Microbiology

Question 1

centor criteria?

Answer 1

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

Question 2

management of infectious mononucleosis

Answer 2

supportive

systemic steroids if severe

Question 3

what abx must never be given for infectious mononucleosis

Answer 3

Amoxicillin, causes rash

Question 4

pathogens in acute epiglottitis

Answer 4

generally HiB

strep pyogenes, staph aureus, strep pneumoniae

Question 5

management of acute epiglottitis

Answer 5

abx
neb adrenaline and saline
steroids
intubate/ventilate, tracheostomy

Question 6

transmission of herpex simplex

Answer 6

oral-oral
oral-genital
genital-genital
abrasion contacts secretion

Question 7

pathophysiology of herpes simplex?

Answer 7

chronic infection in neural ganglia and reactivates on skin and mucosa
happens due to infected nerve endings that travel to ganglia

Question 8

features of herpes reactivation and management

Answer 8

pain, burning, tingling, pruritus
lesions at vermillion border
treated with gancyclovir

Question 9

features of primary gingivostomatitis, causative organism and management

Answer 9

HSV
systmeic upset, lips, buccal mucosa, hsrd palate have vesicles and ulcers
fever/local lymphadenopathy
managed with ganciclovir

Question 10

risk factors for HSV recurrence

Answer 10

stress
sunlight
fever
immune deficiency

Question 11

what is herpetic whitlow

Answer 11

occupational hazard of dentistry and anaesthetics

use gloves

Question 12

diagnosis HSV

Answer 12

swab of lesiob in medium

DNA by PCR

Question 13

what is herpangina, causative organism and presentation

Answer 13

vesicles and ulcers on hard palate, generally cocksackie

high fever, hyperaemia, yellow/grey papulovesicular lesions

Question 14

feature of hand, foot, mouth disease, diagbosis and organism

Answer 14

cocksackie, maculopapular, macular or vesicular rash of hands and feet
PCR swab by transport medium

Question 15

recurrence risk factors for apthous ulcers

Answer 15

trauma 
stress
smoking cessation 
hormone imbalance 
diet

Question 16

how do apthous ulcers appear

Answer 16

painful
round or ovoid
inflammatory halo

Question 17

ulceration associated with systemic disease

Answer 17

inflammatory skin disease 
drugs 
reiters 
IBD 
coeliac 
bechets

Question 18

common viral cause of acute throat infection

Answer 18

rhinovirus 
coronavirus 
adenovirus 
flu A/B
parainfluenza 
CMV
HSV
Cocksackie 
EBV

Question 19

common bacterial causes of acute throat infection

Answer 19

GAS

strep pneumoniae

Question 20

uncommon organsims causing acute throat infection

Answer 20

HIV
gonococcal pharyngitis
diptheria

Question 21

complications of acute sore throat

Answer 21

parapharyngeal abscess
quinsy
otitis media
lemierre syndrome

Question 22

when to admit for acute throat infection

Answer 22

stridor 
breathing difficulty 
acute epiglottitis 
kawasaki 
throat cancer

Question 23

non-infectious causes of acute sore throat

Answer 23

GORD
Hayfever
chronic smoking

Question 24

general management of acute sore throat

Answer 24

GAS - penicillin if score high
analgesia
fluids
lozenge

Question 25

complications of GAS

Answer 25

glomerulonephritis | rheumatic fever

Question 26

features of glomerulonephritis caused by GAS?

Answer 26

1-3 weeks post sore throat | haematuria, albuminuria, oedeka

Question 27

features of rheumatic fever caused by GAS?

Answer 27

3 weeks at leasr | fever, arthritis, pericarditis

Question 28

feverPAIN criteria

Answer 28

``` fever purulent tonsils attend early <3d inflamed tonsils no cough 0/1 is low 2/3 consider delayed abx 4/5 prescribe abx ```

Question 29

symptoms of DMARD sore throat and what to do

Answer 29

``` withhold DMARD and request FBC rash oral ulcers sore throat N&V diarrhoea dry cough SOB abnnormal bruising ```

Question 30

what may cause neuropaenia to lead to sore throat

Answer 30

HIV, chemo carbimazole immunosuppressives

Question 31

organism and features of diphtheria

Answer 31

``` corynebacterium diptheriae malaise cervical lymphadenopathy fever erythema pseudomembrane ```

Question 32

complications of diphtheria

Answer 32

local neuropathy of palate cranail neuropathy peripheral neuritis renal failure

Question 33

management of diphtheria

Answer 33

antitoxin supportive penicillin/erythromycin vaccine

Question 34

features infectious mononucleosis

Answer 34

``` fever cervical lymphadenopathy sore throat malaise lethargy jaundice/hepatitis rash leucocytosis splenomegaly palatal petechiae ```

Question 35

complications glandular fever

Answer 35

splenic rupture thrombocytopaenia, anaemia upper airway obstruction increased risk lymphoma

Question 36

diagnosis of gladular fever

Answer 36

EBV IgM paul-bunnel test or monospot for heterophile Ab blood count and film LFTs

Question 37

management of glandular fever

Answer 37

bed rest paracetamol avoid sport for 6 weeks steroids in haemolytic anaemia or upper airway obstruction

Question 38

organism, features, treatmetn and risk factors for candidiasis

Answer 38

candida albicans fluconazole/nystatin white patches on red raw mucous membranes smokers, endogenous, inhaled steroids

Question 39

common organisms in acute otitis media

Answer 39

h influenza strep pneumoniaw strep pyogenes

Question 40

management of acute otitis media

Answer 40

most dont need abx first line amox 2nd line erythromycin

Question 41

fungal cause and treatment otitis externa

Answer 41

aspergillus candida clean ear and antifungal - clotrimazole

Question 42

bacterial cause of otitis externa and management

Answer 42

``` pseudomonas proteus staph aureus gentamicin aural toilet swab to micro and prescribe for unresponsive or severe ```

Question 43

what is malignant otitis externa

Answer 43

extension of otitis externa to mastoid or temporal bones | fatal as can cause osteomyelitis and meningeal infection if untreated

Question 44

symptoms of malignant otitis externa

Answer 44

pain, headache granulation tissue at bone cartilage jucntion facial nerve palsy exposed bone

Question 45

investigation and risk factors for malignant otitis externa

Answer 45

PV/CRP radiology biopsy/culture diabetic, radiotherapy

Question 46

first line for acute sinusitis

Answer 46

penicillin V or doxy

Question 47

acute sinusitis that is indicative of bacterial infection presents as?

Answer 47

severe pain and tenderness with purulent nasal discharge