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Y2 Opthalmology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Common causes of Bacterial Conjunctivitis

A

Staph Aureus
Strep Pneumoniae
Haemophilus Influenzae (children esp.)

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2
Q

Treatment of Bacterial Conjunctivitis

A

Topical Chloramphenicol (ointment or drops)

NB - avoid in aplastic anaemia and allergy

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3
Q

Common causes of Viral Conjunctivitis

A

Adenovirus
Herpes Simplex
Herpes Zoster

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4
Q

Treatment of Viral Conjunctivitis

A

Nil, supportive where required

Education on hygiene as highly contagious

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5
Q

Features of Chlamydial Conjunctivitis

A

Follicular conjunctivitis - rice grains
Often chronic history, unresponsive to Tx
May or may not have associated symptoms e.g. urethritis, vaginitis

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6
Q

Treatment of Chlamydial Conjunctivitis

A

Topical oxytetracycline
May require oral azithromycin/Tx of genital disease
Contact tracing

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7
Q

Complication of Chlamydial Conjunctivitis

A

Subtarsal scarring

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8
Q

What is keratitis?

A

Infection of the cornea results in a white area in the cornea and a white level of pus at the bottom.
Most frequently with other eye pathology or contact lens wearing.

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9
Q

Suspect bacterial keratitis - what next?

A

Refer
Take scraping for culture
Daily review

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10
Q

Complications of bacterial keratitis

A

Scarring

Perforation

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11
Q

Causes of Viral Keratitis

A

Herpes

Adenovirus

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12
Q

Features of Herpetic Keratitis

A

Dendritic ulcer - branching

Pain

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13
Q

Ix for Herpetic Keratitis

A

Fluorescein dye to show missing epithelium

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14
Q

What is important to avoid in viral keratitis?

A

Steroids - can cause corneal melt and perforation

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15
Q

Features of adenoviral keratitis

A

Subepithelial infiltrates
Bilateral
Following on from URTI
Blurred vision

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16
Q

Tx adenoviral keratitis

A

topical steroids if chronic

Can give topical ABs to prevent secondary infection

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17
Q

Common presentation of Acanthamoeba Keratitis?

A

Contact lens wearer
Non-responsive to treatment for bacterial keratitis
Painful

18
Q

Common presentation of Fungal Keratitis?

A

Chronic history
Outdoor workers - farmers, landscapers, or those with ocular disease
Defined corneal lesion +/- hypopyon

19
Q

Tx of Fungal Keratitis?

A

Topical antifungals and admission

Natamycin/Amphotericin

20
Q

Red swollen eye, pain on movement, proptosis, pyrexial, and may be associated with paranasal sinusitis - diagnosis?

A

Orbital Cellulitis

21
Q

Causes of Orbital Cellulitis

A 
Staph 
Strep 
Coliforms 
H. Influenzae 
Anaerobes

From sinus, focal orbital infection, or post-op

22
Q

Ix for orbital cellulitis

A

CT to identify orbital abscesses
Differentiate between preseptal and orbital
If evidence of muscle restriction or optic nerve dysfunction - scan

23
Q

Tx of Orbital Cellulitis

A

Broad Spec AB, drain abscess if indicated

24
Q

Most common cause of Endophthalmitis

A

Staph Epidermidis

Almost always commensals post-op

25
Q

Features of Endophthlamitis

A

very painful
Decreased vision
very red eye
systemic upset

26
Q

Tx of Endophthalmitis

A

intravitreal amikacin/ceftazidime/vancomycin and topical ABs - give general anaesthetic

27
Q

Causes of Chrioretinitis

A

Haemorrhagic CMV retinitis in those with AIDS
HSV in immunosuppresse (rare)
Parasitic - toxoplasmosis gondii and toxocara

28
Q

Common presentation of Toxoplasmosis

A

Exposure - cats, undercooked meat

Flu like symptoms

29
Q

Tx of toxoplasmosis

A

Systemic clindamycin/azithromycin +/- steroids if sight threatening (check fundoscopy in relation to macula)

30
Q

Toxoplasmosis in immunosuppressed patient

A

May recur due to formation of latent cysts

31
Q

How does Toxocara cause vision loss?

A

Granuloma formation –> scarring –> irreversible vision loss

32
Q

Ix for bacterial keratitis?

A

Corneal scrape

33
Q

Ix for endophthalmitis?

A

aqueous/vitreous culture

34
Q

Ix for parasitic choroiretinitis?

A

Serology

35
Q

What is the mechanism of action of Chloramphenicol?

A

Inhibition of peptidyl transferase - prevents bacterial protein synthesis

Bacteriocidal - Strep and H. influenzae
Bacteriostatic - Staph

36
Q

Side Effects of Chloramphenicol?

A

Allergy
Irreversible aplastic anaemia (rare)
Grey baby syndrome

37
Q

Mechanism of action of penicillins and cephalosporins?

A

B lactam ring inhibits enzyme for bacterial cell wall synthesis

38
Q

ABs used in cellulitis and dacryocystitis?

A

Penicillins and Cephalosporins

39
Q

Mechanism of action of Quinolones?

A

Inhibit DNA gyrase (which is needed for supercoiling of bacterial DNA) - cell death

40
Q

Example of Quinolone and it’s indications

A 
Ofloxacin (aka 4-quinolone) - used sparingly due to resistance 
Corneal ulcers (bacterial keratitis)
41
Q

Tx of Bacterial Keratitis

A

Ofloxacin
Gentamicin
Cefurozime

42
Q

What is the most common contaminant in eyedrops?

A

Pseudomonas - only keep for 28 days max

Y2 Opthalmology (5 decks)

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