Microbiology

Question 1

what is conjunctivitis

Answer 1

inflammation of the conjunctiva

Question 2

different causes of conjunctivitis

Answer 2

bacterial
viral
chlamydial
allergic

Question 3

microbes that cause neonatal bacterial conjunctivitis

Answer 3

Staph A
N Gonorrhoea
Chlamydia

Question 4

what do you do for less than 2 week old babies with conjunctivitis

Answer 4

refer straight to ophthalmology

Question 5

other causes of bacterial conjunctivitis in older ages

Answer 5

Staph A
Strep pneumoniae
H Influenzae

Question 6

symptoms of bacterial conjunctivitis

Answer 6

sticky discharge
usually unilateral
red conjunctiva

Question 7

investigations and management of bacterial conjunctivitis

Answer 7

bacterial swab
topical chloramphenicol
topical fusidic acid

Question 8

side effects and contraindications to chloramphenicol treatment

Answer 8

aplastic anaemia
allergy
grey baby syndrome

Question 9

viral causes of conjunctivitis

Answer 9

adenovirus
herpes simplex
herpes zoster

Question 10

symptoms of adenovirus conjunctivitis

Answer 10

pink watery eye 
no discharge 
self limiting 
highly contagious 
bilateral

Question 11

symptoms of HSV conjunctivitis

Answer 11

vesicles around the eye

Question 12

symptoms of chlamydial conjunctivitis

Answer 12

chronic course 
unresponsive to treatment 
suspect in young adults with bilateral disease 
? urethritis, vaginitis 
"grains of rice" under eyelid

Question 13

investigations and management of chlamydial conjunctivitis

Answer 13

specific chlamydia swab - need to get explicit consent

topical oxytetracycline

Question 14

what is keratitis

Answer 14

inflammation of the cornea

Question 15

what are the different types of keratitis

Answer 15

bacterial
viral
fungal

Question 16

what is a hypopyon and in which disease can it be seen

Answer 16

level of white cells in the eye

seen in keratitis (bacterial, fungal), endophthalmitis, uveitis

Question 17

bacterial keratitis is not very severe, true or false

Answer 17

false, it is sight threatening

Question 18

symptoms of bacterial keratitis

Answer 18

pain
reduced vision
white lesion on cornea
hypopyon

Question 19

management of bacterial keratitis

Answer 19

urgent admission

hourly drops of ofloxacin (quinolone) for 48 hours

Question 20

patients with other corneal pathology tend to be more susceptible to bacterial keratitis, true or false

Answer 20

true

Question 21

patients with other corneal pathology tend to be more susceptible to viral keratitis, true or false

Answer 21

false, can occur in those with a normal cornea

Question 22

causes of viral keratitis

Answer 22

adenovirus

HSV - herpetic keratitis

Question 23

features of herpetic keratitis

Answer 23

pain
cant open eye
dendritic ulcer with fluroscein dye

Question 24

management of herpetic keratitis

Answer 24

aciclovir

Question 25

topical steroids can be used in the management of herpetic keratitis, true or false

Answer 25

FALSE | never treat herpetic keratitis with topical steroids as it can perforate the cornea

Question 26

features of adenovirus keratitis

Answer 26

``` red watery eye +- conjunctivitis bilateral can follow URTI contagious ```

Question 27

causes of fungal keratitis

Answer 27

acanthamoeba | pseudonomas

Question 28

who is more likely to get acanthamoeba keratitis

Answer 28

contact lens wearers

Question 29

features of fungal keratitis

Answer 29

painful | difficult to treat

Question 30

what is orbital cellulitis

Answer 30

inflammation of eye tissues behind the orbital septum

Question 31

features of orbital cellulitis

Answer 31

``` pain on movement proptosis pyrexia associated with paranasal sinusitis, chalazion sight threatening!! ```

Question 32

management of orbital cellulitis

Answer 32

CT to identify abscesses | antibiotics

Question 33

what is preseptal cellulitis

Answer 33

inflammation in outer skin surface, anterior to orbital septum

Question 34

features of preseptal cellulitis

Answer 34

inflammation around the eye | no pain on eye movements

Question 35

SCAR acronym for orbital cellulitis

Answer 35

S - swelling of lids C - chemosis A - axial proptosis R - restriction of ocular movements

Question 36

what is endophthalmitis

Answer 36

devastating infection inside the eye | sight threatening

Question 37

causes of endophthalmitis

Answer 37

iatrogenic - surgery | endogenous - infective endocarditis

Question 38

features of endophthalmitis

Answer 38

painful loss of vision bright red eye hypopyon

Question 39

commonest cause of endophthalmitis

Answer 39

staph epidermidis

Question 40

management of endophthalmitis

Answer 40

intravitreal amikacin / ceftazidime / vancomycin | topical antibiotics

Question 41

what is chorioretinitis

Answer 41

inflammation of the choroid and retinal layers

Question 42

causes of chorioretinitis

Answer 42

CMV in AIDS toxoplasma gondii - protozoa toxocara canis - worm

Question 43

investigations for microbiology

Answer 43

``` swabs - bacterial, viral, chlamydial corneal scrape aqueous/vitreous humour culture serology ```

Question 44

chloramphenicol can be used to treat pseudomonas, true or false

Answer 44

false

Question 45

what is the most common eye drop bottle contaminant

Answer 45

pseudomonas | therefore, discard drops after 4 weeks