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Microbiology Flashcards

1
Q

What bacteria can cause conjunctivitis in neonates?

A

Staphylococcus aureus
Neisseria gonorrhoea
Chlamydia trachomatis

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2
Q

What bacteria commonly cause conjunctivitis in all bar neonates?

A

Staphylococcus aureus
Streptococcus pneumoniae
Haemophilus influenzae (esp in children)

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3
Q

What is conjunctivitis?

A

Inflammation of the conjunctiva

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4
Q

What are the common symptoms of bacterial conjunctivitis?

A 
Minimal pain
Sticky eye
Purulent discharge
Red eye
Spreads between eyes
Clear cornea
Normal pupillary response
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5
Q

How is conjunctivitis diagnosed?

A

Swab

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6
Q

How is conjunctivitis treated?

A 
Chloramphenicol 
If neonate - ophthalmology 
Fusidic acid if staphyloccous aureus
Pseudomonas - gentamicin
Chlamydia - oxytetracycline and azithromycin
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7
Q

What are the side effects of chloramphenicol?

A

Aplastic anaemia

Grey baby syndrome

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8
Q

What viruses commonly cause viral conjunctivitis?

A

Adenovirus
Herpes simplex
Herpes zoster

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9
Q

What are the symptoms of viral conjunctivitis?

A 
Swollen and tender preauricular lymph nodes
Watery eye
Red eye
Extreme eye movements can be painful
Tends to occur with URTI
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10
Q

How will herpes simplex conjunctivitis present?

A

Vesicles around eyes that spreads to eye

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11
Q

What must be done in a patient with chlamydial conjunctivitis?

A

Contact tracing

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12
Q

How will chlamydial conjunctivitis present?

A

Follicular changes in eyelid

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13
Q

What can untreated chlamydial conjunctivitis cause?

A

Subtarsal scarring

Damage to cornea or dry eye

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14
Q

What is the classical sign of bacterial keratitis?

A 
Hypopyon
Pain 
Photophobia
Reduced visual acuity
Epiphora
Red eye
Opacity
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15
Q

How is bacterial keratitis (corneal ulcer) treated?

A

Hourly drops for 48hrs in hospital

Daily review

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16
Q

How can a bacterial keratitis occur?

A

In association with other corneal pathology or contact lens wear

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17
Q

What bacteria can cause bacterial keratitis?

A

Staphylococcus aureus
Streptococcus
Pseudomonas

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18
Q

What viruses can cause keratitis?

A

Herpes simplex

Adenovirus

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19
Q

How can viral keratitis occu?

A

In a normal cornea

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20
Q

What is the characteristic sign of herpetic keratitis?

A

Dendritic ulcer

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21
Q

What are the symptoms of herpetic keratitis?

A

Very painful
Can be recurrent
Recurrences eventually result in reduced corneal sensation

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22
Q

Why should herpetic keratitis NOT be treated with steroids?

A

Corneal melt and perforation of the cornea

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23
Q

Where does herpes simplex reside?

A

In the trigeminal nerve - will reactivate

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24
Q

What is the characteristic sign of adenoviral keratitis?

