Microbiology

Question 1

what symptoms alongside a sore throat would warrant admission to hospital?

Answer 1

stridor

respiratory difficulty

Question 2

what infection other than tonsillitis can cause pain at the back of the mouth?

Answer 2

acute pharyngitis

Question 3

main complications of acute conditions affecting the throat?

Answer 3

otitis media
quinsy
epiglottitis
mastoiditis

Question 4

what is quinsy?

Answer 4

peri-tonsillar abscess

Question 5

how long do throat infections tend to last?

Answer 5

no more than a week

Question 6

when should glandular fever be suspected in sore throat patients?

Answer 6

sore throat and lethargy lasting over a week in a teen

Question 7

when should you suspect throat cancer in someone with a sore throat?

Answer 7

if they have a mass

if the sore throat is persistent

Question 8

most common cause of acute follicular tonsillitis in young people?

Answer 8

group a beta haemolytic strep aka strep pyogenes

Question 9

Tx for bacterial tonsillitis?

Answer 9

penicillin

Question 10

how does strep pyogenes appear on gram stain?

Answer 10

gram positive cocci in chain

Question 11

complications of strep throat?

Answer 11

rheumatic fever

glomerulonephritis

Question 12

why do you get oedema in glomerulonephritis?

Answer 12

due to low albumin

Question 13

what bacteria is responsible for diphtheria?

Answer 13

corynebacterium diphtheriae

Question 14

young boy presents with severe sore throat and a grey/white pseudomembrane across the pharynx. Dx?

Answer 14

diphtheria

Question 15

does corynebacterium diphtheriae produce exo or endotoxin?

Answer 15

exotoxin

Question 16

Tx for diphtheria

Answer 16

antitoxin

penicillin/erythromycin

Question 17

what is an endogenous infection?

Answer 17

when a commensal becomes opportunistic and virulent

Question 18

young girl presents with white patches on her tongue and other mucus membranes. Dx?

Answer 18

thrush

Question 19

Tx for oral thrush?

Answer 19

nystatin

Question 20

presentation of otitis media?

Answer 20

earache

Question 21

where is the infection in otitis media

Answer 21

eustachian tube

Question 22

are middle ear infections mainly viral or bacterial?

Answer 22

viral

Question 23

most common bacterial causes of otitis media?

Answer 23

strep pneumoniae
haemophilus influenzae
moraxella

Question 24

Ix of otitis media

Answer 24

can only be done if eardrum perforates;

if yes do swab of pus

Question 25

Tx of otitis media?

Answer 25

paracetamol/ibruprofen 2. amoxicillin if it lasts more than 4 days 3. erythromycin

Question 26

when would you suspect an acute sinusitis is caused by a secondary bacterial infection?

Answer 26

severe pain and tenderness with purulent nasal discharge

Question 27

how long does acute sinusitis last?

Answer 27

2-3 weeks

Question 28

1st and 2nd line tx for acute sinusitis?

Answer 28

penicillin V | doxycycline (NOT IN KIDS)

Question 29

doxycycline is not safe for use in children T or F

Answer 29

T

Question 30

red, swollen itchy outer ear with increased earwax?

Answer 30

otitis externa

Question 31

how does malignant otitis differ from otitis externa?

Answer 31

infection goes to bone surrounding ear canal

Question 32

symptoms of malignant otitis?

Answer 32

severe pain and headache

Question 33

signs of malignant otitis on examination and investigation?

Answer 33

granulation tissue exposed bone in ear canal facial nerve palsy high CRP/PV

Question 34

bacterial causes of otitis externa?

Answer 34

staph aureus | pseudomonas aeruginosa

Question 35

fungal causes of otitis externa?

Answer 35

aspergillus niger | candida albicans

Question 36

Tx of otitis externa?

Answer 36

topical aural toilet canesten for fungal gentamicin drops for bacterial

Question 37

fever, pharyngitis and lymphadenoathy is a classical triad of symptoms for what condition?

Answer 37

infectious mononucleosis/ glandular fever

Question 38

what antibiotic sometimes prescribed in glandular fever can cause a rash

Answer 38

amoxicillin

Question 39

splenomegaly is rare in glandular fever: T or F?

Answer 39

F, 50% of patients get it

Question 40

haematological findings in glandular fever?

Answer 40

leucocytosis (high WCC) | presence of atypical lymphocytes

Question 41

what are palatal petechiae?

Answer 41

red, tiny haemorrhages commonly found on the hard palate of the mouth

Question 42

how long does fever and pharyngitis in glandular fever last?

Answer 42

2-4 weeks

Question 43

how does the EBV activate in glandular fever?

Answer 43

get infected in childhood -> latent | reactivates through exchange of saliva typically in teens

Question 44

Tx for glandular fever?

Answer 44

bed rest paracetamol NOT antivirals avoid sport

Question 45

Ix for glandular fever?

Answer 45

epstein barr IgM LFTs heterophile Ab

Question 46

difference on investigation between CMV and EBV?

Answer 46

CMV doesnt have heterophile Ab | CMV has fewer atypical lymphocytes

Question 47

what is primary gingivostomatitis a complication of?

Answer 47

HSV1

Question 48

Tx for primary gingivostomatitis?

Answer 48

aciclovir

Question 49

where does the inactive form of HSV1 reside?

Answer 49

sensory nerve cells

Question 50

Ix for HSV?

Answer 50

viral swab for PCR

Question 51

brain comolication of HSV?

Answer 51

herpes simplex encephalitis

Question 52

what is herpangina?

Answer 52

vesicles/ulcers on soft palate

Question 53

cause of herpangina?

Answer 53

coxsackie viruses | NOT HSV

Question 54

cause of hand foot and mouth disease?

Answer 54

coxsackie viruses

Question 55

how long should apthous ulcers persist for?

Answer 55

less than weeks

Question 56

what is a chancre and what condition is it seen in?

Answer 56

painless hard ulcer on genitalia | syphilis

Question 57

what antibiotic covers most gram negative organisms?

Answer 57

gentamicin

Question 58

how is an aspergillus caused otitis externa acquired in swimmers?

Answer 58

aspergillus is environmentally transmitted, swimming pools are moist and warm so the organism grows

Question 59

Tx of fungal otitis externa?

Answer 59

clotrimazole | ear hygiene

Question 60

what antibiotic should be given for tonsillitis?

Answer 60

phenoxymethylpenicillin

Question 61

"large atypical lymphocytes on blood film" indicates what condition?

Answer 61

glandular fever

Question 62

why is amoxicillin prescribed over penicillin for AOM?

Answer 62

better oral absorption

Question 63

Tx for acute otitis media?

Answer 63

oral amoxicillin

Question 64

child with flu like symptoms, problems eating, papules and pain in the legs and feet?

Answer 64

hand foot and mouth

Question 65

what group of viruses can cause hand foot and mouth disease?

Answer 65

coxsackie viruses

Question 66

what kind of virus are the coxsackie viruses?

Answer 66

enteroviruses

Question 67

how are the coxsackie viruses spread?

Answer 67

faecal oral

Question 68

how long does the coxsackie virus cause symptoms for?

Answer 68

1 week

Question 69

name the 4 C's antibiotics; why are they relevant?

Answer 69

clindamycin ciprofloxacin coamoxiclav cephalosporin all can cause c diff