Microbiology Flashcards
centor criteria?
fever tonsillar exudate no cough tender anterior cervical lymphadenopathy \+1 if <15 or -1>44 if 2-3 then culture and +ve then abx if >3 then abx empirical
management of infectious mononucleosis
supportive
systemic steroids if severe
what abx must never be given for infectious mononucleosis
Amoxicillin, causes rash
pathogens in acute epiglottitis
generally HiB
strep pyogenes, staph aureus, strep pneumoniae
management of acute epiglottitis
abx
neb adrenaline and saline
steroids
intubate/ventilate, tracheostomy
transmission of herpex simplex
oral-oral
oral-genital
genital-genital
abrasion contacts secretion
pathophysiology of herpes simplex?
chronic infection in neural ganglia and reactivates on skin and mucosa
happens due to infected nerve endings that travel to ganglia
features of herpes reactivation and management
pain, burning, tingling, pruritus
lesions at vermillion border
treated with gancyclovir
features of primary gingivostomatitis, causative organism and management
HSV
systmeic upset, lips, buccal mucosa, hsrd palate have vesicles and ulcers
fever/local lymphadenopathy
managed with ganciclovir
risk factors for HSV recurrence
stress
sunlight
fever
immune deficiency
what is herpetic whitlow
occupational hazard of dentistry and anaesthetics
use gloves
diagnosis HSV
swab of lesiob in medium
DNA by PCR
what is herpangina, causative organism and presentation
vesicles and ulcers on hard palate, generally cocksackie
high fever, hyperaemia, yellow/grey papulovesicular lesions
feature of hand, foot, mouth disease, diagbosis and organism
cocksackie, maculopapular, macular or vesicular rash of hands and feet
PCR swab by transport medium
recurrence risk factors for apthous ulcers
trauma stress smoking cessation hormone imbalance diet
how do apthous ulcers appear
painful
round or ovoid
inflammatory halo
ulceration associated with systemic disease
inflammatory skin disease drugs reiters IBD coeliac bechets
common viral cause of acute throat infection
rhinovirus coronavirus adenovirus flu A/B parainfluenza CMV HSV Cocksackie EBV
common bacterial causes of acute throat infection
GAS
strep pneumoniae
uncommon organsims causing acute throat infection
HIV
gonococcal pharyngitis
diptheria
complications of acute sore throat
parapharyngeal abscess
quinsy
otitis media
lemierre syndrome
when to admit for acute throat infection
stridor breathing difficulty acute epiglottitis kawasaki throat cancer
non-infectious causes of acute sore throat
GORD
Hayfever
chronic smoking
general management of acute sore throat
GAS - penicillin if score high
analgesia
fluids
lozenge
complications of GAS
glomerulonephritis
rheumatic fever
features of glomerulonephritis caused by GAS?
1-3 weeks post sore throat
haematuria, albuminuria, oedeka
features of rheumatic fever caused by GAS?
3 weeks at leasr
fever, arthritis, pericarditis
feverPAIN criteria
fever purulent tonsils attend early <3d inflamed tonsils no cough 0/1 is low 2/3 consider delayed abx 4/5 prescribe abx
symptoms of DMARD sore throat and what to do
withhold DMARD and request FBC rash oral ulcers sore throat N&V diarrhoea dry cough SOB abnnormal bruising
what may cause neuropaenia to lead to sore throat
HIV, chemo
carbimazole
immunosuppressives
organism and features of diphtheria
corynebacterium diptheriae malaise cervical lymphadenopathy fever erythema pseudomembrane
complications of diphtheria
local neuropathy of palate
cranail neuropathy
peripheral neuritis
renal failure
management of diphtheria
antitoxin
supportive
penicillin/erythromycin
vaccine
features infectious mononucleosis
fever cervical lymphadenopathy sore throat malaise lethargy jaundice/hepatitis rash leucocytosis splenomegaly palatal petechiae
complications glandular fever
splenic rupture
thrombocytopaenia, anaemia
upper airway obstruction
increased risk lymphoma
diagnosis of gladular fever
EBV IgM
paul-bunnel test or monospot for heterophile Ab
blood count and film
LFTs
management of glandular fever
bed rest
paracetamol
avoid sport for 6 weeks
steroids in haemolytic anaemia or upper airway obstruction
organism, features, treatmetn and risk factors for candidiasis
candida albicans
fluconazole/nystatin
white patches on red raw mucous membranes
smokers, endogenous, inhaled steroids
common organisms in acute otitis media
h influenza
strep pneumoniaw
strep pyogenes
management of acute otitis media
most dont need abx
first line amox
2nd line erythromycin
fungal cause and treatment otitis externa
aspergillus
candida
clean ear and antifungal - clotrimazole
bacterial cause of otitis externa and management
pseudomonas proteus staph aureus gentamicin aural toilet swab to micro and prescribe for unresponsive or severe
what is malignant otitis externa
extension of otitis externa to mastoid or temporal bones
fatal as can cause osteomyelitis and meningeal infection if untreated
symptoms of malignant otitis externa
pain, headache
granulation tissue at bone cartilage jucntion
facial nerve palsy
exposed bone
investigation and risk factors for malignant otitis externa
PV/CRP
radiology
biopsy/culture
diabetic, radiotherapy
first line for acute sinusitis
penicillin V or doxy
acute sinusitis that is indicative of bacterial infection presents as?
severe pain and tenderness with purulent nasal discharge
