Infections of the Sensory System Flashcards

Question

What is Orbital Cellulitis?

Answer 1

Infections; - Haemophilus influenza - Staphylococcus pneumoniae - Beta-hemolytic streptococci Post septal is most dangerous can cause; - Spread of infection into deeper structures; - Orbital abscess - Meningitis - Cavernous sinus thrombosis - Optic nerve damage - Bacteraemia Signs; - Swelling, redness, pain, proptosis, RAPD relative afferent pupillary defect and tendernss to touch around one eye with pain on movement of the eyeball

Answer 2

Toxoplasmosis and Cytomegalovirus retinalis Retinocortical lesions Parasite most common for living in cat faeces More detrimental to those with weakened immune system Can cause spontaneous miscarriage so pregnant people should avoid cleaning up cat litter What are the features of cytomegalovirus retinalis? Occurs during late HIV disease Treatment – antiviral Gancicilovir

Answer 3

Rare but serious Develops after; - Intra-ocular operation (e.g cateract surgery) - Trauma with inoulation of foreign body - Complication of systemic infection Treatment – intra-ocular & systemic antibiotics +/- vitrectomy

Answer 4

Innate; - Physical - Cells - Chemicals Adaptive; - T cells - B cells - Antibodies

Answer 5

- Otitis Externa – bacterial and fungal (acute or chronic) - Otitis Media – Viral and Bacterial (acute, chronic, suppurative) - Mastoiditis – bacterial - Sinusitis – acute or chronic

Answer 6

The external ear has a similar microbiota to the skin, epithelium of the ear can be effected by common skin conditions such as eczema and psoriasis to cause a weakened barrier Microorganism; - Most common is Pseudomonas aeruginosa and Staphylococcus aureus - Less common is Candida albicans and aspergillus niger

Answer 7

- Most common in infants and small children, 50% viral in origin – mainly RSV - But also S.pneumoniae and H.influenzae - Pulling at ears, red ears, fever, crying, poor feeding, restlessness - May result in hearing difficulties and delayed learning development

Answer 8

- A severe complication of Otitis media - Spread of infection from middle ear to mastoid aircells via mastoid antrum - Symptoms include; ongoing or recent AOM, redness, tenderness and pain behind the ear, pushed forward pinna, fever, fatigue - Treatment – if child or unwell referral to ENT in -patient for IV antibiotics and investigation including imaging / blood tests

Answer 9

Typically maxillary, facial ethmoidal infection - Pathogen invasion of the air spaces with the URT - Mucosal swelling prevents muco-cillary clearance of infection - Exacerbated by local accumulation of inflammatory bacterial products - Typically follows a common cold so symptoms getting worse and not better around 5 days or continuing for more than 10 days - Symptoms: nasal blockage or discharge with facial pain/pressure +/- loss of smell - Treatment – typically self-limiting 2-3 weeks, little evidence for antibiotics

Answer 10

- ‘Common cold’ – viral - Pharyngitis – viral and bacterial - Tonsilitis – bacterial and viral (peri-tonsilar abscesses – bacterial) - Glandular fever – viral (Epstein-barr virus) - Mumps / parotidis – viral (mumps virus) - Epiglotitis – bacterial (haemophilus influenza) - Diptheria – bacterial (corynebacteerium diptheriae) - Laryngitis/tracheitis – usually viral

Answer 11

Transmission – aerosol and virus-contaminated hands Causative agents; - 40% rhinoviruses - 30% coronaviruses - Coxsackie virus A - Echovirus - Parainfluenza virus Seasonal: early autumn and mid/late spring Symptoms: tiredness, slight pyrexia, malaise, sore nose & pharynx, nasal discharge, sneezing Do we do anything? Not really

