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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
Q

What skin diseases are linked to apthous ulcers?

A

Lichen planus
Pemphigus
Pemphigoid

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26
Q

What are the two common causes of pain at the back of the throat?

A

Acute pharyngitis

Tonsilitis

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27
Q

What are the common causative organisms for acute pharyngitis or Tonsillitis?

A

Influenza

Strep infection

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28
Q

If the sore throat lasts into the second week what should be suspected?

A

Glandular fever

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29
Q

List some less common causes of a sore throat?

A

HIV
Gonococcal pharyngitis
Diptheria

30
Q

What physical irritants can lead to a sore throat?

A

GORD
Cigarette smoke
Alcohol
Hay fever

31
Q

What clinical signs call for immediate hospital admission?

A

Sore throat with stridor or respiratory difficulty

32
Q

What is the most common cause of bacterial sore throat?

A

Strep pyogenes

33
Q

What is the treatment for acute follicular tonsillitis?

A

Penicillin

34
Q

What are you at risk off 3 weeks post acute follicular infection?

A

Rheumatic fever

Arthritis + Fever + Pericarditis

35
Q

What are you at risk of 1-3 weeks post acute follicular tonsilitis?

A

Glomerulonephritis

Haematuria + Albuminuria + Oedema

36
Q

What is the causative organism in diphtheria?

A

Coryebacterium Diptheriae

37
Q

What is the clinical presentation of diphtheria?

A

Severe sore throat
Grey white pseudomembrane
Low fever

38
Q

Why is diphtheria a dangerous infection?

A

The bacteria produces a neurotoxin and a cardiotoxin.

39
Q

What is the treatment for diphtheria?

A

Penicillin/Erythromycin
Anti toxin
Supportive therapy

40
Q

Is diphtheria preventable?

A

Yes the vaccine is an antitoxin.

41
Q

What is infectious mononucleosis?

A

Glandular fever

42
Q

What is the main causative organism of glandular fever?

A

Epstein barr virus

43
Q

What are the main clinical signs of glandular fever?

A 
Fever
Enlarged lymph nodes
Sore throat
Pharyngitis
Tonsilitis
Malaise 
Lethargy
44
Q

What other less common clinical signs might be present in glandular fever?

A

Jaundice
Rash
Splenomegaly
Leucocytosis

45
Q

What is the treatment for glandular fever?

A

Protracted but self limiting illness

Bed rest, Paracetamol, Avoidance of sport

46
Q

What are some complications of glandular fever?

A

Splenic rupture
Upper airway obstruction
Increased risk of lymphoma in immunosuppressed

47
Q

What should be measured in glandular fever?

A

Epstein Barr virus PCR
IgM
LFT
FBC

48
Q

What is the causative organism in candida?

A

Candida albicans

49
Q

What is the clinical appearance of candida?

A

White patches on a raw red mucous membrane

50
Q

What is the cause of candida?

A

Endogenous loss of flora allowing candida to grow.

Antibiotics, inhaled steroids, immunosuppressed, smokers.

51
Q

What is the treatment for candida?

A

Nystatin

Fluconazole

52
Q

What is the pathophysiology behind most acute otitis media?

A

Upper respiratory tract infection has spread via the Eustachian tube into the middle ear.

53
Q

What are the common bacterial causative organisms in acute otitis media?

A

H.Influenza
Strep.pneumonia
Strep.pyogenes

54
Q

What is the common history of acute otitis media?

A

Primary viral with a secondary bacterial infection

55
Q

How is diagnosis undergone in acute otitis media?

A

If the tympanic membrane ruptures you are able to take a PCR of the pus

56
Q

What are the risks associated with malignant otitis?

A

There is a risk of osteomyelitis and then subsequent meningitis.

57
Q

How does malignant otitis start?

A

Normal infection of the ear canal which invades into the temporal bone.

58
Q

How does someone with malignant otitis present?

A

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
Q

What investigations are undertaken in a suspected malignant otitis?

A

Plasma Viscosity
MRI
Biopsy
Culture

60
Q

List some risk factors for developing malignant otitis

A

Diabetes

Radiotherapy

61
Q

What is otitis externa?

A

Inflammation of the outer ear

62
Q

How does someone with otitis external present?

A

Erythema and inflammation
Sore and painful ear
Increased discharge and earwax
Loss of hearing

63
Q

What are the common bacterial causes of otitis externa?

A

S.aureus

Pseudomonas Aeruginosa

64
Q

What are the common fungal causes of otitis externa?

A

Aspergillus niger

Candida Albicans

65
Q

What is the treatment for mild to moderate cases of otitis externa?

A

Topical aural toilet

66
Q

If the patient presents with severe otitis externa what should be done?

A

Swab sent to microbiology and subsequent prescription

67
Q

How does sinusitis present with the initial URT virus?

A

Mild discomfort over frontal and maxillary sinuses

68
Q

If someone develops a secondary bacterial infection from their viral sinusitis how does the clinical picture change?

A

Severe pain over the frontal and maxillary sinuses

Purrulent rhinorrhea

69
Q

When are antibiotics used in sinusitis?

A

Severe cases which haven’t resolved in 10 days

70
Q

What is first line in sinusitis?

A

Phenoxymethylpenecillin

71
Q

What is 2nd line in sinusitis and when can it not be used?

A

Doxycycline

Not used in children

ENT Year 2 Medicine (12 decks)

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