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Ophthalmology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Conjunctivitis

A

Inflammation of the conjunctiva (skin of the eye)

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2
Q

Conjunctivitis features

A

Red and swollen conjunctiva
Watery or pus-containing discharge
Discomfort

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3
Q

Bacterial Conjunctivitis Aetiology neonates

A

Staph Aureus
Neisseria Gonorrhoea
Chlamydia Trachomatic

Refer all cases to ophthalmology

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4
Q

Bacterial conjunctivitis aetiology

A

Staph Aureus
Step Pneumonia
H.influenzae (especially children)

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5
Q

Bacterial conjunctivitis treatment

A 
Swab 
Topical antibiotic (chloramphenicol)

Avoid chloramphenicol if history of aplastic anaemia or allergy

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6
Q

Viral Conjunctivitis Aetiology

A

Adenovirus
Herpes Simplex
Herpes Zoster

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7
Q

Viral Conjunctivitis Treatment

A

Anti-virals for herpes

Topical lubricants for adenovirus

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8
Q

Chlamydial Conjunctivitis

A

often chronic history and unresponsive to treatments

Suspect in bilateral conjunctivitis in young adults

+/- symptoms of urethritis, vaginitis

need contact tracing

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9
Q

Chlamydial conjunctivitis consequence

A

Subtarsal scarring

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10
Q

Keratitis

A

Inflammation of the cornea of the eye

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11
Q

Microbial Keratitis

A

bacteria
viruses
fungi
acanthamoeba

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12
Q

Bacterial keratitis

A

Need admission for hourly drops
Daily review

Usually in association with other corneal pathology or contact lens wear

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13
Q

Viral Keratitis Aetiology

A

herpes

adenovirus

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14
Q

Herpetic keratitis feature

A

Dendritic Ulcer
- very painful and can be recurrent

Recurrence usually results in reduced corneal sensation

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15
Q

herpetic keratitis Treatment

A

Topical antiviral (ganciclovir)

NO STEROIDS (can cause corneal melt and perforation of cornea)

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16
Q

Adenoviral Keratitis features

A

Sub Epithelial infiltrates

Normally bilateral
Usually follows an URTI/ conjunctivitis
May affect vision

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17
Q

Adenoviral Keratitis Treatment

A

Usually self-limiting

May require steroids to speed up recovery if chronic + vision problems

18
Q

Fungal keratitis - epidemiology and features

A

Often chronic history

Work outside or have ocular surface disease

Corneal lesions (more defined than bacterial keratitis )

often diagnosed late

19
Q

Fungal keratitis treatment

A

Topical anti-fungals

- natamycin amphotericin

20
Q

Acanthamoeba keratitis

A

Contact lenses
Often extremely painful- can be diagnosed late
Culture contact lenses

21
Q

Orbital Cellulitis Organisms

A 
Staphylococci 
Streptococci 
Coliforms 
H.influenzae 
Anaerobes
22
Q

Orbital Cellulitis Features

A

painful (especially on eye movement)

proptosis (forward displacement of eye- exophthalmos)

Often associated with paranasal sinusitis

Pyrexial

Sight threatening

23
Q

Orbital Cellulitis Investigation

A

CT scan

- identify orbital abscesses

24
Q

Orbital Cellulitis pattern of spread

A

Direct extension from sinus
Extension from focal orbital infection
Post-operative

25
Q

Orbital Cellulitis management

A

Suggestion of restriction of muscles or optic nerve dysfunction
–> scan

Broad spectrum antibiotic and monitor

26
Q

Endophthalmitis

A

Inflammation, usually due to infection, within the eye

- Devastating infection

27
Q

Endophthalmitis Features

A

Post surgical or endogenous
Very painful and decreasing vision
Very red eye
Sight threatening

28
Q

Endophthalmitis Organisms

A

Commensals

- Mainly staph epidermis

29
Q

Endophthalmitis Treatment

A

Intravitreal amikacin/ ceflazidime and topical antibiotics

30
Q

Chorioretinitis

A

Inflammation involving both the choroid and retina

Very rare 9mainly seen in immunocompromised

31
Q

Chorioretinitis Organisms

A 
CMV in AIDs
HSV/ HZV
Endogenous (candida) 
Toxoplasma Gondii
Toxocara canis (worm)
32
Q

Toxoplasmosis aetiology

A

Protozoan Infection
Congenital or acquired
- contaminated soil or undercooked meat

33
Q

Toxoplasmosis features

A

Mild flu like illness

Immunocompetent patients
- latent phase with cysts forming

Rarely causes a problem

34
Q

Toxoplasmosis Treatment

A

Rarely requires treatment

Systemic treatment if cysts become sight threatening

35
Q

Diagnosis of eye infections

A

Swabs for culture

  • bacterial
  • chlamydial
  • viral

Aqueous/ nitrous culture in endophthalmitis

Microscopy/ culture for acanthoemeba

Serology for toxoplasma and toxocara

36
Q

Antibiotics- mechanisms of action (3)

A

Inhibit protein synthesis
Inhibit cell wall synthesis
inhibit nucleic acid synthesis

37
Q

Chloramphenicol

A

Inhibits peptide transferable enzyme

Bacteriocidal
- strep and haemophilis

Bacteriostatic
- staph

38
Q

Chloramphenicol Side effects

A

allergy
irreversible aplastic anaemia
grey baby syndrome

39
Q

bacterial keratitis antibiotics

A

4-quinolone (Ofloxacin)

  • Gram -ve
  • NOT active vs strep pneumonia

Gentamicin and Cefuroxime
- Gram +ve and Gram -ve

40
Q

bacterial conjunctivitis antibiotics

A

Chloramphenicol
- treats most except pseudomonas aeruginosa

Fusidic acid
- Staph aureus

Gentamicin
- Gram -ve

41
Q

Antivirals

A

Ganciclovir

  • Inhibits viral DNA synthesis
  • base analogue
  • Topical and systemic
  • tears dendritic ulcers of cornea
42
Q

Chlamydial Conjunctivitis treatment

A

Topical oxytracycline

Ophthalmology (8 decks)

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