Microbiology Flashcards
what symptoms alongside a sore throat would warrant admission to hospital?
stridor
respiratory difficulty
what infection other than tonsillitis can cause pain at the back of the mouth?
acute pharyngitis
main complications of acute conditions affecting the throat?
otitis media
quinsy
epiglottitis
mastoiditis
what is quinsy?
peri-tonsillar abscess
how long do throat infections tend to last?
no more than a week
when should glandular fever be suspected in sore throat patients?
sore throat and lethargy lasting over a week in a teen
when should you suspect throat cancer in someone with a sore throat?
if they have a mass
if the sore throat is persistent
most common cause of acute follicular tonsillitis in young people?
group a beta haemolytic strep aka strep pyogenes
Tx for bacterial tonsillitis?
penicillin
how does strep pyogenes appear on gram stain?
gram positive cocci in chain
complications of strep throat?
rheumatic fever
glomerulonephritis
why do you get oedema in glomerulonephritis?
due to low albumin
what bacteria is responsible for diphtheria?
corynebacterium diphtheriae
young boy presents with severe sore throat and a grey/white pseudomembrane across the pharynx. Dx?
diphtheria
does corynebacterium diphtheriae produce exo or endotoxin?
exotoxin
Tx for diphtheria
antitoxin
penicillin/erythromycin
what is an endogenous infection?
when a commensal becomes opportunistic and virulent
young girl presents with white patches on her tongue and other mucus membranes. Dx?
thrush
Tx for oral thrush?
nystatin
presentation of otitis media?
earache
where is the infection in otitis media
eustachian tube
are middle ear infections mainly viral or bacterial?
viral
most common bacterial causes of otitis media?
strep pneumoniae
haemophilus influenzae
moraxella
Ix of otitis media
can only be done if eardrum perforates;
if yes do swab of pus
Tx of otitis media?
paracetamol/ibruprofen
- amoxicillin if it lasts more than 4 days
- erythromycin
when would you suspect an acute sinusitis is caused by a secondary bacterial infection?
severe pain and tenderness with purulent nasal discharge
how long does acute sinusitis last?
2-3 weeks
1st and 2nd line tx for acute sinusitis?
penicillin V
doxycycline (NOT IN KIDS)
doxycycline is not safe for use in children T or F
T
red, swollen itchy outer ear with increased earwax?
otitis externa
how does malignant otitis differ from otitis externa?
infection goes to bone surrounding ear canal
symptoms of malignant otitis?
severe pain and headache
signs of malignant otitis on examination and investigation?
granulation tissue
exposed bone in ear canal
facial nerve palsy
high CRP/PV
bacterial causes of otitis externa?
staph aureus
pseudomonas aeruginosa
fungal causes of otitis externa?
aspergillus niger
candida albicans
Tx of otitis externa?
topical aural toilet
canesten for fungal
gentamicin drops for bacterial
fever, pharyngitis and lymphadenoathy is a classical triad of symptoms for what condition?
infectious mononucleosis/ glandular fever
what antibiotic sometimes prescribed in glandular fever can cause a rash
amoxicillin
splenomegaly is rare in glandular fever: T or F?
F, 50% of patients get it
haematological findings in glandular fever?
leucocytosis (high WCC)
presence of atypical lymphocytes
what are palatal petechiae?
red, tiny haemorrhages commonly found on the hard palate of the mouth
how long does fever and pharyngitis in glandular fever last?
2-4 weeks
how does the EBV activate in glandular fever?
get infected in childhood -> latent
reactivates through exchange of saliva typically in teens
Tx for glandular fever?
bed rest
paracetamol
NOT antivirals
avoid sport
Ix for glandular fever?
epstein barr IgM
LFTs
heterophile Ab
difference on investigation between CMV and EBV?
CMV doesnt have heterophile Ab
CMV has fewer atypical lymphocytes
what is primary gingivostomatitis a complication of?
HSV1
Tx for primary gingivostomatitis?
aciclovir
where does the inactive form of HSV1 reside?
sensory nerve cells
Ix for HSV?
viral swab for PCR
brain comolication of HSV?
herpes simplex encephalitis
what is herpangina?
vesicles/ulcers on soft palate
cause of herpangina?
coxsackie viruses
NOT HSV
cause of hand foot and mouth disease?
coxsackie viruses
how long should apthous ulcers persist for?
less than weeks
what is a chancre and what condition is it seen in?
painless hard ulcer on genitalia
syphilis
what antibiotic covers most gram negative organisms?
gentamicin
how is an aspergillus caused otitis externa acquired in swimmers?
aspergillus is environmentally transmitted, swimming pools are moist and warm so the organism grows
Tx of fungal otitis externa?
clotrimazole
ear hygiene
what antibiotic should be given for tonsillitis?
phenoxymethylpenicillin
“large atypical lymphocytes on blood film” indicates what condition?
glandular fever
why is amoxicillin prescribed over penicillin for AOM?
better oral absorption
Tx for acute otitis media?
oral amoxicillin
child with flu like symptoms, problems eating, papules and pain in the legs and feet?
hand foot and mouth
what group of viruses can cause hand foot and mouth disease?
coxsackie viruses
what kind of virus are the coxsackie viruses?
enteroviruses
how are the coxsackie viruses spread?
faecal oral
how long does the coxsackie virus cause symptoms for?
1 week
name the 4 C’s antibiotics; why are they relevant?
clindamycin
ciprofloxacin
coamoxiclav
cephalosporin
all can cause c diff
