Eye + Ear infections Flashcards by Omar Gazar

بسم الله الرحمن الرحيم
___________________
“وإذا سألك عبادي عني فإني قريب أجيب دعوة الداعي إذا دعان فليستجيبوا لي وليؤمنوا بي لعلهم يرشدون “
Normal biota :

Normal flora espically mucous membranes + Orficies as GIT
____________AS :-conjunctiva + eyelid
S,epidemids + Lactobacillus
Maybe:-Propinobacterum acne

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قال بعض الحكماء:
إياك والعجلة، فإن العرب كانوا يسمونها أم الندامة.
لأن صاحبها:

يقول قبل أن يعلم.
ويجيب قبل أن يفهم.
ويعزم قبل أن يفكر.
ويقطع قبل أن يقّدِّر.
ويحمد قبل أن يجرب.
ويذم قبل أن يخبر.
ولن يصحب هذه الصفة أحد إلا صحب الندامة، واعتزل السلامة.

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Innate immunity of eye

-Eyelashes prevent passage of foreign materials
-Blinking 15-20 times/m spreasding lacrimal galnds secrfetion lysozymes + IgA washing Bacteria and foreign matters

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Mention routres of tranmssion of infections to eye

1-Direct contact; contatct lens + Trauma - neonate from birth canal
2-Via blood then Nervous system : Varicella zoster + Herpes simplex reactivation

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eye lid infections

Blpheirtis by S.aeures
Styes due to infection of eye glands
Maybe just inflammation irritation itching

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Conunctivits

bacterial or viral
easily sperad to other eye Acute Hemorrhagic conjunctivits due to ?
Enteroviruses + Coxackie viruses

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Stap aeures is
Gram … cocci
,,,,,hEmolytic ?
Catalse ….. ? Coagulae …..?
Ferments …..? (specific )
Produce ….. pigment

Gram +
Beta Hemolytic
Catalase + and Coagulase +
Ferments Mannitol in mannitol salt agar
Produce Golden yellow endopigments

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Mention virulence factors of s.aerues

pcp toxins
Cell associated :
-Protein A binidng IgG Preventing Opsoinzation and phagocytosis
-Clumping factor Bound coagulase
-Capsule antiphagocytic
_______________________
Enzymes
Coauglaes
Penecillinase
_______________——–
TOXINS :-
alpha toxin
leckcidin

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Sterp.Pnemoniae :
Gram….cocci
,…..shaped
diplococci
….Hemolytic
catalase………..
Growth inhibited by ….+…….
Important Virulence factors ?
1-
2-

+ dipolococci
Lancet shaped
Alpha hemolytic
Catalase -
Optochin + Bile
Virulence :
1-Antiphagocytic polysaccaride capsule secreting
2-IgA prtoeases Degrading IgA

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Compare between H.influenzae + N.gonorrhea

H.Influenzae :-
Gram - cocobacilli
Require Hemin X &NAD V
Virulence factor :
as s.penmonaie : Antiphagocytic capsule + IgA protease
___________________________-
N.gonorrheae : Gram - deplococci
Oxidase ++++++++++++++++++++++
Virulence factors :
IgA protease as S,p+ H.influenzae
Pilli

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MOst common cause of Viral conjunctivits

Adenovirus(swimming pools )

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Adenovirus :
….ENVELOPED ?
….stranded ….?
CASUIGN ………Conjuctivits + ,,,,,,,,,Fever ?
In children usually aden serotype ….. ?
Assoicated with use …….. +,……

-Non enveloped
-Double stranded -DNA
-Non specific follicular+
-pharyngoConjuctivial fever PCF
Serotype 3
-Unchlorinated Pools + small lakes

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Enterovirus 70 + cosaxkie virus 24
……Enveloped ? …stranded …… vrisues
Causing Out breaks ???

non enveloped
Single stranded - RNA
Outbreaks :-
of acute hemorrhagic Conjunctivits

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Herps simplex virus 1
,,,,Enveloped??
…stranded ….VIRUS
Establish ,…. infection in Trigeminal ganglion and reactivated in ……….
Cause neontal………… but accompanied with generalized herpes infection

Enveloped
Double stranded DNA viruses
Latent
Immunocompression
Nenontal conjunctivits

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autoinoculation occure with …+.,……

N,gonorhhea + Chalamydia trachomatis found in genital tract via hands +Fomites

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Presnenation of conjunctivits

Red eye
Lacrimation
Discharege :
Purulent bacteiral
watery viral

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Opthalmia Neonatorum it is ,,,,,,
due to ,,,,,,,,+,,,,,,,

Neonatal conjuctivits
due to
C,trachmotis + N.gonorrhea
aslo stap aeures + pnemonaie + herpes simplex

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How to prevent opthalamia nenontorum

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Topical routine : erythromycin drops + Ointment
If mother has Chalamydia , give Oral erythromycin

why corneal inclusion in Infection so bad?