Answer 12

Causative agents Pharyngitis is often is associated with pharyngeal exudate and cervical lymphadenopathy Sore throat, reduced oral/fluid intake fatigue, lethargy, fever, headache, nausea, vomiting. Management: Self-limiting for most, antibiotics need to be considered for some. Viruses; - Cytomegalovirus (CMV) - Epstein-Barrvirus(EBV) - Herpes simplex virus type I (HSV-I) - Rhinovirus - Coronavirus - Adenovirus Bacteria; - Streptococcus pyogenes - Haemophilus influenzae - Corynebacterium diphtheriae

Answer 13

- Transmission in body secretions and organ transplants - Usually asymptomatic or mild in healthy adults - CMV causes cold-like symptoms, such as a sore throat, fever, fatigue and swollen glands - Symptoms last for only a few short weeks and is not worrying for healthy children or adults - Virus can reactivate and cause disease when cell-mediated immunity is compromised - Treatment with ganciclovir, foscarnet, cidofovir

Answer 14

Inflammation of the tonsils - typically palatine. Can be viral or bacterial. Therefore - may or may not need antibiotics Symptoms: Dysphagia, odynophagia, cervical lymphadenopathy, fever 90% of cases will resolve in 7 days without treatment If have more than 7 times in 1 year, 5 times each year can get tonsillectomy but NHS try to not do

Answer 15

A score of 0-1 is associated with 13-18% isolation of streptococcus (close to background carriage rates) - No antibiotics recommended A score of 2 is associated with 30 - 35% isolation of streptococcus - Delayed antibiotic may be appropriate A score of 3 is associated with 39-48% isolation of streptococcus - Delayed antibiotic may be appropriate A score of 4 or more is associated with 62-65% isolation of streptococcus - Consider antibiotics if symptoms,ptoms severe or a short delayed prescribing strategy may be appropriate (48 hours)

Answer 16

Complications; - Scarlet fever - caused by erythrogenic toxin from s. pyogenes - Peritonsillar abscess ("quinsy") - Ottis media / sinusitis - Rheumatic heart disease - Glomerulonephritis Acute Group A streptococcal (GAS); - 5 to 15 years old - More common in winter - High Fever PAIN or CENTOR score - A scarlatiniform rash may be present, especially in children - Significant complications if not treated Treatment; - Able to swallow Benzylpenicillin IV - Unable to swallow Penicillin V - Paracetamol, ibuprofen, IV fluids

Answer 17

Collection of pus between the tonsillar capsule and superior constrictor muscle Complication of untreated bacterial pharyngitis / tonsillitis Symptoms: fever, pain, trismus, general malaise Signs: Hot-potato voice, unilateral swelling, deviation of uvula Management: Same day hospital admission to ENT - Needle aspiration / drainage, IV antibiotics (penicillin based) and IV steroids, analgesia and IV fluids until oral route available Complications; Retropharyngeal or deep neck space infection in fascial planes of neck

Answer 18

Glandular Fever: Epstein-Barr Virus (EBV) Swollen tonsils and uvula, petechiae on soft palate, white exudate Replicated in B lymphocytes Clinical features; - Fever - Headache - Malaise - Sore throat - Anorexia - Palatal petechiae - Cervical lymphadenopathy - Splenomegaly - Mild hepatitis Diagnosis: EBV Serology, FBC and LFTs EBV IgM - Acute 4-6 weeks EBV IgG - Lifelong (indicative of past infection)

Answer 19

Parotitis (mumps virus); Clinical features; - Fever, Malaise, headache - Anorexia, Trismus, Joint pain - Severe pain and swelling of parotid gland(s) Treatment is supportive / symptomatic 88% resistance with full vaccination

Answer 20

Present in nasopharynx of 75% healthy people 88% reduction in cases since vaccine in 1992 Clinical features; - High fever / Bacteraemia - Massive oedema of the epiglottis - tripod position - Severe airflow obstruction - Stridor, dyspononea Most often seen in young children 2 - 6 years old. MEDICAL EMERGENCY needing 999 ambulance to hospital for intubation and IV antibiotics, Do Not examine a child with suspected epiglottis without an anaesthetist

Infections of the Sensory System Flashcards

(44 cards)