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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
Mechanism of Action for Trimethoprim
Bacteriostatic; inhibits bacterial dihydrofolate reductase (low affinity for mammalian enzyme)
26
Mechanism of Action for Moxifloxacin (fluoroquinolone)
Inhibits DNA gyrase (Topo II) and Topo IV = stops cell replication
27
Treatment of Acute Bacterial Conjunctivitis
Self-limiting, but treat with Trimethoprim and Polymyxin B
28
Mechanism of Action of Polymyxin B
Gram Negative Multidrug Resistant that binds to lipopolysaccharide in membrane creating holes causing release of cellular contents
29
Hyperacute Bacterial Conjunctivitis Cause
Neisseria gonorrhoeae
30
Symptoms of Hyperacute Bacterial Conjunctivitis
Yellow-Green Discharge (Purulent); preauricular adenopathy
31
Claffify Neisseria gonorrhoeae
Gram negative intracellular diplococci; growth on chocolate agar
32
Treatment of Hyperacute Bacterial Conjunctivitis
Systemic Ceftriaxone, topical antibiotics and irrigation
33
Mechanism of Action for Ceftriaxone
3rd Generation cephalosporin; cell wall inhibitor that binds to penicillin binding proteins
34
Ophthalmia Neonatorum
Conjunctivitis or keratoconjunctivitis occurring within the first four weeks of birth
35
Causes of Ophthalmic Neonatorum
Neisseria gonorrhoeae, C. trachomatis, Staphlococcus, Streptococcus, E. coli, H. influenzae, Herpes simplex
36
Treatment of Ophthalmic Neonatorum
Prophylaxtic: erythromycin (often the same for empiric)
37
How do you diagnose Ophthalmia Neonatorum
Cultures and smears
38
Mechanism of Action for Erythromycin/Azithromycin
Inhibits translation by binding 23S subunit of 50S subunit
39
Spectrum of Erythromycin/Azithromycin
Broad, including Chlamydia and Respiratory pathogens
40
Resistance of Erythromycin/Azithromycin
Increased efflux, methylation of drug binding site,
41
Adverse effects of Erythromycin/Azithromycin
GI discomfort, liver failure, Prolonged QT, inhibition of CYP 450 enzymes
42
Chlamydia trachomatis: 2 forms
1) Inclusion conjunctivitis (serotypes D-K) | 2) Trachoma (serotypes A-C)
43
Diagnosis of Chlamydia trachomatis
direct fluorescent antibody
44
What co-infection often exists with Chlamydia trachomatis?
Neisseria gonorhoaea
45
What does Chlamydia trachomatis (Trachoma type) cause?
Blindness = no long lasting immunity
46
Treatment of Chlamydia trachomatis
Systemic Azithromycin
47
What is the mechanism of action for Azithromycin?
Binds to 50S ribosomal subunit, inhibiting translation of mRNA and thus protein synthesis
48
Chlamydia Trachomatis Life Cycle
1) Elementary body (rigid outer membrane) enters epithelial cells 2) Converts to Reticulate body 3) replicates via binary fission
49
Keratoconjunctivitis is caused by...
Herpes Simplex Virus 1 (Dendritic Pattern on the Cornea)
50
Treatment of Keratoconjunctivitis
Topical Trifluridine and Systemic Acyclovir | Prophylactic treatment with erythromycin
51
Mechanism of Action for Trifluridine
Pyrimidine analog effective against acyclovir resistant viruses; can be phosphorylated by host kinases; highly toxic; use topically
52
Symptoms of Keratitis
Vision defects, photophobia, pain, foreign body sensation
53
Biological Causes of Keratitis
Trauma, drying of the epithelia, hypoxia
54
Viral Causes of Keratitis
HSV-1, adenovirus, VZV
55
Bacterial Causes of Keratitis
Staphlococcus aureus, Staphlococcus epidermidis, Pseudomonas aeruginosa, Bacillus cereus
56
Other causes of Keratitis
Acanthamoeba, Fungal in warm climate
57
Treatment for Keratitis
Bacteria: moxifloxacin eye drops | HSV-1: Trifluridine and Acyclovir
58
Mechanism of Action for Acyclovir
Converted by viral Thymidine kinase to inhibit and inactivate viral DNA polymerases
59
Classification of Pseudomonas aeroginsoa
Gram negative, aerobic rod with flagella, opportunistic infection, naturally antibiotic resistant
60
What is the common physical finding for Pseudomonas aeroginsoa?
Blue Pigment Pyocyanin - inhibits mitochondrial enzymes disrupting ciliary beating
61
Classify acanthamoeba
Single Cell, eukaryote, causing keratits or granulomathous amebic encephalitis
62
Treatment of acanthamoeba
Azoles
63
Mechanism of Action of Azoles
Antifungal - block ergosterol production
64
What is the infectious stage acanthamoeba?
Trophozoite
65
Uveitis Symptoms
blurred vision and permanent vision loss
66
Iritis
Anterior uveitis with photophobia, pain, decreased visual acuity
67
Causes of Uveitis
Treponema pallidum, HSV, VZV
68
Chorioretinitis Symptoms
Posterior uveitis, cause floaters, no pain, with blurred vision, common in immunocompromised patients
69
Congenital Chorioretinitis Causes
Toxoplasma and Cytolomegalovirus
70
Parasitic causes of Chorioretinitis
Toxocara canis and onchoerca volvulus = river blindness; sand flies
71
Toxoplasmosis diagnosis
IgM serology
72
Treatment of Toxoplasmosis
Pyrimethamine and Sulfadiazine
73
Mechanism of Action for Pyrimethamine
DHFR inhibitor
74
Mechanism of Action for Sulfadiazine
Folate synthesis inhibitor
75
Endophthalmitis
vitreous/aqueous humors infection characterized by pain, redness, decreased vision
76
What are the causes of Endophthalmitis?
Bacterial Pseudomonas, Staphylococci, Candida/Fungi
77
Treatment of Endophthalmitis
Fluoroquinolone or Vancomycin injected into the eye
78
Mechanism of Action for Fluoroquinolones
Inhibit Topo II or Topo IV, causing DNA strand breaks - Effective on Gram Positives
79
Mechanism of Action for Vancomycin
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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