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2 ENT > Microbiology > Flashcards

Microbiology Flashcards

1
Q

how do HSV1 infections spread

A

through saliva contact

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2
Q

symptoms of HSV1

A

oral lesion

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3
Q

what is primary gingivostomatitis

A

disease of preschool children

primary HSV1 infection leading to

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4
Q

symptoms of primary gingivostomatitis

A

systemic upset, fever, lymphadenopathy

lips, buccal mucosa, and hard palate involved

vesicles 1-2mm long

ulcers

may take up to 3 weeks to recover

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5
Q

treatment for primary gingivostomatitis due to HSV1

A

Aciclovir

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6
Q

what happens after primary infection of HSV1

A

Latency

inactive form of the virus is in sensory nerve cells

it can reactivate to re-infect mucosal surfaces

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7
Q

what is a cold sore

A

reactivation from latent HSV1 causes activation

tend to decrease in frequency - only half of infected people get clinical recurrences

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8
Q

treatment for cold sores

A

aciclovir therapy or suppression

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9
Q

how to confirm HSV

A

swab lesion in virus transport medium

detection of viral DNA by PCR

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10
Q

what is herpangina

A

vesicles/ulcers on the soft palate

coxsackie viruses (not HSV)

also tends to be in young children

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11
Q

how do you diagnose herpangina

A

PCR test of swap in viral transport medium

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12
Q

what is hand, foot and mouth disease

A

coxsackie virus infection

family outbreaks common

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13
Q

how do you diagnose hand. foot and mouth disease

A

clinically or by PCR test of swab

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14
Q

what is chancre

A

painless indurated (hardened) ulcer caused by primary syphilis

most commonly genital but can also be oral

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15
Q

what bacteria causes syphilis

A

treponema pallidum

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16
Q

what are pathos ulcers

A

non viral, self limiting, recurring painful ulcers of the mouth

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17
Q

symptoms of apthous ulcers

A

painful ulcers that are round or ovoid and have inflammatory halos

confined to mouth

absence of systemic disease

begin in childhood but chill in 3rd decade

each ulcer lasts <3 weeks

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18
Q

what systemic diseases are associated with recurrent ulcers

A 
Behcet's disease
gluten-sensitive enteropathy or IBD
Reiter's disease
Drug reactions 
Skin diseases
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19
Q

who gets acute throat infection

A

children ages 5-10

young people aged 15-25

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20
Q

presentation of acute throat infection

A

pain at back of mouth

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21
Q

what is acute pharyngitis

A

inflammation of the part of the throat behind the soft palate (oropharynx)

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22
Q

what is tonsillitis

A

inflammation of the tonsils

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23
Q

causes of acute throat infection in primary care

A

viral or bacterial infection

common cold
influenza
streptococcal infection

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24
Q

what are some non infectious causes of acute sore throat

A

uncommon but include:

physical irritation (reflux disease, alcohol, smoking, hay fever)

