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Neurological Medicine > Ocular Infections > Flashcards

Ocular Infections Flashcards

1
Q

Blepharitis

A

Inflammatory disease of the eyelid margin where too much oil is produced

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2
Q

Conjunctivitis

A

Discharge, red eye, irritation, sensitivity to palpitation

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3
Q

Keratitis

A

Infection of the Cornea

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4
Q

Keratoconjunctivitis

A

Infection of the Conjunctiva and Cornea

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5
Q

Uveitis

A

Inflammation of uveal tract [Middle Layer of the Eye (Iris, Ciliary Body, and Choroid)]

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6
Q

Chorioretinitis

A

Infection of Choroid and Retinal Layers

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7
Q

Endophthalmitis

A

Infection of the Aqueous and Vitreous Humor

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8
Q

Routes of Ocular Infection

A

Trauma, transfer from paranasal sinus, immunocompromised, anatomic abnormalities, dysfunctional tear states

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9
Q

Bacterial cause of Chronic Conjunctivitis associated with Blepharitis

A

Staphylococcus epidermidis

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10
Q

Cause of Chronic Conjunctivitis associated with Blepharitis

A

Stye or Hordeolum

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11
Q

Stye/Hordeolum

A

localized inflammation often on lower lid due to bacterial growth in eyelash

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12
Q

Treatment of Chronic Conjunctivitis associated with Blepharitis

A

Keep lid clean. Warm compress. Erythromycin ointment.

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13
Q

Eye Defense Mechanisms

A

Physical barrier: Sclera and Cornea
Lubrication: sIgA and Lysozyme
Blinking: inhibits microbial attachment

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14
Q

What is conjunctivitis caused by?

A

dilation and congestion of subepithelial vessels

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15
Q

Noninfectious causes of Conjunctivitis

A 
Allergic Rhinoconjunctivitis
Chemical Reaction
Prolonged use of Ocular Medications
Neoplasm
Irritation from contact lens or foreign body
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16
Q

Cause of Allergic Rhinoconjunctivitis

A

IgE mediated hypersensitivity precipitated by airborne allergens type 1

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17
Q

Management of Allergic Rhinoconjunctivitis

A

Antihistamines, Mast Cell Stabilizers, NSAIDs

Avoid: Antigen and Glucocorticoids

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18
Q

Causes of Viral Conjunctivitis
Neonatal and
Postnatal

A

Neonatal: HSV
Postnatal: Adenovirus, Coxsackie A24, HSV1 and HSV2, VZV, EBV, Rubella, Mumps, Influenza

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19
Q

Contributing factors to Viral Conjunctivitis

A

URI and Preauricular adenopathy

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20
Q

Treatment for Viral Conjunctivitis

A

Cold Compress and Topical Vasoconstrictors

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21
Q

Cause ofAcute Hemorrhagic Conjunctivitis

A

Enterovirus 70

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22
Q

Coxsackie adenovirus Classification

A

Non-enveloped, dsDNA
lytic = epithelial cells of respiratory tract, conjunctiva and enteric organs; latent = lymphoid
spread through fomites
Highly Contagious

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23
Q

Causes of Acute Bacterial Conjunctivitis in Children

A

Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella lacunata

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24
Q

Causes of Acute Bacterial Conjunctivitis in Adults

A

Staphlococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Pseudomonas aeruginosa

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25
Q

Mechanism of Action for Trimethoprim

A

Bacteriostatic; inhibits bacterial dihydrofolate reductase (low affinity for mammalian enzyme)

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26
Q

Mechanism of Action for Moxifloxacin (fluoroquinolone)

A

Inhibits DNA gyrase (Topo II) and Topo IV = stops cell replication

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27
Q

Treatment of Acute Bacterial Conjunctivitis

A

Self-limiting, but treat with Trimethoprim and Polymyxin B

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28
Q

Mechanism of Action of Polymyxin B

A

Gram Negative Multidrug Resistant that binds to lipopolysaccharide in membrane creating holes causing release of cellular contents

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29
Q

Hyperacute Bacterial Conjunctivitis Cause

A

Neisseria gonorrhoeae

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30
Q

Symptoms of Hyperacute Bacterial Conjunctivitis

A

Yellow-Green Discharge (Purulent); preauricular adenopathy

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31
Q

Claffify Neisseria gonorrhoeae

A

Gram negative intracellular diplococci; growth on chocolate agar

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32
Q

Treatment of Hyperacute Bacterial Conjunctivitis

A

Systemic Ceftriaxone, topical antibiotics and irrigation

33
Q

Mechanism of Action for Ceftriaxone

A

3rd Generation cephalosporin; cell wall inhibitor that binds to penicillin binding proteins

34
Q

Ophthalmia Neonatorum

A

Conjunctivitis or keratoconjunctivitis occurring within the first four weeks of birth

35
Q

Causes of Ophthalmic Neonatorum

A

Neisseria gonorrhoeae, C. trachomatis, Staphlococcus, Streptococcus, E. coli, H. influenzae, Herpes simplex

36
Q

Treatment of Ophthalmic Neonatorum

A

Prophylaxtic: erythromycin (often the same for empiric)

