Microbiology Flashcards
name the virus responsible for the cold sore virus
herpes simplex virus
name the types of HSV
type 1 and type 2
which HSV type is acquired in childhood and the cause of oral lesion?
type 1
name the disease of pre-school children, causing systemic upset affecting the lips, buccal mucosa, hard palate with vesicles 1-2mm and ulcers due to HSV1
primary gingivostomatitis
fever, local lymphadenopathy
may take up to 3 weeks to recover
spread beyond mouth
primary gingivostomatitis treatment?
aciclovir
what nerve does primary gingivostomatitis hide?
trimeginal
aciclovir does not prevent ________
aciclovir does not prevent LATENCY
recurrent HSV tends to be on the ____ and not ______ of the ______
recurrent HSV tends to be on the LIPS and not INSIDE of the MOUTH
name the type of patient that would get recurrent oral herpetic lesions
those who are immunocompromised
name the lab confirmation of HSV
swab of lesion in virus transport medium
detection of viral DNA by PCR
what causes herpangina?
coxsackie viruses
herpangina diagnosis?
vesicles/ulcers on soft palate
diagnosis clinically or by PCR test of swab in viral transport medium
what virus causes hand, foot and mouth disease?
coxsackie viruses
what is seen in primary syphilis?
chancre
what is a chancre?
PAINLESS indurated ulcer at site of entry of bacterium Treponema pallidum
if a chancre is left undiagnosed and untreated, it can progress to what?
secondary and tertiary syphilis
non viral
self limiting
recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos
confined to mouth, absence of systemic disease, begin in childhood, tend to abate in 3rd decade, each ulcer lasts less than 3 weeks
diagnosis?
apthous ulcer
name the disease that causes recurrent non-viral ulcers:
Recurrent oral ulcers Genital ulcers Uveitis. It can also involve visceral organs such as the gastrointestinal tract, pulmonary, musculoskeletal, cardiovascular and neurological systems Commonest in Middle East and Asia
Behçet’s disease
what is the condition that causes inflammation of the part of the throat behind the soft palate (oropharynx)
acute pharyngitis
pain at the back of the mouth
inflammation of the tonsils is known as what?
tonsilitis
what is the most common cause of a sore throat?
viral cause
if sore throat and lethargy persist into the second week, especially if the person is 15-25years of age, what should be suspected?
infectious mononucleosis (glandular fever)
what causes infectious mononucleosis (glandular fever)?
Ebstein Barr Virus
name some non infectious causes of a sore throat
GORD, cigarette smoke irritation, alcohol, hay fever
name the condition that causes a sore throat that is a medical emergency
stridor
what self care advice should be given to those with a sore throat?
regular analgesia like paracetamol or ibuprofen
medicated lozenges
the vast majority of (over 2 thirds) are _____ and therefore do not need antibiotics
the vast majority of (over 2 thirds) are VIRAL and therefore do not need antibiotics
state the most common cause of bacterial sore throat
streptococcus pyogenes
group A streptococcus and group A beta haemolytic strep and GAS are other names for what?
streptococcus pyogenes
what is the treatment for streptococcus pyogenes causing bacterial sore throat?
penicillin
name the 2 rare late complications of streptococcus pyogenes
rheumatic fever and glomerulonephritis
what criteria is used for GAS
CENTOR criteria or Fever PAIN criteria
what makes up the CENTOR criteria
tonsillar exudate
tender anterior cervical lymph nodes
history of fever (>38)
absence of cough
1 point for each/4
name the drug that causes neutopenia
carbimazole
severe sore throat with a grey white membrane across the pharynx
the organism produces a potent exotoxin which is cardiotoxic and neurotoxic
vaccine preventable
diagnosis?
diphtheria
Corynebacterium diphtheriae
diptheria treatment?
antitoxin
supportive
penicilin/erythromycin
Fever
Enlarged lymph nodes
Sore throat, pharyngitis, tonsillitis
Malaise, lethargy
diagnosis?
infectious mononucleosis
jaundice/hepatitis, rash, leucocytosis (lymphocytosis), presence of atypical lymphocytes in blood film, splenomegaly, palatal petechiae – rash on palate, lots of lymphocytes – atypical lymphocytes
the above are all other signs and symptoms of what?
infectious mononucleosis
name some complications of infectious mononucleosis
anaemia thrombocytopenia splenic rupture upper airway obstruction increased risk of lymphoma if immunosuppressed
there is usually ___ phases of primary infection with EBV
there is usually TWO phases of primary infection with EBV
do you give steroids for a virus?
no!
infectious mononucleosis treatment?
bed rest
paracetamol
avoid sport
what is the laboratory confirmation of EBV?
EPV IgM
heterophile antibody - paul-bunnell test, monospot test
blood count and film
liver function tests
white patches on red, raw mucous membranes in throat/ mouth caused by candida albicanas
diagnosis?
candida
what causes candida?
endogenous - post antibiotics, immunosuppressed, smokers, inhaled steroids
candida treatment?
nystatin or fluconazole
an upper respiratory infection involving the middle ear by extension of infection up the Eustachian tube in infants and children presenting with earache
diagnosis?
acute otitis media
infections of the middle ear is often ______ with _________ secondary infection
infections of the middle ear is often VIRAL with BACTERIAL secondary infection
name the 3 common bacteria of middle ear infections
haemophilus influenza
streptococcus pneumonias
streptococcus pyogenes
swab pus of infections of the middle ear if the ________ ___________
swab pus of infections of the middle ear if the EARDRUM PERFORATES
__% of infections of the middle ear resolve in _ days without treatment
1st line -
2nd line -
80% of infections of the middle ear resolve in 4 days without treatment
1st line - amoxicillin
2nd line - erythromycin
pain and headache, more severe than clinical signs would suggest
granulation tissue at bone–cartilage junction of ear canal; exposed bone in the ear canal. Facial nerve palsy (drooping face on the side of the lesion)
diagnosis?
malignant otitis
seen in diabetics
inflammation of the outer ear canal is known as what?
otitis externa
redness and swelling of the skin of the ear canal
it may be itchy (especially in the early stages)
can become sore and painful
there may be a discharge, or increased amounts of ear wax
if the canal becomes blocked by swelling or secretions, hearing can be affected
diagnosis?
otitis externa
name 3 bacterial causes of otitis externa
staphylococcus aureus
proteus spp
pseudomonas aeruginosa
name 2 fungal causes of otitis externa
aspergillus niger
candida albicans
otitis externa management?
topical aural toilet
swab reserved for unresponsive/severe cases
treat depending on culture results - topical clotrimazole for aspergillum niger also get gentamicin 0.3% drops
mild discomfort over frontal or maxillary sinuses due to congestion
seen in patients with upper respiratory viral infections
severe pain and tenderness with purulent nasal discharge indicates secondary bacterial infection
diagnosis?
acute sinusitis
acute sinusitis treatment?
1st line -
2nd line -
acute sinusitis treatment?
1st line - phenoxymethylpenicillin
2nd line - doxycycline
who should you not give doxycycline to?
children - affects bone and teeth growth
