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Ophthalmology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is the name given to an infection of the entire eye?

A

Endophthalmitis

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2
Q

Keratitis is an infection of what part of the eye?

A

Cornea

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3
Q

What is cellulitis with regards to the eye?

A

An infection of the skin around the eye

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4
Q

How does bacterial conjunctivitis usually present?

A
  • red eye

- pus discharge

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5
Q

When should you worry about bacterial conjunctivitis?

A

If it is present in neonates

these should all be referred to ophthalmology

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6
Q

What organisms usually cause bacterial conjunctivitis in neonates?

A

Staph aureus
Neisseria gonorrhoeae
Chlamydia trachomatis

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7
Q

What organisms cause bacterial conjunctivitis in other ages?

A

Staph aureus
Strep pneumoniae
Haemophilus influenzae (especially in children)

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8
Q

How is bacterial conjunctivitis treated?

A

Swab

Topical antibiotic - chloramphenicol (drops vs ointment)

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9
Q

When should chloramphenicol not be given?

A

if history of aplastic anaemia

OR should be stopped if suspicion of allergy

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10
Q

Where should chloramphenicol eye drops be kept?

A

Fridge

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11
Q

Why do patients struggle to use chloramphenicol gel?

A

It is very thick and difficult to apply to the infected eye

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12
Q

What viruses commonly cause conjunctivitis?

A

Adenovirus
Herpes simplex
Herpes zoster

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13
Q

How does adenovirus conjunctivitis present?

A

Red bloodshot eye

no pus

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14
Q

What can be a sign of herpes simplex conjunctivitis?

A

vesicles beside the eye

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15
Q

What presentation can make you suspect chlamydial conjunctivitis?

A

Chronic problem (many infections)
Unresponsive to treatments
Present in young adults
May or may not have symptoms of urethritis, vaginitis

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16
Q

What sign of chlamydial conjunctivitis can be found in the eyelid?

A 
Follicular change
(looks like rice)
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17
Q

What complication can chlamydial conjunctivitis cause?

A

subtarsal scarring

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18
Q

How does a bacterial keratitis usually appear?

A

white clouded areas on cornea

hypopyon (white layer of fluid) at bottom of cornea

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19
Q

How is bacterial keratitis treated?

A
  • admission for hourly drops (Ofloxacin)

- Daily review

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20
Q

Bacterial keratitis usually occurs when there is other corneal pathology present. TRUE/FALSE?

A

TRUE

Usually in association with other corneal pathology or contact lens wear

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21
Q

What viruses most commonly cause keratitis?

A

Adenovirus

Herpes

22
Q

What sign is distinctive of herpetic keratitis?

A

Dendritic ulcer

23
Q

What treatment should not be used in herpetic keratitis?

A

Corneal melt and perforation of the cornea

Ulcer dissolves

24
Q

Adenovirus keratitis is usually bilateral and contagious. TRUE/FALSE?

A

TRUE

25
Q

What type of infection usually precedes an adenovirus keratitis?

A

Upper Respiratory Tract Infection (URTI)

26
Q

How is an adenovirus keratitis treated?

A

Topical antibiotic to prevent secondary infection

Mild steroids to speed up recovery if becomes chronic

27
Q

What sign is distinctive of adenovirus keratitis?

A

Subepithelial infiltrates

28
Q

What organisms usually cause keratitis from contact lenses?

A

Acanthamoeba (commonly from tap water)

Pseudomonas aeruginosa

29
Q

Who usually gets fungal keratitis?

A

Farmers/gardeners:

=> history of trauma from vegetation.

30
Q

What symptoms and signs present in orbital cellulitis?

A

Painful – especially on eye movements
Proptosis
Pyrexial

31
Q

What imaging is used to look for orbital abscesses?

A

CT Scan

32
Q

What is meant by pre-septal cellulitis?

A

Only affects top layers of skin

=> not as serious and wont damage any strctures in eye

33
Q

What is dacryocystitis?

A

Infection of the lacrimal sac due to an obstruction

34
Q

What organisms usually cause orbital cellulitis?

A 
Staphylococci
Streptococci
Coliforms
Haemophilus influenzae
Anaerobes
35
Q

How is orbital cellulitis managed?

A

If restriction of muscles or optic nerve dysfunction then scan
Broad spectrum antibiotics
abscess will require drainage

36
Q

How does endophthalmitis usually present?

A

Painful
Decreasing vision
Very red eye
Sight threatening

37
Q

What is the main cause of endophthalmitis?

A

Post-surgical (Iatrogenic)

38
Q

What organisms most commonly cause endophthalmitis?

A

conjunctival “commensals”

staph epidermidis

39
Q

What antibiotics are used to treat endophthalmitis and how are they normally delivered?

A

Antibiotics are injected into vitreous fluid

Intravitreal amikacin/ ceftazidime/ vancomycin`

40
Q

What organisms are known to cause chorioretinitis?

A

CMV in AIDS
Toxoplasma gondii
Toxocara canis (worm)

41
Q

Toxoplasmosis can enter a latent state and reactivate. TRUE/FALSE?

A

TRUE

especially in immunocompromised individuals

42
Q

When is toxoplasmosis treated?

A

If sight threatening, it is treated systemically

43
Q

Toxocara cannot replicate in humans and is therefore self limiting. TRUE/FALSE?

A

TRUE

can only replicate in animals such as cats or dogs

44
Q

How can a Toxocara infection cause vision loss?

A

Form granulomas which can cause irreversible visual loss

45
Q

What investigations are used to diagnose eye infections?

A 
Swabs for culture
Corneal scrapes in bacterial keratitis
Aqueous/vitreous fluid sample for culture in endophthalmitis
Microscopy/culture for acanthamoeba
Serology for toxoplasma and toxocara
46
Q

What is grey baby syndrome?

A

Baby looks grey following chloramphenicol overdose

47
Q

Why do most eye drop bottles have a recommended “use by” date of 28 days after opening?

A

Pseudomonas can culture in the bottles after this time

48
Q

What antiviral is most commonly used in viral conjunctivitis?

A

Aciclovir

49
Q

What is used to treat chlamydial conjunctivitis?

A

topical oxytetracycline

adults may also need oral azithromycin for genital chlamydia infection

50
Q

Chloramphenicol, fusidic acid and gentamicin are all used to treat what eye infection?

A

Bacterial conjunctivitis

51
Q

Other than offloxacin, what antibiotics can be used to treat Bacterial keratitis?

A

Gentamicin and Cefuroxime

Ophthalmology (13 decks)

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