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Year 2(B6) - E.N.T > Week 1 - H - ENT microbiology > Flashcards

Week 1 - H - ENT microbiology Flashcards

1
Q

inflammation of the part of the throat behind the soft palate (oropharynx). Usually presents with pain at the back of mouth What is this?

A

Acute pharyngitis

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2
Q

What type of infection is sore throat most commonly?

A

2/3rds are viral infections

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3
Q

What is the most common complication infections of the throat? Travels via what tube on the lateral wall of the pharynx?

A

Otitis media

Infection travels via the Eustachian tube

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4
Q

What is the eustachian tube also known as?

A

Audiotry tube or Pharyngotympanic tube

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5
Q

If sore throat and lethargy persist into the second week, especially if the person is 15-25 years of age What should be suspected?

A

Infectious mononucleosis aka Glandular fever (aka Kissing disease)

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6
Q

What is the most common bacterial cause of a sore throat?

A

Streptococcus pyogenes (Group A Beta Haemolytic strep)

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7
Q

What is the treatment of strep pyogenes? Is alpha or beta haemolysis complete or partial haemolysis?

A

Penicillin (phenoxymethylpenicillin (V)

Alpha haemolysis is partial haemolysis

Beta is complete

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8
Q

What is given to treat step throat if pen allergic?

A

Give clathriromyicn

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9
Q

Describe this? What colour is the agar plate in alpha and beta haemolysis?

A

Gram positive cocci in chains - streptococcus

Alpha - agar plate is greenish

Beta - agar plate is yellowish

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10
Q

What are two late complications of streptococcal sore throat?

A

Rheumatic fever after 3 weeks post sore throat

Glomerulonephritis after 1-3 wees

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11
Q

What is the nice guideline scoring system for estimating the cause of the sore throat is due to GABHS (Group A beta haemolytic streptococcus - streptococcus pyognes)?

A

The Centor scoring system

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12
Q

What age group is the score not validated for? Also the chances of a child having Group A strep decreases as the age of the person increases past 13

A

Centor score not used in children under 3

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13
Q

What are the 4 sections of the Centor scoring system?

A

Tonsilar exudate

Tender anterior cervical lymph nodes

History of fever

Cough - should be absent

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14
Q

Which bacteria causes diptheria? What is diphtheria also known as due to the membrane coat over the pharynx?

A

Corneybacterium diphtheriae

Also known as white throat disease

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15
Q

The diptheria organisms produce an exotoxin which is dangerous to what systems?

A

Can be dangerous as it is cardiotoxic and a neurotoxic

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16
Q

What type of vaccine is the diptheria vaccine?

A

It is a toxoid vaccine

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17
Q

Candida/Thrush is caused by the fungi (fungus is a form of yeast) candida albicans What does it look like on the throat?

A

It appears as white patches on red raw mucous membrane of mouth and pharynx

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18
Q

What is the 1st and 2nd line treatment for oral thrush?

A

If the infection is mild and localized, prescribe topical antifungal treatment for 7 days.

Offer miconazole oral gel first-line.

If miconazole is unsuitable, offer nystatin suspension

If the infection is extensive or severe infection, consider prescribing oral fluconazole 50 mg a day for 7 days.

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19
Q

An upper respiratory infection involving the middle ear by extension of infection up the eustachian tube Predominantly disease of infants and children Present with earache What is this?

A

Otitis media

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20
Q

Otitis media is usually viral and 80% resolve within 4 days What are some bacterial causes?

A

Strep pneumoniae, H.influenza and morexella catarrhalis

21
Q

If otitis media does not resolve, what is the first line then second line treatment?

A

First line - amoxicillin

Second line - clarithromycin or erythromycin

22
Q

How can a swab of pus be obtained in otitis media?

A

Can only be obtained if the ear drum perforates due to the pressure of fluid build up

23
Q

If antibiotic treatment fails for acute otitis media bacterial infection what can be carried out?

A

Can carry out tympanocentesis - relieves the pressure and the otalgia in the ear

24
Q

What paranasal sinus most commonly gets sinusitis?

A

The maxillary sinus - due to the cilia beating against gravity

25
Q

Acute sinusitis usually presents with Mild discomfort over frontal or maxillary sinuses due to congestion often seen in patients with upper respiratory viral infections. However, severe pain and tenderness with purulent nasal discharge indicates secondary bacterial infection What can be given as treatment in a severe/deteriorating disease?

A

First line - Penciillin V

Second line - Doxycylcine

26
Q

What is penicillin V and G? Can doxycycline be given inchildren?