37
Q

How do you diagnose Ophthalmia Neonatorum

A

Cultures and smears

38
Q

Mechanism of Action for Erythromycin/Azithromycin

A

Inhibits translation by binding 23S subunit of 50S subunit

39
Q

Spectrum of Erythromycin/Azithromycin

A

Broad, including Chlamydia and Respiratory pathogens

40
Q

Resistance of Erythromycin/Azithromycin

A

Increased efflux, methylation of drug binding site,

41
Q

Adverse effects of Erythromycin/Azithromycin

A

GI discomfort, liver failure, Prolonged QT, inhibition of CYP 450 enzymes

42
Q

Chlamydia trachomatis: 2 forms

A

1) Inclusion conjunctivitis (serotypes D-K)

2) Trachoma (serotypes A-C)

43
Q

Diagnosis of Chlamydia trachomatis

A

direct fluorescent antibody

44
Q

What co-infection often exists with Chlamydia trachomatis?

A

Neisseria gonorhoaea

45
Q

What does Chlamydia trachomatis (Trachoma type) cause?

A

Blindness = no long lasting immunity

46
Q

Treatment of Chlamydia trachomatis

A

Systemic Azithromycin

47
Q

What is the mechanism of action for Azithromycin?

A

Binds to 50S ribosomal subunit, inhibiting translation of mRNA and thus protein synthesis

48
Q

Chlamydia Trachomatis Life Cycle

A

1) Elementary body (rigid outer membrane) enters epithelial cells
2) Converts to Reticulate body
3) replicates via binary fission

49
Q

Keratoconjunctivitis is caused by…

A

Herpes Simplex Virus 1 (Dendritic Pattern on the Cornea)

50
Q

Treatment of Keratoconjunctivitis

A

Topical Trifluridine and Systemic Acyclovir

Prophylactic treatment with erythromycin

51
Q

Mechanism of Action for Trifluridine

A

Pyrimidine analog effective against acyclovir resistant viruses; can be phosphorylated by host kinases; highly toxic; use topically

52
Q

Symptoms of Keratitis

A

Vision defects, photophobia, pain, foreign body sensation

53
Q

Biological Causes of Keratitis

A

Trauma, drying of the epithelia, hypoxia

54
Q

Viral Causes of Keratitis

A

HSV-1, adenovirus, VZV

55
Q

Bacterial Causes of Keratitis

A

Staphlococcus aureus, Staphlococcus epidermidis, Pseudomonas aeruginosa, Bacillus cereus

56
Q

Other causes of Keratitis

A

Acanthamoeba, Fungal in warm climate

57
Q

Treatment for Keratitis

A

Bacteria: moxifloxacin eye drops

HSV-1: Trifluridine and Acyclovir

58
Q

Mechanism of Action for Acyclovir

A

Converted by viral Thymidine kinase to inhibit and inactivate viral DNA polymerases

59
Q

Classification of Pseudomonas aeroginsoa

A

Gram negative, aerobic rod with flagella, opportunistic infection, naturally antibiotic resistant

60
Q

What is the common physical finding for Pseudomonas aeroginsoa?

A

Blue Pigment Pyocyanin - inhibits mitochondrial enzymes disrupting ciliary beating

61
Q

Classify acanthamoeba

A

Single Cell, eukaryote, causing keratits or granulomathous amebic encephalitis

62
Q

Treatment of acanthamoeba

A

Azoles

63
Q

Mechanism of Action of Azoles

A

Antifungal - block ergosterol production

64
Q

What is the infectious stage acanthamoeba?

A

Trophozoite

65
Q

Uveitis Symptoms

A

blurred vision and permanent vision loss

66
Q

Iritis

A

Anterior uveitis with photophobia, pain, decreased visual acuity

67
Q

Causes of Uveitis

A

Treponema pallidum, HSV, VZV

68
Q

Chorioretinitis Symptoms

A

Posterior uveitis, cause floaters, no pain, with blurred vision, common in immunocompromised patients

69
Q

Congenital Chorioretinitis Causes

A

Toxoplasma and Cytolomegalovirus

70
Q

Parasitic causes of Chorioretinitis

A

Toxocara canis and onchoerca volvulus = river blindness; sand flies

71
Q

Toxoplasmosis diagnosis

A

IgM serology

72
Q

Treatment of Toxoplasmosis

A

Pyrimethamine and Sulfadiazine

73
Q

Mechanism of Action for Pyrimethamine

A

DHFR inhibitor

74
Q

Mechanism of Action for Sulfadiazine

A

Folate synthesis inhibitor

75
Q

Endophthalmitis

A

vitreous/aqueous humors infection characterized by pain, redness, decreased vision

76
Q

What are the causes of Endophthalmitis?

A

Bacterial Pseudomonas, Staphylococci, Candida/Fungi

77
Q

Treatment of Endophthalmitis

A

Fluoroquinolone or Vancomycin injected into the eye

78
Q

Mechanism of Action for Fluoroquinolones

A

Inhibit Topo II or Topo IV, causing DNA strand breaks - Effective on Gram Positives

79
Q

Mechanism of Action for Vancomycin

A

Cell wall inhibitor that binds to the D-alanyl-D-alanine, shielding it from the transpeptidation reaction - Effective on Gram Positives

Neurological Medicine (8 decks)

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