject antibiotics into the eye | - amikacin, vancomycin

Question 38

Orbital cellulitis - definition

Answer 38

Infection which affects the skin around the eye

Question 39

Orbital cellulitis - cause

Answer 39

Post sinus surgery sinus infection laceration to the eye

Question 40

Orbital cellulitis - clinical features

Answer 40

``` Redness to the rim of the orbit Collection of pus within orbit Painful during eye movements Swollen, tender eyelid Proptosis Fever Mucous dripping out of nose ```

Question 41

Orbital cellulitis - investigations

Answer 41

CT scan

Question 42

Orbital celulitis - management

Answer 42

Broad spectrum antibiotics

Question 43

Toxoplasma gondii - which type of infection?

Answer 43

Protozoan

Question 44

Toxoplasma gondii - cause

Answer 44

Cats | Raw meat

Question 45

Toxoplasma gondii - examination

Answer 45

Brown area of the retina | White fluffy area of retina is the reactivated organism

Question 46

Toxoplasma gondii - complications

Answer 46

Reactivation

Question 47

Toxacara - which type of infection?

Answer 47

Parasitic

Question 48

Toxacara - cause

Answer 48

Cats, Dogs

Question 49

Toxacara - complications

Answer 49

Formation of granulomas causes irreversible visual loss

Question 50

Dacrocystitis - definition

Answer 50

Due to blockage of the lacrimal canniculi