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ENT Year 2 Medicine > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What type of HSV causes oral lesions?

A

HSV1

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2
Q

In regards to HSV what is its main method of infection?

A

Saliva

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3
Q

What is the name given to the primary HSV1 infection?

A

Primary Gingivostomatitis

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4
Q

Who is mainly affected with primary gingivostomatitis?

A

Young school children generally pre school.

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5
Q

What is the clinical presentation of someone with gingivostomatitis?

A

Systemic upset
Fever
Vesicles - lips buccal cavity and hard palate
Ulcers

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6
Q

Generally primary gingivostomatitis requires acyclovir ? T/F?

A

Generally self resolving , if not then acyclovir is used in severe or unresolved cases.

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7
Q

What happens post primary HSV1 infection?

A

The virus sits within the sensory nerve cells until reactivated, not all reactivations are symptomatic.

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8
Q

What is a secondary reactivation of HSV1 commonly called?

A

A cold sore

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9
Q

In regards to cold sores what is the natural history?

A

A decreasing frequency of reactivations

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10
Q

What is used to detect and diagnose HSV1 latency and infection?

A

Viral PCR swab

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11
Q

What is the causative organism in herpangina?

A

Coxsackie virus

Enterovirus

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12
Q

What is the clinal presentation of herpangina?

A

Vesicles and ulcers on the soft palate

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13
Q

What is used to make a diagnosis of herpangina and Hand Foot and Mouth ?

A

Viral PCR

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14
Q

What is the clinical presentation of Hand Foot and Mouth?

A

Ulcers within the mouth.
Blistering ulcers on the foot and hand
High fever
Family outbreak

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15
Q

What is the causative organism in Hand Foot and Mouth?

A

Coxsackie virus

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16
Q

What is the causative organism in syphilis?

A

Treponema Pallidum

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17
Q

What is the main clinical sign of a primary syphilis infection?

A

Chancre- painless ulcer at the site of the ulcer

- Oral or genital usually

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18
Q

Why is it key to diagnose and treat a primary syphilis infection early?

A

It can progress to secondary and then tertiary syphilis both of which are damaging and ultimately fatal.

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19
Q

What are apthous ulcers?

A

Non viral and self limiting ulcers

Round or ovoid with an inflammatory halo

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20
Q

If there is a history of recurrent apthous ulcers what should you be worried about?

A

A underlying systemic disease

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21
Q

List some diseases which are linked to apthous ulcers.

A 
Behcets
IBD
Reiters
Drug reactions
Skin diseases
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22
Q

How would behcets present?

A

Middle East or asian
Recurrent genital or oral ulcers
Uveitis
Visceral organ involvement

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23
Q

How would IBD or gluten intolerance present?

A

Diarrhoea
Weight loss
Recurrent genital or oral ulcers

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24
Q

How would reiters present?

A

Arthritis

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25
What skin diseases are linked to apthous ulcers?
Lichen planus Pemphigus Pemphigoid
26
What are the two common causes of pain at the back of the throat?
Acute pharyngitis | Tonsilitis
27
What are the common causative organisms for acute pharyngitis or Tonsillitis?
Influenza | Strep infection
28
If the sore throat lasts into the second week what should be suspected?
Glandular fever
29
List some less common causes of a sore throat?
HIV Gonococcal pharyngitis Diptheria
30
What physical irritants can lead to a sore throat?
GORD Cigarette smoke Alcohol Hay fever
31
What clinical signs call for immediate hospital admission?
Sore throat with stridor or respiratory difficulty
32
What is the most common cause of bacterial sore throat?
Strep pyogenes
33
What is the treatment for acute follicular tonsillitis?
Penicillin
34
What are you at risk off 3 weeks post acute follicular infection?
Rheumatic fever | Arthritis + Fever + Pericarditis
35
What are you at risk of 1-3 weeks post acute follicular tonsilitis?
Glomerulonephritis | Haematuria + Albuminuria + Oedema
36
What is the causative organism in diphtheria?
Coryebacterium Diptheriae
37
What is the clinical presentation of diphtheria?
Severe sore throat Grey white pseudomembrane Low fever
38
Why is diphtheria a dangerous infection?
The bacteria produces a neurotoxin and a cardiotoxin.
39
What is the treatment for diphtheria?
Penicillin/Erythromycin Anti toxin Supportive therapy
40
Is diphtheria preventable?
Yes the vaccine is an antitoxin.
41
What is infectious mononucleosis?
Glandular fever
42
What is the main causative organism of glandular fever?
Epstein barr virus
43
What are the main clinical signs of glandular fever?
``` Fever Enlarged lymph nodes Sore throat Pharyngitis Tonsilitis Malaise Lethargy ```
44
What other less common clinical signs might be present in glandular fever?
Jaundice Rash Splenomegaly Leucocytosis
45
What is the treatment for glandular fever?
Protracted but self limiting illness | Bed rest, Paracetamol, Avoidance of sport
46
What are some complications of glandular fever?
Splenic rupture Upper airway obstruction Increased risk of lymphoma in immunosuppressed
47
What should be measured in glandular fever?
Epstein Barr virus PCR IgM LFT FBC
48
What is the causative organism in candida?
Candida albicans
49
What is the clinical appearance of candida?
White patches on a raw red mucous membrane
50
What is the cause of candida?
Endogenous loss of flora allowing candida to grow. | Antibiotics, inhaled steroids, immunosuppressed, smokers.
51
What is the treatment for candida?
Nystatin | Fluconazole
52
What is the pathophysiology behind most acute otitis media?
Upper respiratory tract infection has spread via the Eustachian tube into the middle ear.
53
What are the common bacterial causative organisms in acute otitis media?
H.Influenza Strep.pneumonia Strep.pyogenes
54
What is the common history of acute otitis media?
Primary viral with a secondary bacterial infection
55
How is diagnosis undergone in acute otitis media?
If the tympanic membrane ruptures you are able to take a PCR of the pus
56
What are the risks associated with malignant otitis?
There is a risk of osteomyelitis and then subsequent meningitis.
57
How does malignant otitis start?
Normal infection of the ear canal which invades into the temporal bone.
58
How does someone with malignant otitis present?
Pain and a headache more severe that the clinical picture. Granulation tissue at the seam between bone and cartilage. Exposed bone on exploration Facial nerve palsy
59
What investigations are undertaken in a suspected malignant otitis?
Plasma Viscosity MRI Biopsy Culture
60
List some risk factors for developing malignant otitis
Diabetes | Radiotherapy
61
What is otitis externa?
Inflammation of the outer ear
62
How does someone with otitis external present?
Erythema and inflammation Sore and painful ear Increased discharge and earwax Loss of hearing
63
What are the common bacterial causes of otitis externa?
S.aureus | Pseudomonas Aeruginosa
64
What are the common fungal causes of otitis externa?
Aspergillus niger | Candida Albicans
65
What is the treatment for mild to moderate cases of otitis externa?
Topical aural toilet
66
If the patient presents with severe otitis externa what should be done?
Swab sent to microbiology and subsequent prescription
67
How does sinusitis present with the initial URT virus?
Mild discomfort over frontal and maxillary sinuses
68
If someone develops a secondary bacterial infection from their viral sinusitis how does the clinical picture change?
Severe pain over the frontal and maxillary sinuses | Purrulent rhinorrhea
69
When are antibiotics used in sinusitis?
Severe cases which haven't resolved in 10 days
70
What is first line in sinusitis?
Phenoxymethylpenecillin
71
What is 2nd line in sinusitis and when can it not be used?
Doxycycline | Not used in children

ENT Year 2 Medicine (12 decks)

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