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Opthalmology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

name the types of gram positive cocci

A

strep and staph

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2
Q

what are the types of gram negative bacteria

A

cocci (e.g. neisseria)
cocci-bacilli (H. influenzae)
bacilli (pseudomonas)

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3
Q

what is an infection of the cornea called

A

keratitis

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4
Q

what is an infection of the entire globe called

A

endophthalmitis

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5
Q

when do you always refer bacterial conjunctivitis

A

when it affects a neonate (under 2 weeks)

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6
Q

what organisms can cause bacterial conjunctivitis in neonates

A

staph aureus
neisseria gonorrhoeae
chlamydia trachomatis

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7
Q

what organisms commonly cause bacterial conjunctivitis

A

staph aureus, strep pneumoniae, haemophilus influenzae

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8
Q

what organism commonly causes bacterial conjunctivitis in children

A

haemophilus influenzae

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9
Q

how do you treat bacterial conjunctivitis

A 
swab 
topical antibiotic (chloramphenical) drops/ ointment
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10
Q

when do you not give chloramphenicol

A

if history of aplastic anaemia or allergy

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11
Q

when should you be suspicious of a cholramphenical allergy

A

is symptoms of bacterial conjunctivitis get worse (redder and itchy)

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12
Q

what commonly causes viral conjunctivitis

A

adenovirus, herpes simplex, herpes zoster

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13
Q

what is the difference in presentations of bacterial and adenoviral conjunctivitis

A

viral wont usually have discharge

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14
Q

what is the treatment for adenovirus conjunctivitis

A

usually self limiting

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15
Q

what is the presentation of herpes simplex conjunctivitis

A

can get vesicle around eye

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16
Q

what is the presentation of herpes zoster conjunctivitis

A

shingles of the ophthalamic trigeminal nerve
vesicles in dermatome

(aka herpes zoster ophthalmicus)

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17
Q

what is the usual presentation of chlamydial conjunctivits

A

often chronic- conjunctivitis that doesnt respond to topical antibiotics

suspect it in bilateral conjuctivitis in young adults

may have symptoms of urethritis, vaginitis

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18
Q

what is the appearance of chlamydia conjunctivitis

A

follicular, grains of rice appearance under the lid

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19
Q

what does the folliclular appearance of chlamydial conjunctivitis cause

A

subtarsal scarring (damage to the cornea)

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20
Q

what is the outer lining of the cornea continuous with

A

the conjunctivia

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21
Q

what is a hypopyon

A

leukocytic exudate in the anterior chamber of the eye (within cornea)

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22
Q

what is a hypopyon seen in

A

keratitis- very serious, sight threatening

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23
Q

what is the treatment for bacterial keratitis

A

need admitted for hourly drops and daily review

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24
Q

what is bacterial keratitis usually seen with

A

other corneal pathology or contact lens wear

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25
Q

what us a corneal ulcer

A

keratitis

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26
Q

what viruses cause microbial keratitis

A

herpes and adenovirus

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27
Q

can viral keratitis happen in a normal eye

A

yes, unlike bacterial keratitis

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28
Q

what do you get dendritic ulcers in

A

herpetic keratitis (looks like a branching tree) (caused by herpes simplex)

29
Q

what are the features of herpetic keratitis

A

dendritic ulcer
very painful
recurrent (can cause reduced corneal senation, scarring)

30
Q

can you treat herpetic keratitis with steroid

A

NO can cause corneal to melt and perforate

31
Q

what are the features of adenovirus keratitis

A

supepithelial infiltrates, almost always with conjunctivitis, bilateral, usually follow URTI, contagious, may affect vision

32
Q

what is the treatment for adenoviral keratitis

A

topical AB to prevent secondary infection, can give mild steroids to speed up recovery if it becomes chronic

33
Q

what can cause fungal keratitis

A

acanthamoeba, pseudomonas aeruginosa

34
Q

what is the usual presentation of fungal keratitis

A

infection caused by contact lenses or in farmers or gardeners after trauma, painful, scarring, very hard to treat, takes long time to heal

