Microbiology

Question 1

name the virus responsible for the cold sore virus

Answer 1

herpes simplex virus

Question 2

name the types of HSV

Answer 2

type 1 and type 2

Question 3

which HSV type is acquired in childhood and the cause of oral lesion?

Answer 3

type 1

Question 4

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

Answer 4

primary gingivostomatitis

fever, local lymphadenopathy

may take up to 3 weeks to recover

spread beyond mouth

Question 5

primary gingivostomatitis treatment?

Answer 5

aciclovir

Question 6

what nerve does primary gingivostomatitis hide?

Answer 6

trimeginal

Question 7

aciclovir does not prevent ________

Answer 7

aciclovir does not prevent LATENCY

Question 8

recurrent HSV tends to be on the ____ and not ______ of the ______

Answer 8

recurrent HSV tends to be on the LIPS and not INSIDE of the MOUTH

Question 9

name the type of patient that would get recurrent oral herpetic lesions

Answer 9

those who are immunocompromised

Question 10

name the lab confirmation of HSV

Answer 10

swab of lesion in virus transport medium

detection of viral DNA by PCR

Question 11

what causes herpangina?

Answer 11

coxsackie viruses

Question 12

herpangina diagnosis?

Answer 12

vesicles/ulcers on soft palate

diagnosis clinically or by PCR test of swab in viral transport medium

Question 13

what virus causes hand, foot and mouth disease?

Answer 13

coxsackie viruses

Question 14

what is seen in primary syphilis?

Answer 14

chancre

Question 15

what is a chancre?

Answer 15

PAINLESS indurated ulcer at site of entry of bacterium Treponema pallidum

Question 16

if a chancre is left undiagnosed and untreated, it can progress to what?

Answer 16

secondary and tertiary syphilis

Question 17

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?

Answer 17

apthous ulcer

Question 18

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

Answer 18

Behçet’s disease

Question 19

what is the condition that causes inflammation of the part of the throat behind the soft palate (oropharynx)

Answer 19

acute pharyngitis

pain at the back of the mouth

Question 20

inflammation of the tonsils is known as what?

Answer 20

tonsilitis

Question 21

what is the most common cause of a sore throat?

Answer 21

viral cause

Question 22

if sore throat and lethargy persist into the second week, especially if the person is 15-25years of age, what should be suspected?

Answer 22

infectious mononucleosis (glandular fever)

Question 23

what causes infectious mononucleosis (glandular fever)?

Answer 23

Ebstein Barr Virus

Question 24

name some non infectious causes of a sore throat

Answer 24

GORD, cigarette smoke irritation, alcohol, hay fever

Question 25

name the condition that causes a sore throat that is a medical emergency

Answer 25

stridor

Question 26

what self care advice should be given to those with a sore throat?

Answer 26

regular analgesia like paracetamol or ibuprofen medicated lozenges

Question 27

the vast majority of (over 2 thirds) are _____ and therefore do not need antibiotics

Answer 27

the vast majority of (over 2 thirds) are VIRAL and therefore do not need antibiotics

Question 28

state the most common cause of bacterial sore throat

Answer 28

streptococcus pyogenes

Question 29

group A streptococcus and group A beta haemolytic strep and GAS are other names for what?

Answer 29

streptococcus pyogenes

Question 30

what is the treatment for streptococcus pyogenes causing bacterial sore throat?

Answer 30

penicillin

Question 31

name the 2 rare late complications of streptococcus pyogenes

Answer 31

rheumatic fever and glomerulonephritis

Question 32

what criteria is used for GAS

Answer 32

CENTOR criteria or Fever PAIN criteria

Question 33

what makes up the CENTOR criteria

Answer 33

tonsillar exudate ƒtender anterior cervical lymph nodes ƒhistory of fever (>38) ƒabsence of cough 1 point for each/4

Question 34

name the drug that causes neutopenia

Answer 34

carbimazole

Question 35

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?

Answer 35

diphtheria Corynebacterium diphtheriae

Question 36

diptheria treatment?

Answer 36

antitoxin supportive penicilin/erythromycin

Question 37

Fever Enlarged lymph nodes Sore throat, pharyngitis, tonsillitis Malaise, lethargy diagnosis?

Answer 37

infectious mononucleosis

Question 38

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?

Answer 38

infectious mononucleosis

Question 39

name some complications of infectious mononucleosis

Answer 39

``` anaemia thrombocytopenia splenic rupture upper airway obstruction increased risk of lymphoma if immunosuppressed ```

Question 40

there is usually ___ phases of primary infection with EBV

Answer 40

there is usually TWO phases of primary infection with EBV

Question 41

do you give steroids for a virus?

Answer 41

no!

Question 42

infectious mononucleosis treatment?

Answer 42

bed rest paracetamol avoid sport

Question 43

what is the laboratory confirmation of EBV?

Answer 43

EPV IgM heterophile antibody - paul-bunnell test, monospot test blood count and film liver function tests

Question 44

white patches on red, raw mucous membranes in throat/ mouth caused by candida albicanas diagnosis?

Answer 44

candida

Question 45

what causes candida?

Answer 45

endogenous - post antibiotics, immunosuppressed, smokers, inhaled steroids

Question 46

candida treatment?

Answer 46

nystatin or fluconazole

Question 47

an upper respiratory infection involving the middle ear by extension of infection up the Eustachian tube in infants and children presenting with earache diagnosis?

Answer 47

acute otitis media

Question 48

infections of the middle ear is often ______ with _________ secondary infection

Answer 48

infections of the middle ear is often VIRAL with BACTERIAL secondary infection

Question 49

name the 3 common bacteria of middle ear infections

Answer 49

haemophilus influenza streptococcus pneumonias streptococcus pyogenes

Question 50

swab pus of infections of the middle ear if the ________ ___________

Answer 50

swab pus of infections of the middle ear if the EARDRUM PERFORATES

Question 51

__% of infections of the middle ear resolve in _ days without treatment 1st line - 2nd line -

Answer 51

80% of infections of the middle ear resolve in 4 days without treatment 1st line - amoxicillin 2nd line - erythromycin

Question 52

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?

Answer 52

malignant otitis seen in diabetics

Question 53

inflammation of the outer ear canal is known as what?

Answer 53

otitis externa

Question 54

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?

Answer 54

otitis externa

Question 55

name 3 bacterial causes of otitis externa

Answer 55

staphylococcus aureus proteus spp pseudomonas aeruginosa

Question 56

name 2 fungal causes of otitis externa

Answer 56

aspergillus niger | candida albicans

Question 57

otitis externa management?

Answer 57

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

Question 58

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?

Answer 58

acute sinusitis

Question 59

acute sinusitis treatment? 1st line - 2nd line -

Answer 59

acute sinusitis treatment? 1st line - phenoxymethylpenicillin 2nd line - doxycycline

Question 60

who should you not give doxycycline to?

Answer 60

children - affects bone and teeth growth