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Ophthalmology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

How does bacterial conjunctivitis present?

A

Red eye and purulent discharge

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2
Q

Name three common pathogens in neonatal conjunctivitis

A

Staph aureus
Neisseria gonorrhoea
Chlamydia trachomatis

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3
Q

What should be done if you see neonatal conjunctivitis?

A

Urgent ophthalmology referral

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4
Q

In other age groups what pathogens cause bacterial conjunctivitis?

A

Staph aureus
Strep pneumoniae
H.influenza (especially kids)

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5
Q

How is bacterial conjunctivitis managed?

A 
Swab 
Topical antibiotics (chloramphenicol QDS)
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6
Q

When is chloramphenicol contraindicated?

A

Patients with a history of aplastic anaemia or patients with a chloramphenicol allergy

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7
Q

What are the two types of chloramphenicol and what is the disadvantage of each?

A

Drops need to be kept in the fridge

Ointment can cause visual problems

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8
Q

Name three causes of viral conjunctivitis

A

Adenovirus
Herpes Simplex
Herpes Zoster

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9
Q

Describe adenoviral conjunctivitis

A

Pink eye, usually after URTI is highly contagious but does not require treatment

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10
Q

What often occurs with herpes simplex conjunctivitis?

A

Associated skin rash

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11
Q

What is Hutchison Sign and why does this occur?

A

Herpes zoster of the nasociliary branch of the ophthalmic division of the trigeminal nerve causes vesicles on the tip/side of nose and indicates eye involvement

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12
Q

How does chlamydial conjunctivitis present?

A

Chronic history of conjunctivitis which is unresponsive to treatment - usually bilateral in young adults, low grade red eye but no discharge.

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13
Q

What is the classic sign of chlamydial conjunctivitis?

A

Follicles on inner eyelid

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14
Q

What can chlamydial conjunctivitis cause?

A

Sub tarsal scarring

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15
Q

What is keratitis?

A

Infection of the cornea

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16
Q

How does the cornea look when infected?

A

Cloudy as bacteria dislodges the natural arrangement

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17
Q

Define hypopyon

A

Pus behind the eye

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18
Q

How is bacterial keratitis managed?

A

Scraping for culture

Admission for hourly drops

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19
Q

What is the serious complication of bacterial keratitis?

A

Perforation

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20
Q

How does keratitis caused by herpes present?

A

Very painful and often recurrent infection with dendritic ulcers

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21
Q

What stain can be used to see dendritic ulcers?

A

Flurocein

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22
Q

What can recurrent herpes keratitis lead to?

A

Reduced corneal sensation

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23
Q

What must not be given in herpes keratitis and why?

A

Steroids - risk of corneal melt and perforation

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24
Q

How does adenovirus cause keratitis?

A

Autoimmune reaction post URTI

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25
Q

What does adenovirus keratitis look like?

A

Bilateral subepithelial infiltrates and blurred vision

26
Q

Why are antibiotics given in adenovirus keratitis?

A

To prevent secondary infection

27
Q

What may be required if adenovirus keratitis becomes chronic?

A

Steroids

28
Q

Describe keratitis caused by fungi

A

Not as bad as bacterial, takes a few weeks to develop and usually has a history of trauma from vegetation

29
Q

How will fungal keratitis present?

A

Well defined ulcer that takes a long time to heal

30
Q

What infections are caused by contact lenses?

A 
Acanthamoeba 
Pseudomonas aeruginosa (very painful)
31
Q

What is orbital cellulitis and how does it occur?

A

Pus in the orbit pushes the eye forward usually a direct extension from the sinus/focal orbital infection.

32
Q

How does a patient with orbital cellulitis present?

A

Proptosis, severe pain on movement, extremely unwell, pyrexic, well demarcated erythema

33
Q

Why is orbital cellulitis sight threatening?

A

It can cause damage to the optic nerve

34
Q

Name the pathogens associated with orbital cellulitis

A 
Staphylococci 
Streptococci 
Coliforms 
H.influenza
Anaerobes
35
Q

What investigation can be done on a patient with suspected orbital cellulitis?

A

CT scan

36
Q

What is the difference between preseptal and orbital cellulitis?

A

Preseptal - no compression of the nerve, less serious

Orbital - emergency, sight threatening compression of the nerve

37
Q

How is orbital cellulitis treated?

A

Broad spectrum antibiotics and drainage

38
Q

What is endophthalmitis?

A

Infection of the whole globe

39
Q

How does endophthalmitis present?

A

Usually 48 hours post surgery patients lose sight, extremely painful and red eye, systemically unwell

40
Q

How does endophthalmitis occur?

A

Blood retinal barrier is perforated resulting in infiltration of commensals such as staph epidermis

41
Q

What surgery is endophthalmitis a complication of?

A

Cataract surgery

42
Q

How is endophthalmitis managed?

A

Needle into vitreous to take culture and inject antibiotics

43
Q

Define chorioretinitis

A

Infection of the choroid and retina

44
Q

Name three causes of chorioretinitis

A
  • CMV in AIDS and HSV
  • Toxoplasmosis Gondii
  • Toxocara Canis
45
Q

Describe toxoplasmosis gondii

A

Protozoan infection from cats and raw meat that causes a mild flu like illness and rarely further problems. Can sit in the eye in the latent phase but can reactivate

46
Q

What happens when toxoplasmosis gondii reactivates?

A

It interferes with vision and requires systemic therapy

47
Q

Describe toxocara canis

A

Roundworm affects cats/dogs but is unable to replicate in the human body so remain immature larvae, fairly self limiting

48
Q

What is the serious compilation of toxocara canis?

A

Granuloma formation and irreversible visual loss

49
Q

State four methods of diagnosis for eye infections

A
  • swabs
  • corneal scrapes
  • aqueous/vitreous culture
  • serology
50
Q

What is dacrocystitis?

A

Lacrimal sac outflow is occluded which leads to bacterial proliferation

51
Q

How does chloramphenicol work?

A

Inhibits protein synthesis

52
Q

Is chloramphenicol bacteriostatic/cidal?

A

Bactericidal - strep and haemophillus

Bacteriostatic - staph

53
Q

What can be used for staph infections which don’t respond to chloramphenicol?

A

Fusidic acid

54
Q

What can chloramphenicol cause?

A

Aplastic anaemia

Grey Baby Syndrome

55
Q

What quinolone is commonly used in keratitis?

A

Ofloxacin

56
Q

How do quinolones work?

A

Inhibit DNA synthesis

57
Q

Why should use of ofloxacin be monitored closely?

A

Antibiotic resistance

58
Q

What bacteria is a common contaminant?

A

Pseudomonas

59
Q

What can be used to treat gram negative bacteria?

A

Gentamicin

60
Q

How does acyclovir work?

A

Mimics G base to inhibit DNA synthesis - used to treat dendritic corneal ulcers

61
Q

What is the treatment for chlamydial conjunctivitis?

A

Oxytetracycline (adults may also need treatment for genital chlamydia)

Ophthalmology (12 decks)

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