35
Q

what is the presentation of orbital cellulitis

A 
painful- especially on eye movement 
proptosis 
often with paranasal sinusitis
pyrexial 
sight threatening
36
Q

what is the risk with orbital cellulitis

A

compartment syndrome due to pus behind eye, can compromise eye circulation

37
Q

what can cause orbital cellulitis

A

extension from focal orbital infection, post operative

38
Q

what is the most worrying type of orbital cellulitis

A

orbital

preseptal cant cause compartment syndrome

39
Q

what organisms cause cause orbital cellulitis

A

staph, strep, coliforms, h. influenzae (children), anaerobes

40
Q

when do you CT scan in orbital cellulitis

A

if there is any suggestion of muscles or optic nerve dysfunction

41
Q

how do you treat orbital cellulitis

A

broad spectrum AB, monitor closely, maybe need drainage

42
Q

what is first to go when optic nerve is compromised

A

colour vision- red

43
Q

what is endophthalmitis

A

devasting infection inside of the eye, very rare

44
Q

what causes endophthalmitis

A

post surgical, endogenous (e.g. bacterial endocarditis)

often conjunctival commensals- staph epidermis

45
Q

what is the presentation of endophthalmitis

A

very painful, decreasing vision, sight threatening

46
Q

what is the treatment for endophthalmitis

A

Intravitreal amikacin/ ceftazidime/ vancomycin and topical antibiotics

inject AB after surgery as prophylaxis

47
Q

what is chorioretinitis

A

infection of the choroid

48
Q

what are the causes of chorioretinitis

A 
CMV in AIDS
toxoplasma gondii (protozoan)
toxocara canis (worm)
49
Q

where do you get toxoplasma gondii

A

cats and raw meat

50
Q

what is the presentation of toxoplasma gondii chorioretinitis

A

Mild flu like illness
Rarely causes any further problems
In immunocompetent patients it enters latent phase with cysts forming
can reactivate, needs systemic treatment if life threatening

51
Q

where is Toxocara canis (worm) found

A

cats and dogs

unable to replicate in humans so self limiting

52
Q

is Toxocara canis (worm) choriorentinitis bad

A

self limiting but can form granulomas which can cause irreversible visual loss

53
Q

when do you do a corneal scrape

A

in baterial keratitis (bacterial ulcer)

54
Q

how do you diagnose endophthalmitis

A

aqueous/ vitreous for culture

55
Q

how do you diagnose acanthamoeba

A

microscopy/ culture

56
Q

when do you serology

A

if suspect toxoplasma or toxocara (choriodrentinitis)

57
Q

how can you give chloramphenicol

A

drops (4x per day, has to be kept in fridge) or ointment (had to use)

58
Q

how does chloramphenicol work

A

Inhibits peptidyl transferase enzyme (therefore stops bacterial protein being made)

59
Q

what does chloramphenicol work against

A

Bacterocidal for strep and haemophilus

Bacterostatic for staph

60
Q

what are the side affects of chloramphenicol

A

allergy, aplastic anaemia, grey baby syndrome (when give too much to babies they go grey, reduce dsose)

61
Q

what are antibiotics than inhibit cell wall synthesis

A

Penicillins & cephalosporins (have B lactam ring)

62
Q

what is dacrocystitis

A

when lacrimal sac becomes infected

63
Q

what are antibiotics that inhibit nucleic acid synthesis

A

Quinolones

64
Q

what antibiotic for corneal ulcers

A

quinolones

65
Q

what are the antibiotics ffor bacterial conjunctivitis

A

chloramphenicol
(treats most bacteria except Pseudomonas aeruginosa)

fusidic acid
(treats Staph. aureus)

gentamicin
(treats most Gram negative bacteria including coliforms, Pseudomonas aeruginosa)

66
Q

what treatment for herpetic ulcers

A

aciclovir

67
Q

how do you treat chlamydial conjunctivitis

A

topical oxytetracycline

68
Q

how do you treat bacterial keratitis

A

A 4-quinolone (Ofloxacin)
(treats most Gram negative bacteria including coliforms, Pseudomonas aeruginosa, Haemophilus influenzae. Not active vs. Strep. pneumoniae)

Gentamicin and cefuroxime
(the combination will treat most Gram positive and Gram negative organisms)

Opthalmology (16 decks)

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