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Corneal infection in keratitis and keratoconjuctivites may casue scar = blindeness

________
Deep layes in globe infection
rupture globe due trauma or infection through blood in Immunocompromiesed
Congenital infection= Rubella +CMV
Catarct - MicroPthalmia-ChorioRetinits
___________

_______________

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Deep layes in globe infection due to

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rupture globe due trauma + infection through blood in Immunocompromiesed

Congenital infection

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as rubella + CMV
Casing
catarct + Micropthalmia + Chorioretnitns

AIDS +CMV =

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Chorioretinits

Bacterial opportouinctis infection as …
cause …..+…..

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psudeomonas =
Chorioretins + Infection in deep layers of the eye

Infection affect conjunctiva via blood with intial infection ?

Measels

ChLAMYDIA : obligate intracellular bacteria They are agents of Sexually Transmitted diseased Why cannot be stained with Gram ?

Atypical rigid cell wall with no typical peptidoglcans for gram stain

All chlamydia shares .? but there are species specific .. immunotype specific antigen proteins Chalmydia tRACHOMATIS has at least ..... immunotypes ?

Group specific Lipopolysaccharide proteins 15 immunotypes (A-L)

Type ,,,and,,,and,,,, of chalmydia trachomatis cause chronic conjuncvitivts endemin if africa and asia

A B C may recur over many years and leads to blindness with no systemic illness

Chlamydia inculsion ocnjuctivits occurs by types ....to....... By ,,,,,,, in adults

D to K bY Autoinfection

Chlamydia infects only humans strict human pathogen ________________________ Transmission of chlamydia through ?

Close personal contact through birth canal Autoinfection from genital infection to eye by finger to eye + Fomite to eye contact

Pathoensis of trachoma

Infect primarily epithelial cells of Mucous membranes The pathogen multiplies in cells of the conjunctiva and kills them with replication cycle infecting more and more cells triggering: Purulent discharge + Scarring of conjunctiva Inward turned Eylid irritating Cornea with Blood vessels invasion + scarring = blindness

Why chylamida : 1-cannot be gram stained ? 2-Cannot be grown in artifical culture media

1- due to no peptidoglycan in the rigid cell wall 2-Due to Its Obligate intracellular property so cultured in tissue culture

How to diagnose Chlaymidia ?

Direct: Stain : Gimesa for inclusion bodies Gentic: PCR for DNA sEROLOGy : for antibodies IF + ELISA but ? _______________ Indirect : cell culture showing Glycogen filled Inclusions with iodine stain characteristic for chalmydia

Serology is not reliable in diagnosing chlamydia why ?

ناس كتير جالهم كلاميديا فعندهم اصلا الاجسام المضادة قبل كده فمش هتعرف تفرق لو ده عدوي قديمة ولا جديدة

tREATMENT Of chalmydia

Infection in neoneats: Eryhtromycin cream 10-14 days _________________ infection in adults : Erythromicn oral Tetracylnie doxycyline 3-6 weeks Surgical in case of eye deformities ________ no vaccine so transmission should be lighted

Otitis externa similar to soft tissue infections aCUTE Lloacliazed as .......+....... by ,,,,,, Acute diffuse otitsi externa called .....ear with Maceration of ear from ,,,,,,,,or,,,,,,, Gram - Pesudomonas areuginosa plays imp role

Pustules + fruncles by s,aerues ___________________________________ swimmer's ear Swiming or hot humid weather called malingant externa

Necrotizing infection that spreads to areas of soft tissue cartilages and bones casued by anaerobic pseudomona areuginosas and seen in Diabetics

Malginant oTtits Externa

Acute otitis media caused by

سهم من سهام عينك SHM Streptococcus pnemnoaie H.influenzae Moraxella catarrhalis _________________ Viral : respiratory synctial virus belonging to paramyxoviruses they have unsemgents -sense ss RNA

CoVs : ??enveloped ??? ...ense ,,,standed,,,,, largers genome of RNA viruses helical nuclocapsid

Envelopd ! + SENSE Single stranded RNA

Rhino belongs to ,,,,, small ,,,,envelope??? ...sense ,,,standed...... replicate at ...... than ...... infection is limtied to ....... and.....

Picorna viruses:- Non envelopes +SENSE SINGLE STANDED RNA AT 33 THAN 37 limted to mucosa of URT + Conjunctiva

lab diagnosis of otitis media

Clinical + discharge culture + needle aspiration of middle ear

treatment of otitis media

Antimicrobials + Follow up as resiudal may cause hearing impairment

most common cause of blindness in egypt ?

Trachoma

الحمدلله رب العالمين

Eye + Ear infections Flashcards

(44 cards)