micro: patience’s question review Flashcards by Bella Forster

Upon slit lamp examination, you observe collarettes at the base of the lashes. What is this indicative of?

Demodex

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What lice are more likely to infect the lashes due to their long and straight body shape?

Pthriasis Palpebrum

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What bug/lice/mite is apart of the normal flora?

Demodex

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You suspect a patient has fungal keratitis, what might you use to confirm it is fungal?

Gomori-Methanamine Silver Stain

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The dermatophyte Trichophyton rubrum is responsible for the most common cause of ______.

Nail Fungus

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Dermatophytes use _______ for nutrition and include epidermophyton, microsporum, and trichophyton

Keratin

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What fungi is most likely to be acquired from traumatic inoculations such as a rose thorn?

Sporothrix schenckii

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A patient presents with salmon-colored tumors on their conjunctiva. What fungal infection do you suspect they have acquired?

Sprorotrichosis

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Which fungal infection was I most likely to acquire at academy 2024 if Indy was an endemic area based on this picture (no shoes on)

Mycetoma - Madurella Grisea

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All fungi causing systemic fungal infections are

Dimorphic

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Which fungal infection manifesting in the eye is considered presumed as it does not follow Koch’s postulates?

Ocular Histoplasmosis

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What are the 3 signs of ocular histoplasmosis

Chorioretinal scars, neovascular membrane, peripapillary atrophy

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What dimorph is the most common nosocomial fungal infection

Candida

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What opportunistic fungal pathogen is most likely to affect the cranial nerves, resulting in nerve palsies, papilledema, optic atrophy, etc?

Cryptococcus

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A patient presents to clinic and upon examining EOMs, you notice cranial nerve 4 palsy. You suspect a cryptococcus infection due to other pulmonary issues the patient described during case history. What would be helpful in diagnosis?

India Ink - Capsule visible

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Which opportunistic fungus is likely to block the alveoli and cause cyanosis, along with possible retinal ischemia, choroiditis and granulomas?

Pneumocystis

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What fungus can cause rhino cerebral disease resulting in loss of the orbit?

Mucormycosis - Rhizopus oryzae

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A patient during case history discusses having recent respiratory issues. Upon examination, the patient has endophthalmitis and dacryocystitis. If this is due to a fungal infection, which would be most likely?

Aspergillus

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What subcutaneous fungal infection is associated with corneal ulcers?

Cladosporium

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What is the most commonly diagnosed parasite in the US?

Giardia

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What is the most common protozoan infection and non-viral STD in the US and how might it affect the eyes?

Trichomoniasis; neonatal conjunctivitis

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Amebic dysentery has _____ as the only important reservoir, and can be diagnosed by presence of cysts/trophozoites in the stool

Humans

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T/F: A reservoir of Giardia, Beavers, are Patience’s favorite animal.

True

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A patient, named Kyle, presents with resolving Giardia infection, what may be found on fundus exam?

Retinal Pigment Changes/Salt & Pepper Retinopathy and Vasculitis

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In what protozoan infection is there rupturing of the red blood cells that results in severe fever?

Malaria - Plasmodium

Malaria has many ocular presentations, such as

Malarial retinopathy, VF defects, optic neuritis/atrophy, oculomotor paresis

What are signs of malaria during pregnancy?

Low birth weight baby, impaired Neurocognitive development and gross motor skills, ROP

What is the definitive host of toxoplasma gondii?

Cats

It is important for pregnant women not to clean the litter box due to risk of contracting what protozoan infection?

Toxoplasmosis

While you are trying to complete retinoscopy & subjective refraction in 7 minutes, your standardized patient is trying to put you onto using a netipot for your sinuses instead of reading the chart, and says he just uses tap water from the sink. Unfortunately, you do not have time to tell him he can't do that due to the 7 minute time limit so now he may acquire what protozoan infection/condition?

Naegleria Fowleri - amebic meningitis

The tsetse fly is responsible for transmitting ______, that can invade the CNS and result in oculomotor paresis.

Trypanosomiasis

King James presents to clinic in pain with a ring infiltrate and severe keratitis. He says he does not take out his contacts and dives daily looking for underwater treasures. What protozoan infection is likely?

Acanthamoeba

What makes Acanthamoeba keratitis difficult to treat?

Cyst formation

Nonhealing sores are most closely related to _______ protozoan infection that is transmitted by _______, but the reservoir is _____.

Leishmaniasis; sandflies; dogs

Leishmaniasis is problematic to the eye because it can

Attack almost any layer, resulting in: conjunctivitis, nodular episcleritis, panuveitis, corneal ulcer

Cestodes are also known as ______ and include ______

Tapeworms; taenia solium

Untreated tapeworm can lead to what ocular problems

Papilledema, canaliculitis, iritis, subconjunctival mass, EOM paresis

What class of Helminths have snails as the intermediate host

Trematodes - Flukes

You order bloodwork on a patient who came into clinic with iritis, AC chamber inflammation, and EOM pain. The bloodwork comes back and the patient has a high number of eosinophils. What helminth infection is most likely?

