Microbiology

Question 1

how is herpes simplex virus type 1 transmitted

Answer 1

saliva

Question 2

what % of the population are infected with HSV1 and when do most people acquire it

Answer 2

70% - get it in childhood

Question 3

where does herpes virus lay in dormant after it’s primary infection

Answer 3

sensory nerve cells

Question 4

when HSV1 reactivates what can happen

Answer 4

re-infects mucosal surfaces and cause cold sores

Question 5

what virus causes primary gingivostomatitis and in which age group

Answer 5

HSV - preschool children

Question 6

what are symptoms of primary ginivostomatitis

Answer 6

systemic upset, fever, swollen lymph nodes and ulcers on lips, buccal mucosa and hard palate

Question 7

how do you diagnose HSV

Answer 7

swab and PCR

Question 8

what do you treat cold sores and primary gingivostomatis with

Answer 8

acyclovir

Question 9

what virus causes herpangina

Answer 9

coxsackie virus (type of enterovirus)

Question 10

what are symptoms of herpangina and who normally gets it

Answer 10

vesicles/ ulcers on soft palate in pre school children

Question 11

what virus cause hand foot and mouth disease

Answer 11

coxsakie virus

Question 12

what are symptoms of hand foot and mouth and who normally gets it

Answer 12

ulcers/ vesicles on mouth, hands and feet - family outbreaks common

Question 13

how do you diagnose coxsakie virus

Answer 13

PCR

Question 14

what bacteria causes syphillis

Answer 14

trep pallidum

Question 15

what do primary syphillis ulcers look like and what are they called

Answer 15

chancre - painless ulcer commonly on genitals but can be oral

Question 16

what is an aphthous ulcer

Answer 16

non-viral and self limiting. recurring ulcers with inflamm halos and no systemic disease

Question 17

what are common causes of a sore throat

Answer 17

acute pharyngitis and tonsillitis

Question 18

what type of infections are the majority of sore throat

Answer 18

viral

Question 19

how would you manage a viral sore throat

Answer 19

NO ABs, regular analgesia, lozenges, fluids and mouth washes

Question 20

what is the most common cause of a bacterial sore throat

Answer 20

strep pyogenes - group A strep

Question 21

describe strep pyogenes

Answer 21

gram +ive cocci chains, beta haemolytic

Question 22

how do you diagnose strep throat with centor criteria

Answer 22

tonsillar exude / tender cervical nodes / fever / no cough –> 3 or 4 = pen V

Question 23

how do you diagnose strep throat with fever PAIN criteria

Answer 23

fever / purulence / attend rapidly (fast onset) / inflamed tonsils / No cough –> 4 or 5 –> pen V

Question 24

what additional tests can be done for strep throat

Answer 24

FBC, swab and culture

Question 25

how do you treat strep throat

Answer 25

phenoxymethylpenicillin - pen V

Question 26

how would rheumatic fever present as a complication of strep

Answer 26

3 weeks post infection --> fever, arthritis, endocarditis

Question 27

how would glomerulonephritis present as a complication of strep

Answer 27

1-3 weeks post infection --> haematuria and oedema

Question 28

what is a complication of taking DMARDs with strep throat

Answer 28

agranulocytosis

Question 29

what bacteria causes diphtheria

Answer 29

corynebacterium diphtheriae

Question 30

what are symptoms of diphtheria

Answer 30

severe sore throat with grey membrane across pharynx - produces cardio/neurotix endotoxin

Question 31

how do you treat diphtheria

Answer 31

vaccine- penicillin and erythromycin

Question 32

what virus causes infectious mononucleosis and what family does it belong to

Answer 32

epstein barr virus (EPV), part of herpes virus

Question 33

what are symptoms of glandular fever

Answer 33

young person, fever, lymph nodes, sore throat, malaise, lethargy, jaundice/ hepatitis, haematosplenomegaly

Question 34

what are serious complications of EBV

Answer 34

anaemia, splenic rupture, upper airway obs, lymphoma

Question 35

how do you diagnose EBV

Answer 35

serology: EBV ImG, heterophile antibody, blood count, LFTs

Question 36

what causes candida/ thrush

Answer 36

candida albicans

Question 37

what are symptoms of thrush on the mouth

Answer 37

white lacy patch on mucous membrane that wipes away

Question 38

who commonly gets thrush

Answer 38

ab's, immunocompromised, smokers, inhaled steroids, diabets

Question 39

how do you treat thrush

Answer 39

nystatin or fluconazole

Question 40

what is acute otitis media

Answer 40

upper resp infection involving the middle ear via the eustachian tube

Question 41

who commonly gets acute otitis media

Answer 41

infants and children

Question 42

what are the symptoms of acute otitis media and how do you diagnose it

Answer 42

earache - swab and look

Question 43

what organisms cause acute otitis media

Answer 43

viral --> secondary bacteria infection - HAEM INFLE, strep pneumonia and strep pyogenes

Question 44

how do you treat acute otitis media

Answer 44

most resolve 4 days. 1st line = amox, 2nd line = erythromycin

Question 45

what is otitis externa

Answer 45

inflamm of outer ear canal

Question 46

what are symptoms of otitis externa

Answer 46

redness and swelling, itchy sore, discharge

Question 47

what bacteria commonly cause otitis externa

Answer 47

staph A, proteus, pseudomonas A

Question 48

what fungal infections commonly cause otitis externa

Answer 48

aspergillus, candida

Question 49

how do you diagnose and treat otitis externa

Answer 49

swab - clotrimazole and gentamicin if severe

Question 50

what is malignant otitis externa and what can happen in serious cases

Answer 50

extension of otitis externa to temporal bone - osteomyelitis of skull spreading to brain

Question 51

who is at risk of getting malignant otitis externa

Answer 51

diabetics, immunocompromised, radio to head and neck

Question 52

what are symptoms of malignant otitis externa

Answer 52

severe pain and headache, granulation tissue in ear canal, exposed bone in ear canal, facial nerve palsy

Question 53

how do you treat malignant otitis externa

Answer 53

bloods (plasma and CRP), X ray, biopsy, culture (pseudomonas A)

Question 54

what are symptoms of sinusitis and what would be different in a bacterial infection

Answer 54

mild discomfort over frontal sinuses from congestion / bacteria causes severe pain and purulent discharge

Question 55

how would you treat bacterial sinusitis

Answer 55

1st lin = pen V, 2nd line= doxy (not for kids) - only give ABs if severe