A

Peniclline V - Phenoxymethylpenicillin

Penicillin G - Benzylpenicillin

Cannot give doxycycline in children under 12 due to the risk of yellow tooth discolouration and dental enamel hypoplasia.

27
Q

What is inflammation of the outer ear canal known as? Can become sore and painful There may be a discharge, or increased amounts of ear wax (which glands produce ear wax?)

A

Otitis externa Ceruminous glands produce ear wax

28
Q

What is another name for otitis externa? What bacteria causes otitis externa?

A

Swimmer’s disease The bacterial cause of otitis externa is usually pseudomonas aerguinosa howver can be staph aureus

29
Q

What is the treatment of otitis externa? involves manually cleaning the ear

A

Do not swab if mild or moderate

Consider aural toilet

If mild - prescribe acetic acid (2%) - (earcalm)

If moderate - give Otomize® or Sofradex®

30
Q

What does otomize and sofradex contain?

A

Otomize -Neomycin/Dexamethasone/Acetic Acid (antibiotic, steroid, vinegar)

Sofradex - Framycetin sulfate and gramicidin - different antibiotics

31
Q

What is the extension of otitis externa into the bone surrounding the ear canal (i.e. the mastoid and temporal bones). known as? What can happen if not treated?

A

It is knwon as malignant otitis externa

Can be fatal if not treated as Osteomyelitis will progressively involve the skull and meninges

32
Q

What is the cause of malignant otitis externa ? What type of people are at risk of otitis externa to maligant?

A

Pseudomonas aeruginosa

People with diabetes are at risk of malignant otitis externa if they have otitis externa

33
Q

Agains state Apart from pseudomonas aerguinosa, what are other causes of otitis externa? (bacterial and fungal)

A

Bacterial - staph aureus

Fungal - aspergillus niger and candida albicans

34
Q

If otitis externa is unresolving after one course of treatment for moderate symptoms, then swab ear for culture and sensitivities ensuring sample is labelled as ‘otitis externa’. What is the treatment of the bacterial and fungal infections of otitis externa? * Pseudomonas * Aspergillus niger

A

For pseuduomonas aerguinsoa - gentamicin or ciproflaxacin ear drops

For aspergillus niger- clotrimazole ear drops

35
Q

Classic triad of fever, enlarged lymph nodes and sore throat Usually accompanied by lethargy and malaise What is this?

A

Infectious mononucleosis - Glandular fever

36
Q

What do patients get in glandular fever when given amoxicillin?

A

A widespread rash

37
Q

In glandular fever, what can patients get on the palate?

A

Palatal petechiae - a small red or purple spot caused by bleeding into the skin. (palatal happens on the palate obviously)

38
Q

What should be avoided for 6 weeks if having glandular fever and why? How long should gladnular fever take to settle?

A

Avoid sport as spelnic rupture is a rare complication due to splenomegaly

Glandular fever usually takes around 4 weeks to settle It is a self-limiting illness

39
Q

What is human herpes virus 4?

A

This is Epstinn Barr virus - the virus which causes the glandular fever

40
Q

What is the treatment for Glandular fever?

A

Bed rest, paracetamol and avoid sport

Antivirals are not clinically affected

41
Q

What cancer is EBV associated with? What does being immunosuppressed increase the risk of?

A

It is associated with nasopharyngeal carcinoma

Being immunosuppressed increases the risk of lymphoma

42
Q

What test is carried out to test for EBV?

A

Monospot test - type of heterophile antibody test specifically refers to a rapid test for antibodies produced against the Epstein-Barr virus (EBV), the causative agent of infectious mononucleosis.

43
Q

Which type of herpes virus causes sores around the mouth and lip? Which type of herpes virus causes sores around the genitals or rectum?

A

Herpes simplex virus type 1 causes sores around the mouth

Herpes simplex virus type 2 causes sores around genitals or rectum

44
Q

What represents the worst end of spectrum of disease seen during primary HSV1 infection.? Is seen in pre-school children

A

Primary gingivostomatitis

45
Q

What is the treatment of severe herpes? Does this prevent latent herpes?

A

Treatment is aciclovir

Does not prevent the latent herpes

46
Q

How is HSV confirmed in the lab?

A

Swab of lesion in virus transport medium detection of viral DNA by PCR

47
Q

mouth blisters, is a painful mouth infection caused by coxsackieviruses. What is its medical name?

A

Herpangina

48
Q

What bacterium causes syphilis?

A

Treponema pallidum

49
Q

What is the treatment for syphilis?

A

Penicillin G - benzylpenicllin

Year 2(B6) - E.N.T (32 decks)

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