Opthalmology-Infections

Question 1

What is keratitis, what are the types

Answer 1

Inflammation of the cornea/ bacterial, viral, fungal, parasitic

Question 2

What increases the risk of keratitis

Answer 2

Topical steroids, cornea trasnplant,soft contact lens wear, trauma

Question 3

What is the most common keratitis

Answer 3

Bacterial keratitis

Question 4

What are the pathogens that cause bacterial keratitis

Answer 4

Staph aureus and staphylococcal pneumonia, Pseudomonas aeruginosa, Moraxella

Question 5

What is the most common presentation of bacterial keratitis, others

Answer 5

Mucopurulent discharge/ decreased vision, photophobia, pain, hyperemia (redness), eyelids also affected

Question 6

What can be used to treat bacterial keratitis (broad spectrum)

Answer 6

Ciprofloxacin 0.3%, ofloxacin 0.3%, norfloxacin 0.3%, gatifloxacin 0.3%, moxifloxacin 0.5%

Question 7

What is the dosing interval for floriquinolones, side effects

Answer 7

Every 2 hours/ stinging, burning, bitter taste

Question 8

What antibiotic class is good gains gram positive organisms, works best against staph

Answer 8

Cephalosporins, Vancomycin

Question 9

What cycloplegic agent would be given with antibiotics, why

Answer 9

Scopolamine 0.25% TID, improves patient discomfort and possible adherence of the iris to the cornea or lens

Question 10

If the bacterial infection is vision threatning what is the regimen

Answer 10

Tobramycin or gentamicin every 30-60 minutes alternating with cefazolin or vancomycin every hour WITH oral fluroquinolones

Question 11

What drug should be avoided for bacterial or virus infections in the eye, why

Answer 11

Steroids, suppress immune system allowing bacteria to grow while also inducing corneal thinning increasing the risk of corneal perforation

Question 12

What are the types of viral keratitis

Answer 12

Herpes-simplex, Varicella-zoster, Epstein-Barr, Cytomegalovirus

Question 13

What is the most common cause of corneal ulceration and corneal blindness

Answer 13

Herpes simplex

Question 14

What is the hallmark symptom of herpes simplex viral infection

Answer 14

Crusting on eyelids and dendritic lesion

Question 15

When would antibiotic medication be used in herpes simplex viral kerativis

Answer 15

Eyelid/skin involvement, erythromycin or bacitracin BID OR warm or cool soaks

Question 16

What is treatment for corneal epithelial disease caused by herpes simplex, add ons

Answer 16

Trifluridine 1% 1gtt nine times a day OR ganicilovir 0.15% gel five times a day, Scopalamine 0.25% TID or homatropine 5% TID PLUS oral acyclovir 400 mg every day for 5 days

Question 17

What is the treatment for corneal stroma disease due to herpes simplex, add ons

Answer 17

Trifluridine 1% 1gtt TID-QID OR oral acyclovir 400 mg by mouth five times a day, Scopolamine 0.25% TID AND Prednisolone acetate 1% 1 gtt QID

Question 18

What is the hallmark symptom of varicella-zoster virus

Answer 18

Rash only on ONE side of head and hutchinson sign (rash at the tip of the nose)

Question 19

What is the treatment for viral keratitis

Answer 19

Oral acyclovir 800 mg five times a day for 7-10 days

Question 20

Which fungi cause fungal keratitis

Answer 20

fusarium, aspergillus, candida albicans

Question 21

What is the treatment regimen to treat fungal keratitis, add on

Answer 21

Natamycin 5% drops every 1-2 hours around the clock tapered over 4-6 weeks OR amphotericin B 0.15% drops PLUS flucytosine topical and oral/ Scopalamine 0.25% TID, voricanazole, flucanozole, and ketoconazole

Question 22

What is the most common cause parasite to cause parasitic keratitis, where is it found

Answer 22

Acanthamoeba, contact lenses (93%) and contaminated water

Question 23

What is the treatment regimen of acenthamoeba

Answer 23

PHMB 0.02% or chlorhexidine 0.02 every hour (corneal transplant)

Question 24

What is a way to prevent contact lens contamination

Answer 24

STAY AWAY FROM WATER, follow directions of lens and lens case changing (replace every 3 months), DO NOT SLEEP in LENSES

Question 25

What is blepharitis

Answer 25

superficial bilateral chronic inflammtory condition of the lid margins (common cause of recurrent conjunctivitus)

Question 26

How is blepharitis treated

Answer 26

Eyelid scrub BID, warm compresses, artifical tears, erythormycin or bacitracin (severe)

Question 27

What is a hordeolum, how is it treated

Answer 27

Localized, red, swollen,acutely tender area on upper or lower lid, warm compresses (4 days at most)

Question 28

What is chalzion, how is it treated

Answer 28

Hard, non-tender swelling of upper or lower lid with redness and swelling, warmcompresses with massage and possibly steroids

Question 29

What is the differnce between pre-septal and orbital cellulitis

Answer 29

Pre-septal is restricted to the eye and surronding skin and caused by staph aureus while orbital is the orbital septum and associated with systemic symptoms as well caused by S.pneumoniae (extension of a sinus infection)

Question 30

T/F: cellulitis is serious and needs to be treated with antibiotics at a hospital immediately

Answer 30

True

Question 31

What causes endophthalmitis, treatment

Answer 31

infection inside the globe of the eye (connected to surgery), Intravitreal vancomycin AND ceftazidime or amikacin

Question 32

What is bacterial conjunctivitis, what causes

Answer 32

Pink eye: S. pneumoniae, H. influenzae, pseudomonas, moraxella, gonococcal

Question 33

T/F: IF someone has bacterial conjunctivitis they should be given amoxicillin

Answer 33

False: Bacterial conjunctivitis is self limiting

Question 34

How is severe bacterial conjunctivitis treated

Answer 34

Trimethoprim/polymixin B, gentamicin/tobramycin, erythromycin, fluroquinolones

Question 35

What is the most common cause of viral conjuncitivts

Answer 35

adenovirus

Question 36

T/F: Nothing can be given for viral conjunctivits and it is self limiting

Answer 36

True

Question 37

What is the eye infection that is seen to be a medical emergency

Answer 37

Orbital cellulitis