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ENT 2020 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

what are some viral causes of oral ulceration?

A

herpes simplex virus (HSV)
herpangina
hand, foot and mouth disease
primary syphilis (bacteria)

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2
Q

which type of HSV causes oral lesions?

A

type 1

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3
Q

what is primary gingivostomatitis?

A

vesicles and ulcers on lips, buccal mucosa and hard palate

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4
Q

presentation of HSV

A

primary gingivostomatitis
fever
local lymphadenopathy

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5
Q

management of HSV

A

acyclovir

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6
Q

what is a cold sore?

A

HSV has established latency in a sensory nerve root and can be reactivated

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7
Q

diagnosis of HSV

A

swab to detect viral DNA by PCR

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8
Q

presentation of herpangina

A

vesicles/ ulcers on soft palate

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9
Q

cause of herpangina

A

coxsackie virus (enterovirus)

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10
Q

diagnosis of herpangina

A

swab

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11
Q

what causes hand, foot and mouth disease?

A

coxsackie virus

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12
Q

diagnosis of hand, foot and mouth disease

A

swab

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13
Q

presentation of primary syphilis

A

chancre is a painless indurated ulcer at the site of bacterial entry

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14
Q

what are apthous ulcers?

A

non-viral ulcers

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15
Q

presentation of apthous ulcers

A

painful with inflammatory halos

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16
Q

what conditions are recurrent ulcers associated with?

A

HSV

IBD, etc.

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17
Q

what is tonsilitis?

A

inflammation of the tonsils

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18
Q

causes of tonsilitis

A

bacterial
viral= coryza, influenza, strep
less common= HIV, gonococcal pharyngitis and diphtheria
non-infectious causes

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19
Q

non-infectious causes of tonsilitis

A

physical irritation e.g. GORD, tobacco, alcohol, hay-fever

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20
Q

cause of infectious mononucleosis?

A

EBV (herpes family)

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21
Q

presentation of infectious mononucleosis

A 
sore throat
lethargy 
15-25 most common
fever
enlarged lymph nodes
other= jaundice/hepatitis, rash, leucocytosis, splenomegaly and palatal petechiae

consider as differential in tonsillitis especially if lethargy persists.

22
Q

when should infectious mononucleosis be suspected?

A

lethargy persists in second week

23
Q

two criteria’s that are used for tonsilitis

A

CENTOR

FeverPAIN

24
Q

describe the FeverPAIN criteria

A 
fever
purulence
attend rapidly w3/7
inflamed tonsils
no cough
25
Q

when should phenoxymethylopenicillin be considered in tonsilitis?

A

score 4-5 on FeverPAIN

26
Q

late complications of strep pyogenes

A

rheumatic fever

GM

27
Q

presentation of rheumatic fever in strep pyogenes

A

3 weeks post sore throat with fever, arthritis and pancarditis

28
Q

presentation of GM in strep pyogenes

A

1-3 weeks post sore throat with haematuria, albuminuria and oedema

29
Q

presentation of diphtheria

A

sore throat
grey-white membrane across pharynx
exotoxin is cardio and neurotoxic

30
Q

management of diptheria?

A

vaccine

31
Q

complications of EBV

A 
anaemia
thrombocytopenia
splenic rupture
upper airway obstruction
increased risk of lymphoma (immunosuppressed)
32
Q

diagnosis of EBV

A

EBV IgM
Paul-Bunnel test or Monospot test for heterophile Ab
blood count and film
LFTs

33
Q

management of EBV

A

bed rest
paracetamol
avoid sport
steroids in complicated cases

34
Q

presentation of candida in the mouth

A

white patches on red and raw mucous membranes

35
Q

causes of candida in the mouth

A

post-antibiotics
immunosuppressants
smoking
inhaled steroids

36
Q

management of candida in the mouth

A

nystatin

fluconazole

37
Q

how can a throat infection cause otitis media?

A

extension of infection up the eustachian tube

38
Q

causes of otitis media

A

most viral with secondary bacterial (H. influenza, strep pneumonia and pyogenes)

39
Q

management of otitis media

A

most resolve without antibiotics

40
Q

how can otitis media lead to facial palsy?

A

facial nerve is exposed in the middle ear and can swell

41
Q

how can otitis media cause mastoiditis?

A

otitis media > peri-tonsillar abscess (quinsy) > parapharyngeal abscess > mastoiditis

42
Q

what is otitis externa?

A

inflammation of the outer ear canal

43
Q

presentation of otitis externa

A 
redness
swelling
itch 
pain
discharge/ earwax
potential for hearing loss
44
Q

bacteria causes of otitis externa

A

staph aureus
proteus
pseudomonas aeruginosa

45
Q

fungal causes of otitis externa

A

aspergillus

candida

46
Q

what is malignant otitis externa?

A

extension of otitis externa into the bone surrounding the ear canal e.g. mastoid and temporal

47
Q

risk if malignant otitis externa is not treated?

A

death due to risk of osteomyelitis of the skull

48
Q

presentation of malignant otitis externa

A

pain and headache (more severe than clinical signs suggest)
granulation tissue at bone-cartilage junction
facial nerve palsy (drooping on side of lesion)

49
Q

diagnosis of malignant otitis externa

A

CRP
imaging
biopsy
cultures

50
Q

RF for malignant otitis externa

A

DM

radiotherapy of head and neck

51
Q

presentation of acute sinusitis

A

discomfort over frontal and maxillary sinuses
URTIs
severe pain with purulent discharge if bacterial

52
Q

management of acute sinusitis

A

antibiotics are only used in severe cases >10 days
1st line= phenoxymethylpenicillin
2nd line= doxycycline (NOT in children)

ENT 2020 (17 decks)

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