A

Subepithelial infiltrates

Reduced vision

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25
How is adenoviral keratitis treated?
Topical antibiotic to prevent secondary infection Artificial tears Steroids to speed up recovery if chronic and you are SURE it is not herpetic
26
What keratitis is associated with contact lens wearing?
Acanthamoeba | Pseudomonas aeruginosa
27
What is the disease progression of fungal keratitis?
More indolent that microbial Usually a history of trauma from vegetation Takes a long time to heal
28
What are the symptoms of orbital cellulitis?
``` Painful on eye movements Proptosis Paranasal sinusitis Pyrexial Sight threatening Cared for by ENT and ophthalmology ```
29
What investigation is required in suspicion of orbital cellulitis?
CT scan Compartment syndrome Can compromise the optic nerve
30
How does orbital cellulitis occur?
Direct extension from sinus Extension from focal orbital infection (infected chalazion, dacryocystitis) Post-op
31
What organisms commonly cause orbital cellulitis?
``` Staphylococci Streptococci Coliforms Haemophilus influenzae Anaerobes ```
32
How is orbital cellulitis treated?
Broad spectrum antibiotics and monitor closely | Abscess will require drainage
33
What is endophthalmitis?
``` Devastating infection inside of eye Post-surgical or endogenous Painful +++ with decreasing vision V red eye Sight threatening ```
34
What bacteria can cause endophthalmitis?
Conjunctival commensals | Staphylococcus epidermis
35
How is endophthalmitis treated?
Intravitreal amikacin/ cefazidime/ vancomycin Topical antibiotics Systemic antibiotics
36
What is chorioretinitis?
Infection of the choroid of retina
37
What can cause chorioretinitis?
Cytomegalovirus Toxoplasma gondii Toxocara canis
38
What will CMV retinitis look like under fundoscopy?
Huge areas of exudation and haemorrhage
39
How is CMV retinitis treated?
Injections in eye
40
How is keratitis diagnosed?
Fluorescein | Corneal scrape
41
What is endophthalmitis?
Inflammation of the intraocular space occupied by vitreous humor
42
What is blepharitis?`
Inflammation of the eyelids
43
What can cause anterior blepharitis?
Seborrhoeic dermatitis | Staph aureus
44
What can cause posterior blepharitis?
Acne rosacea | Meibomian gland dysfunction
45
What are the symptoms of blepharitis?
``` Itchy, sore, red eyelid Burning sensation in eyes Photophobia Swollen eyelid margins Cysts ```
46
What is dacryocystitis?
Blockage of lacrimal system
47
How is dacryocystitis treated?
Broad spectrum antibiotics
48
What is a chalazion?
Meiboman cyst treated with heat and daily massage
49
What causes toxoplasmosis in the eye?
Protozoan infection with toxoplasmosis ondii
50
Where can toxoplasmosis gondii be found?
Cats and raw meat
51
What is the disease progression of toxoplasmosis?
Mild flu like illness Scar forming Can reactivate
52
What causes toxocara and where is it found?
Parasitic nematode Affects cats and dogs Unable to replicate in humans
53
How does toxocara affect the eye?
Forms granulomas which can cause irreversible visual loss`
54
How are toxoplasma and toxocara diagnosed?
Serology
55
How is acanthamoeba diagnosed?
Microscopy/ culture
56
How is endophthalmitis diagnosed?
Aqueous/ vitreous humour culture
57
What is the mode of action of chloramphenicol?
Inhibits peptidyl transferase enzyme to stop bacterial protein Bactericidal for strep and haemophilus Bacteriostatic for staph
58
How do quinolones work?
Inhibits DNA gyrase, an enzyme that compresses bacterial DNA into supercoils Inhibition of DNA gyrase leads to unwinding of supercoils and cell death
59
What bacteria can contaminate antibiotic bottles?
Pseudomonas - can cause bad corneal ulcers
60
What antiviral is used for dendritic ulcers?
Acyclovir which inhibits viral DNA synthesis
61
How is bacterial keratitis treated?
Ofloxacin (treats coliform, pseudomonas, haemophilus) | Gent and cefuroxime (treats most gram positive and gram negative organisms)
62
What should be taken in the history of a red eye?
``` Pain - grittiness, ache Itch Discharge Photophobia Visual loss Past ocular disorders Contact lenses ```
63
What can cause anterior blepharitis?
Seborrhoeic | Staphylococcal aureus
64
What can cause posterior blepharitis?
Meibomian gland dysfunction
65
What are the symptoms of seborrhoeic blepharitis?
Lid margin red Scales Dandruff No ulceration, lashes unaffected
66
What are the symptoms of staphylococcal blepharitis?
``` Lid margin red Lashes distorted, loss of lashes, ingrowing lashes (trichiasis) Styes Corneal staining Marginal ulcers ```
67
What is a meibomian cyst called?
Chalazia
68
What is posterior blepharitis associated with?
Acne rosacea
69
How is blepharitis treated?
Lid hygiene Supplementary tear drops Oral doxycycline for 2-3 months
70
What can cause chronic conjunctivitis?
``` Blepharitis Chlamydial infection Keratoconjunctiviti sicca Lacrimal disease (chronic dacryocystitis) Glaucoma medication Sub-tarsal foregin body ```
71
What can cause peripheral corneal ulcers?
RA Hypersensitivity Granulomatosis with polyangitis Polyarteritis
72
What are signs of anterior uveitis?
``` Cirilary injection Cells and flares in anterior chamber Keratic precipitates Hypopyon Synechiae ```
73
What are the symptoms of anterior uveitis?
Red eye Dull ache Photophobia Referred pain to eyebrow
74
How is anterior uveitis managed?
Topical steroids Mydriatics Investigate for systemic association
75
What is associated with episcleritis?
Gout
76
What is associated with scleritis?
RA | Wegner's
77
What are the signs and symptoms of scleritis?
Painful Injection of deep vascular plexus Phenylephrine test will show no blanching
78
How is scleritis treated?
Oral NSAIDs Oral steroids Steroid sparing agents

Ophthalmology (14 decks)

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