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ENT > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What are the common causes of infection?

A

Viral or bacterial (non-infectious is not common)

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2
Q

When are non-infectious sore throat seen?

A

physical irritation from reflux, smoking,alcohol

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3
Q

What is the most common complication of a sore throat?

A

otitis media, peri-tonsillar abscess, mastoiditis

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4
Q

What is common treatment?

A

self-limiting

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5
Q

What are common causes?

A

common cold, influenza and strep infection

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6
Q

What are less common causes?

A

HIV, gonoccocal pharyngitis, diptheria

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7
Q

When would you refer?

A

Suspect throat cancer (many weeks of pain in throat + mass)
Pain for more than 3 weeks
Pain/difficulty swallowing >3weeks
Stridor/resp difficulty

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8
Q

How will more serious infections be treated?

A

Antibiotic therapy

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9
Q

Why do you need to identify immunosuppressed people?

A

At greater risk of complications

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10
Q

What is most common cause of throat infection?

A

Strep pyogenes (group a strep)

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11
Q

What does it cause?

A

acute follicular tonsilitis

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12
Q

What is the treatment?

A

Penicillin

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13
Q

What infection control do you need to do if patient has resp symptoms and strep pyogenes throat infection?

A

Drop control (e.g. face mask and apron)

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14
Q

What is clinical presentation of diptheria?

A

severe sore throat with grey/white membrane across the pharynx - produces toxin that is cardiotoxic and neurotoxic

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15
Q

What causes diptheria?

A

Corynebacterium diphtheriae

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16
Q

What is treatment?

A

anti-toxin and supportive and penicillin/erythromycin

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17
Q

What causes oral thrush?

A

candida albicans

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18
Q

What is treatment for diptheria?

A

anti-toxin and supportive and penicillin/erythromycin

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19
Q

What causes oral thrush?

A

candida albicans

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20
Q

What is clinical presentation of oral thrush?

A

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

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21
Q

What is the treatment of oral thrush?

A

Nystatin

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22
Q

What causes otitis media?

A

URTI by extention of infection up the eustachian tube

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23
Q

Clinical presentation of otitis media?

A

earache +/- discharge

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24
Q

Treatment?

A

amoxicillin or erythromycin (if not resolved within 4 days)

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25
Q

How would you diagnose otitis media?

A

Swab if tympanic membrane rupture and pus

26
Q

Treatment of otitis media?

A

amoxicillin or erythromycin (if not resolved within 4 days)

27
Q

What is acute sinusitis?

A

mild discomfort over frontal and maxillary sinuses due to congestion seen in patients with URTI (viral) - pain and tenderness with purulent discharge suggests secondary bacterial infection.

28
Q

What is a risk factor for otitis externa?

A

Swimming

29
Q

What is the management otisis externa?

A

Clean and dry until ear recovers

Swab and use topical clotrimazole or gentamicin drops for more serious infections (or resistant)

30
Q

WHat is infectious mononucleosis?

A

Glandular fever (disease of young adults)

31
Q

What is infectious mononucleosis?

A

Glandular fever (disease of young adults)

32
Q

What is clinical presentation of infectious mononucleosis?

A 
Fever (all day)
lymphadenopathy
sore throat
pharyngitis
tonilitis
malaise
lethargy
(may have jaundice, rash)
33
Q

When will the rash appear more florid in infectious mononucleosis?

A

If amoxicillin is given

34
Q

What will be found in a blood film of someone with mononucleosis?

A

Atypical lymphocytes

Leukocytosis

35
Q

What are treatment?

A

Self-limiting

36
Q

What are complications of infectious mononucleosis?

A

anaemia, thrombocytopenia, splenic rupture (due to splenomegaly), upper airway obstruction, increased risk of lymphoma

37
Q

What is the main cause of infectious mononucleosis?

A

Epstein-Barr Virus

38
Q

What family is EBV from?

A

Herpes virus

39
Q

Describe EBV infection?

A

persistent infection in the epithelial cells (in the pharynx)

40
Q

If a child becomes infected with EBV before 10 years will they present infection?

A

NO

41
Q

If EBV primary infection occurs >10 what happens?

A

Present with infectious mononucleosis

42
Q

What is the therapy of infectious mononucleosis?

A 
Best rest
paracetamol
avoid sport
anti-virals not clinically effective
corticosteroids in complicated cases (in patients with occluded upper airway or thrombocytopenia or anaemia)
43
Q

How is infectious mononucleosis confirmed?

A 
EBV IgM test
Heterophile antibody
- monospot test/paul-bunnell test
Blood count and film
LFTs
44
Q

What does cytomegalovirus cause?

A

similar virus to mononucleosis and is a strain of herpes family

45
Q

What do toxoplasmmosis and cytomegalovirus have in common?

A

Cause glandulary fever type illness but can affect the foetus and cause foetal defects

46
Q

If negative EBV then what do you test for?

A

Primary HIV infection

47
Q

What causes gingivostomatitis?

A

HSV type 1

48
Q

What are the clinical presentation of gingivostomatitis?

A

ulceration on lips, buccal mucosa and hard palate
fever
lymphadenopathy
may spread beyond mouth (life threatening if eczema)

49
Q

How do you treat gingivostomatitis?

A

aciclovir

50
Q

Does herpes simplex virus reactivate?

A

Yes periodically as it is latent in the nerve fibres (cold sores)

51
Q

What can you give to a patient with lots of cold sores?

A

aciclovir daily to keep latent

52
Q

What is a danger for dentists and anaesthetists?

A

Herpetic whitlow (but will be prevented with gloves)

53
Q

How do you confirm HSV?

A

swab for viral DNA PCR

54
Q

What can HSV sometimes present as (rare and serious)?

A

herpes simplex encephalitis

55
Q

What causes herpangina?

A

coxsackie virus

56
Q

Where does herpangina effect?

A

soft palate

57
Q

How is herpangina treated?

A

self-limiting

58
Q

What are apthous ulcers?

A

non-viral painful recurring ulcers of that mouth that are round or ovoid and have inflammatory halos

59
Q

Clinical presentation of apthous ulcers?

A

self-limiting, recurrent, painful, confined to mouth, no systemic disease, ulcer lasts less than 3 weeks

60
Q

What can also cause recurrent ulcers?

A

Behcet’s disease, Crohn’s. IBD, drug reactions, skin disease (pemphigus/pemphigoid)

61
Q

When will syphillus been seen at mouth?

A

when oral sex with someone with a syphylis infection

ENT (11 decks)

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