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Flashcards in ENT Microbiology Deck (67)
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1

What generally is responsible for causing inflammation of the throat and pharynx?

Infectious causes (2/3rd viral)

(non-infectious causes are rare)

2

If sore throat and lethargy persist into the second week, and if the patient is 15-25 years old, what should be suspected?

Infectious mononucleosis (glandular fever)

3

Which pathogen causes infectious mononucleosis?

Epstein barr virus

4

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

Streptococcus pyogenes

5

What causes the beta haemolysis associated with S. pyogenes?

LMW toxin diffusing out of the colonies

6

What is "quinsy"?

Peri-tonsillar abscess

7

When will quinsy normally occur?

Usually a complication of tonsillitis

Streptococci most frequently cause unilateral infection in the palatine tonsils

8

What is Lemierre's syndrome?

An infection, most commonly by F. necrophorum, of the posterior compartment of the lateral pharyngeal space as a complication of a bacterial sore throat infection in young, otherwise healthy adults

It involves a triad of symptoms:

  1. Pharyngotonsillar or odontogenic infection
  2. Lateral pharyngeal space invasion leading to internal jugular vein thrombosis
  3. Metastatic disease (sepsis or lung involvement)

(it is also known as human necrobacillosis and postanginal sepsis)

9

Which condition may result as a complication of an inadequately treated Streptococcus throat infection?

Rheumatic fever

10

What are the key symptoms of Rheumatic fever?

  1. Fever
  2. Arthritis
  3. Pancarditis

11

Which condition involving the kidneys can become a late complication of a streptococcus throat infection?

Glomerulonephritis

(presents with haematuria, albuminuria and oedema)

12

What is the treatment for a bacterial sore throat caused by S. pyogenes?

Penicillin

13

Which pathogen causes diptheria?

Corynebacterium diphtheriae

14

How does diptheria affect the posterior pharynx?

Causes severe sore throat

Grey/white membrane across pharynx

15

What is the treatment for diptheria?

Antitoxin and supportive penicillin/erythromycin

(it is vaccine preventable and rare in the UK)

16

How does candida present in the throat and mouth?

White patches in red/raw mucous membranes

17

What causes thrush?

Candida albicans (endogenous)

18

How can thrush be treated?

Nystatin

19

What is acute otitis media?

URTI involving middle ear

This happens as the infection passes via the Eustachian tube

20

How doe acute otitis media typically present?

  1. Infants/children
  2. Ear ache
  3. Discharge (if ear drum ruptures)

(hearing loss, fever and lethargy are also common)

21

Which bacteria are most commonly found to infect the middle ear?

  1. Streptococcus pneumoniae
  2. Haemophilus influenzae
  3. Streptococcus pyogenes
  4. Moraxella catarrhalis

22

How can middle ear infections be diagnosed?

 Only by discharge swabs

23

How are infections of the middle ear treated?

Most resolve spontaneously

1st line - Amoxicillin

2nd line - Erythromycin

24

What is acute sinusitis?

Mild discomfort over the frontal or maxillary sinuses due to congestion often seen in patients with URTI

25

What does severe pain and tenderness with purulent nasal discharge indicate in a patient with acute sinusitis?

Secondary bacterial infection

26

Which bacteria commonly affect the sinuses in acute sinusitis

  1. Streptococcus pneumoniae
  2. Haemophilus influenzae
  3. Streptococcus pyogenes
  4. Moraxella catarrhalis

27

How long does acute sinusitis usually last?

2.5 weeks

28

When should antibiotics be used for acute sinusitis?

Severe or deteriorating cases lasting longer than 10 days

29

What is the definition of chronic sinusitis?

Sinusitis lasting longer than 4 weeks

(Acute is < 4 weeks)

30

What is the treatment for acute sinusitis?

1st line - Penicillin

2nd line - Doxycyline (clarithromycin in children)