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Ophthalmology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is the term for inflammation of the conjunctiva?

A

Conjunctivitis

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2
Q

What is the term for inflammation of the cornea?

A

Keratitis

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3
Q

What is the term for inflammation of the entire globe (orbit etc.)

A

Endophthalmitis

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4
Q

What are the common pathogens for neonatal bacterial conjunctivitis?

A

Staph aureus
Neisseria gonorrhoea
Chlamydia trachomatis

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5
Q

When would a neonatal conjunctivitis case be referred to ophthalmology?

A

Always

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6
Q

What is the commonest bacterial cause of conjunctivitis in children?

A

Haemophilus influenzae

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7
Q

What are the common bacteria causing conjunctivitis in adults?

A

Staph aureus

Strep pneumoniae

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8
Q

What antibiotic is typically used for bacterial conjunctivitis?

A

Topical chloramphenical

Unless history of aplastic anaemia it allergy

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9
Q

What are the main viral causes of conjunctivitis?

A

Adenovirus
Herpes simplex
Herpes zoster

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10
Q

What should you suspect when a young adult presents with bilateral conjunctivitis?

A

Chlamydia conjunctivitis

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11
Q

What can a sign of progressive chlamydial conjunctivitis be?

A

Subtarsal scarring

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12
Q

What is the physical description of an eye with bacterial keratosis?

A

Red eye
Reduced vision
White lesion in cornea (sits at the bottom +/- patch over central iris)

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13
Q

What is the pathophysiology of white lesions in the cornea?

A

The usually very organised collagen fibres in the cornea have been disturbed by the bacterial infiltration

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14
Q

What is the treatment plan for people with bacteria keratitis?

A

Admission for 48 hours - hourly eye drops

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15
Q

What typically gives you clues towards a diagnosis of bacterial keratitis?

A

Other corneal pathology

Contact lens wearers

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16
Q

What keratitis is more likely to occur in someone with a previously non-pathological cornea?

A

Viral kerititis

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17
Q

What is the sign of herpetic keratitis?

A

Dendritic ulcers

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18
Q

What is unfortunate about having a herpetic keratitis?

A

It is very painful
It can be recurrent
And recurrence can cause eventual reduced corneal sensation
Higher risk of developing bacterial keratitis

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19
Q

What must you never treat herpetic keratitis with?

A

Steroids

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20
Q

What is a typical sign of adenoviral keratitis?

A

Subepithelial infiltrates

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21
Q

What pathologies are associated with adenoviral keratitis?

A

Conjunctivitis

Respiratory infection

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22
Q

Are adenoviral keratitis infections bilateral or unilateral?

A

Bilateral

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23
Q

Are adenoviral keratitis infections contagious?

A

YES

24
Q

What would you prescribe to treat adenoviral keratitis?

A

Topical antibody- prevent secondary infection

Steroids to speed up recovery (if condition chronic)- BUT ONLY IF CERTAIN IT ISN’T HERPETIC KERATITIS

25
Q

What is the likely pathogens for keratitis caused by washing contact lenses in tap water?

A

Acanthamoeba

Pseudomonas aeruginosa

26
Q

What would the causative pathogen for a keratitis resulting from a trauma associated with vegetation be?

A

Fungal pathogen

27
Q

What would you treat fungal keratitis with?

A

Have to try different things as very difficult and long healing process
Often need corneal grafts

28
Q

What is the typical presentation of an orbital cellulitis?

A

Extremely painful (especially on eye movements)
Associated Paranasal sinusitis
Pyrexia
Proptisis (protruding eye)

29
Q

Why would you CT someone with orbital cellulitis?

A

To check for and identify orbital abscesses

30
Q

What is the most common cause of orbital cellulitis?

A

Infection from skin commensals post operatively

31
Q

What must you differentiate orbital cellulitis from?

A

Preseptal cellulitis (when it’s just the outer surface of the skin- should have no altered structure and function of the eye)

32
Q

What are the organisms that can cause orbital cellulitis?

A 
Staphylococci (epi/aureus)
Streptococci 
California
Haemophilus influenzae
Anaerobes
33
Q

What would you do to manage orbital cellulitis?

A

Examine routinely to check for restriction of muscles or optic nerve dysfunction (CT scan if so)
Broad spectrum antibiotics and close monitoring
Possibly drain abscesses

34
Q

What is the rarest and most devastating eye infection?

And what often the cause

A

Endophthalmititis

Post surgical infection

35
Q

What are some endogenous causes of endophthalmitis?

A

Bacterial endocarditis etc.

36
Q

What does endophthalmitis present as?

A

Very red eye
Extremely painful
Decreasing vision

37
Q

What is the most common organism causing endophthalmitis?

A

Staph epidermidis

38
Q

How do you treat endophthalmitis?

A

Intravitreal (inside posterior eye) amakacin/ceftazidime/vancomycin
Topical antibiotics
Possible systemic antibiotics

39
Q

What are causes of chorioretinitis?

A

Cytomegalovirus in AIDS (much rarer now)
Toxoplasma Gondi
Tococara canis (worm)

40
Q

What was a previously common ocular presentation of aids?

A

Haemorrhagic cytomegalovirus retinitis

41
Q

Where might a person contract toxoplasmosis?

A

Cats

Raw meat

42
Q

What does toxoplasmosis present as?

A

Mild flu-like illness

In the immunocompromised- latent phase with cyst formation

43
Q

Is toxoplasmosis recurrent?

A

Yes in the immunocompromised

44
Q

Can the toxocara worm replicate in humans?

And what damage does it do?

A

No, but it lives as an immature larvae form of the worm

It forms granulomas—> lead to irreversible visual loss

45
Q

How do you diagnose and eye infection?

A

Swan for culture (bacterial, chlamydial, viral)
Corneal scrapes (bacterial keratitis)
Aqueous/vitreal humour for culture (endophthalmitis)
Microscopy/culture for acanthamoeba (of contact lenses too)
Serology (toxoplasma, toxocara)

46
Q

What is the most common topical antibiotic for eye infections?

A

Chloramphenicol

47
Q

How does chloramphenicol work?

A

Inhibits peptides transferase enzyme (prevents bacterial protein synthesis)

Kills strep and haemophilus
Slows down staph

48
Q

What are chloramphenicol’s side effects?

A

Allergy
Irreversible aplastic anaemia
Grey baby syndrome

49
Q

What is a common bottle contaminant?

A

Pseudomonas

Dispose of bottles after 4 weeks

50
Q

What can psueudomonas cause in the eye?

A

Ulcers

51
Q

What would you treat a staph aureus conjunctivitis with?

A

Fusidic acid

52
Q

What would you treat most conjunctivitis infections with?

A

Chloramphenicol

53
Q

What would you treat a gram negative conjunctivitis with?

A

Gentimicin

54
Q

What antiviral can be used for viral keratitis?

A

Aciclovir

55
Q

What do you treat chlamydial conjunctivitis with?

A

Topical oxytetracycline

Oral azithromycin if genital chlamydia too

56
Q

What would you treat keratitis caused by gram negative, pseudomonas areuginosa, haemophilus influenzae?

A

Ofloxavcin (4-quinolone)

57
Q

What would you treat a keratitis caused by most gram positive/negative organisms?

A

Gentamicin and cefuroxime

Ophthalmology (7 decks)

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