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25
how do diagnose an acute sore throat
history and clinical examination throat swabs should not be carried out routinely in primary care
26
complications of an acute sore throat
Ottis media peritonsillar abscess para-pharyngeal abscess mastoiditis
27
management of an acute sore throat
self care advice antibiotics (only where appropriate) identify and manage immunosuppressed people
28
when should you refer someone with a sore throat
suspicion of throat cancer lasts 3-4 weeks (pain on swelling for >3 weeks) red or red and white patches, ulceration or swelling that persists >3 weeks stridor/respiratory difficulty is an emergency
29
self care steps for a sore throat
regular analgesia (paracetamol, ibuprofen) medicated lozenges (local anaesthetic, analgesia or antiseptic) adequate fluid intake mouthwashes/gargles/spray
30
what is the most common cause of a sore throat
VIRAL (doesn't need antibiotics)
31
what is the most common bacterial cause of a sore throat
streptococcus progenies (group a step)
32
clinical presentation of a strep infection (throat)
acute follicular tonsillitis
33
treatment for a group A strep infection (strep progenies)
penicillin
34
characteristics of strep progenies
gram +ve cocci in chains beta-haemolysis
35
complications of strep progenies infection
rheumatic fever (3 weeks post sore throat, fever, arthritis, pancarditis) glomerulonephritis (1-3 weeks post sore throat, haematuria, albuminuria and oedema)
36
you need to score 4/5 of what criteria to have a 65% risk of group A strep infection
``` 5-15 year olds tonsillar exudate tender anterior cervical lymph nodes history of fever absence of cough ```
37
steps to take if a sore throat presents in someone on DMARDS
FBC | seek urgent specialist advice if patient has low white cell count
38
what is neutropenia
low neutrophils increases risk of infection
39
what can cause neutropenia
drugs eg. carbimazole chemo immunosuppressants
40
when should you consider phnoxymethypenicillin
fever or pain score 4/5 Centor 3 or 4
41
what is diphtheria
corynebacterium diphtheria infection
42
presentation of diphtheria
severe sore throat with grey white membrane across the pharynx the organism produces a potent exotoxin which is cardiotoxic and neurotoxic
43
why is diphtheria rare
there is a vaccine - made from cell-free purified toxin
44
treatment for diphtheria
antitoxin and supportive | penicillin/erythromycin
45
what is infectious mononucleosis
glandular fever | disease of young adults
46
symptoms of glandular fever
``` fever enlarged lymph nodes sore throat pharyngitis, tonsillitis malaise lethargy ``` ``` jaundice/hepatitis rash haematology (leucocytosis, prince of atypical lymphocytes in blood film) splenomegaly palatal petechiae ```
47
complications of glandular fever
``` anaemia thrombocytopenia splenic rupture upper airway obstruction increased risk of lymphoma (especially in immunosuppressed) ```
48
what virus causes glandular fever
eptsein-barr virus | virus of the herpes family which establishes a persistent infection in epithelial cells
49
what are the 2 phases of EBV infection
primary in childhood - rarely causes infectious mononucleosis primary infection in those >10 usually causes mononucleosis
50
management for infectious mononucleosis
best rest paracetamol avoidance of sport corticosteroids (controversial)
51
investigations for EBV
EBV IgM Heterophile antibody blood count and film liver function tests
52
how does an oral candida infection present
white patches on red, raw mucous membranes in that/mouth
53
causes of candida
endogenous (post antibiotics, immunosuppressed, smokers, inhaled steroids)
54
treatment for oral candida
nystatin or fluconazole
55
what is acute otitis media
upper respiratory infection involving the middle ear by extension of the virus u the Eustachian tube most common in infants and children
56
what are the most common bacteria to infect the middle ear
h. influenzas strep pneumoniae strep pyroxenes usually viral with bacterial as a secondary infection
57
how do you diagnose middle ear infections
swab of pus if eardrum perforated otherwise a sample can't be obtained
58
treatment for middle ear infections
(80% resolves in 4 days) first line - amoxicillin second line - erythromycin
59
what is malignant otitis
an extension of an ottis media into the bones surrounding the ear canal without treatment is fatal as osteomyelitis will progressively involve the skull and meninges
60
symptoms of malignant otitis
pain and headache - more severe than clinical signs would suggest
61
signs of malignant otitis
granulation tissue at the bone-cartilage junction of the ear canal exposed bone in ear canal facial nerve palsy
62
what investigations are done for malignant otitis
plasma viscosity/C-reactive protein to demonstrate and inflammatory response imaging biopsy and culture
63
what are some risk factors for malignant otitis
diabetes | radiotherapy
64
what is otitis externa
inflammation of the outer ear canal
65
clinical signs of otitis externa
redness and swelling of the skin of the ear canal itchy (esp in early stages) sore and painful discharge or increased earwax if the canal becomes blocked by swelling or secretions hearing loss can be occur
66
what are some bacterial causes of otitis externa
staphylococcus aures proteus spp pseudomonas aeruginosa
67
what are some fungal causes of otitis externa
aspergillus niger | Candida albicans
68
management of otitis externa
swab for microscopy prescription of antimicrobials are for unresponsive or severe cases treat depending on culture results: ``` topical clotrimazole (canesten) gentamicin ```
69
presentation of acute sinusitis
mild discomfort over frontal or maxillary sinuses due to congestion seen in patients with upper respiratory viral infections
70
what would indicate a secondary bacterial infection in acute sinusitis
severe pain and tenderness with purulent nasal discharge
71
treatment for acute sinusitis
av length of illness 2.5 weeks antibiotics for severe 1st- phenoxymethylpenicilln 2nd - doxycycline (not in children)

2 ENT (15 decks)

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