Infections

Question 1

what are some oral infections

Answer 1

herpes simplex virus- 1y Gingivostomatitis, cold sores, herpetic whitlow, heprangina

Question 2

herpes simplex infection…

Answer 2

t1 (oral) t2 (genital), transmission is through secretions, swab lesions

Question 3

HSV complications

Answer 3

encephalitis- fever, seizure, low consciousness

Question 4

HSV pathosequele

Answer 4

1y Gingivostomatitis: 1y infection- vesicles around lips, buccal mucosa, hard palate, lymphadenopathy

Question 5

cold sores are _______ of 1y gingivostomatitis

Answer 5

reactivation- reactivated with stress or trauma. mx- acyclovir

Question 6

what is herpetic whitlow

Answer 6

HSV infection of fingers often misdiagnosed as paronychia

Question 7

herpangina

Answer 7

enterovirus infection (coxsackie/ echovirus) that causes fever and papule-vesicular ulcerative oral disease

Question 8

throat infections

Answer 8

tonsillitis, diphtheria, mono, oral thrush

Question 9

aetiology of tonsillitis

Answer 9

bacterial: strep pyogenes (GroupA), Group B strep
viral: EBV
non-infectious irritation

Question 10

ix for tonsillitis/pharyngitis

Answer 10

hx and exam- CENTOR criteria: fever, tonsillar exudates, tender anterior cervical adenopathy, absence of cough

Question 11

when do you give abx for tonsillitis

Answer 11

> 2 of centor criteria (phenoxymethylpenicillin)

Question 12

complications of tonsillitis

Answer 12

OM, peritonsillar abscess (Quincy), parapharyngeal abscess

Question 13

what can strep pyogenes cause

Answer 13

rheumatic fever, glomerulonephritis

Question 14

which drug do you withhold with sore throat due to risk of neutropenia

Answer 14

DMARDs

Question 15

what is diphtheria

Answer 15

gram +ve bacillus infection

presents with respiratory disease, cutaneous signs

Question 16

mx for diphtheria

Answer 16

antitoxin, penicillin/erythromycin

Question 17

EBV cause…

Answer 17

mononucleosis

Question 18

s/s of mono

Answer 18

fever, pharyngitis, lymphadenopathy (may have malaise, lethargy, hepatosplenomegaly)

Question 19

ix of mono

Answer 19

IgM for EBV, monospot tests (heterophiles antibodies), LFTs, lymphocytosis

Question 20

T/F: give amoxicillin for mono

Answer 20

F: NEVER GIVE AMOXI FOR MONO! gives maculopapular petechial rash

Question 21

some complications of mono

Answer 21

inc risk of lymphoma, anaemia, thrombocytopenia, splenic rupture, Upper airway obs

Question 22

oral thrush is caused by..

Answer 22

Candida albicans, candida non-albicans

Question 23

who is susceptible to oral thrush

Answer 23

immunosuppressed- endogenous

Question 24

s/s and mx of oral thrush

Answer 24

white patches on red raw mucosa

miconazole/fluconazole

Question 25

acute otitis media is infection of the _____ ear due to a ____ that spreads via ______ ____

Answer 25

middle, URT infection, eustachian tube

Question 26

aetiology/ organisms of OM

Answer 26

bacterial: H.influenzae, strep pneumonia, strep pyogenes viral

Question 27

T/F: lack of breastfeeding and exposure to smoking may be risk factors for ___

Answer 27

T: OM

Question 28

s/s of OM

Answer 28

earache, fever, tugging at ear, irritability on otoscopy- bulging opaque TM, child won't like examination

Question 29

mx of OM

Answer 29

80% resolve, amoxicillin, co-amoxiclav, erythromycin <2yo

Question 30

what is otitis externa

Answer 30

inflammation of external auditory canal

Question 31

comps of OM

Answer 31

medially: SN HL, tinnitus, vertigo, facial palsy, nerve palsy superiorly: brain abscess, meningitis posteriorly: cavernous sinus thrombosis

Question 32

aetiology of OE

Answer 32

swimming, warm/ humid climates, trauma bacterial: staph a, staph epi, pseudomonas aeruginosa fungal: aspergillus niger, Candida albicans

Question 33

what are inc risk for aspergillum niger OE and candida OE

Answer 33

aspergillus niger: swimming candida: prolonged abx course

Question 34

s/s of O externa

Answer 34

redness, swelling or ear canal- can't see TM, discharge, pain on moving pinna/ tragus

Question 35

mx for OE

Answer 35

topical sfrodex | for fungal- topical clotrimazole

Question 36

main complication of OE

Answer 36

necrotising otitis externa- extension of infection into temporal and mastoid bone s/s: pain, headache, exposed bone in ear canal, ^ CRP

Question 37

sinusitis is...

Answer 37

inflammation of the sinuses | aetiology= URTI, allergic rhinitis (organisms same to OM)

Question 38

s/s of sinusitis

Answer 38

discomfort over frontal, maxillary sinuses, may have toothache, headache

Question 39

is pt has severe pain and tenderness and purulent discharge from nose then it is a...

Answer 39

2y infection following sinusitis

Question 40

mx for sinusitis/ 2y infection

Answer 40

self resolves, abx for severe cases- | phenoxymethylpenicillin, doxycycline