Trematodes - Flukes - Schistosoma

What nematode is 35cm long and has an inflammatory response that can be controlled using steroids?

Ascaris

What is the most common helminthic infection in the US?

Pinworm - Enterobius

Strongyloides can be problematic for the eye as it can result in ______ with what findings?

ocular larva migrans; retinal findings & cataract

After a night out, King James's Court goes to Biggins BBQ for pork ribs (that they did not know were undercooked). What nematode could we contract and what ocular signs may you observe if we sat as your patient for slit lamp proficiency?

Trichinosis; periorbital edema, lid swelling, subconj heme, EOM cysts, conjunctival chemosis, papilledema, neuroretinitis, optic neuritis

What is the second cause of infectious blindness

Onchocerca - River Blindness

Loa Loa is transmitted by ______ and can migrate across the ______.

Deer flies; conjunctiva

Once Jeremy's child can walk, he decides to take him to north pikeville to play with the stray dogs and puppies. What helminth infection would Jeremy's child be at risk of contracting, and what signs may Jeremy see when he uses his child as proficiency practice?

Toxocara canis; ocular tococariasis - unilateral retinal inflammation/scarring

Wuchereria bancrofti can lead to ______, where there is abnormal enlargement of body parts, and is transmitted by ____

Lymphatic filariasis; culex/anopheles/aedes mosquitoes

Which Helminths can penetrate intact skin?

Schistoma (fluke - trematode), Strongyloides (Roundworm - Nematode)

Cestodes are problematic as

Dissemination can attack eyes and brain

Which gram positive cocci is likely to cause blepharitis and styles and is the BADDIE of its species?

S. Aureus

Staph spp are clustered and catalase +, which staph sp is also coagulase +?

S. Aureus

You watch a YouTube video of a cataract surgery and decide it looks easy enough for you to do as long as you watch step by step. Due to your rookie skills, what staph spp infection are you most likely to give your patient, and how would it present?

S. Epidermidis; endopthalmitis

After absolutely butchering your DIY IOL insertion and trying to now avoid a lawsuit, you decide you are going to treat your patient's endophthalmitis despite the treatment being out of your scope practice. What is the appropriate treatment?

Intravitreal Injection with vancomycin + moxiflocacin/cephalosporin

What toxins do s. Aureus have?

TSST, leukocidin, enterotoxin, exfoliatin (scalded skin)

Streptococci and Enterococci share what common characteristics?

Catalase +, chains, hemolytic

S. Pyogenes & S. Aglactiae are both ______ hemolytic while s. Pneumoniae is ______ hemolytic.

Beta; alpha

What structures allow Strep pyogenes to be the BADDIE of their species?

Capsule that mimics CT, cell wall with fimbria, M protein, carb, & FNBP

What some extracellular toxins that allow s. Pyogenes to be the baddie of their species ?

Streptokinase (digests fibrin), Hyaluronidase (breaks down HA), Streptolysin S+O (rbc/wbc lysis)

Strep viridans uses _____ hemolysis and those with ______ receive antibiotics before having dental work.

Alpha; MVP (mitral valve prolapse)

Even though you butchered your IOL job, you are happy your patient doesn't have endophthalmitis due to ________ which can be very severe and resistant.

Enterococcus

Impetigo and Erysipelas are associated with what strep species infection?

S. pyogenes

Conjunctivitis and Otitis are associated with what strep species?

S. Pneumoniae

Coryne (diphtheria) are normal flora of the conjunctiva that are unique in that

The toxin is the sole cause of disease

What are the properties of Listeria?

tumbling in media, grow at fridge temps, catalase +, beta hemolytic

What gram positive bacilli may result in foodborne infection in pregnant women who eat deli meats

Listeria

What gram positive rod is pleomorphic and lives of FFA of the skin?

Proprionibacterium

What filamentous gram positive rod that is catalase/oxidase/indole negative causes erysipeloid and is suspectible to penicillin?

Erysipelothrix

There are three forms of Anthrax. The most common is _____ but the second most common form ________ is 100% fatal if untreated and happens due to inhalation of spores

Cutaneous (95%); Respiratory/Wool Sorters Disease (5%)

While performing subjective refraction during your 7 minute station 1 of proficiency, your patient tells you he watched the Netflix Anthrax documentary and seemed a little too excited about biological warfare. You did notice a black ulcer on his face when positioning the phoropter. You are just glad slit lamp is not on a standardized patient because you may see these symptoms associated with cutaneous anthrax?

Ectropion, corneal exposure, epiphora, exophthalmos, optic atrophy, preseptal cellulitis

What gram positive rods produces spores?

bacillus & Clostiridia

What clostridia species can cause gas gangrene and food poisoning?

C. Perfingens

Which clostridia species is associated with pseudomembranous colitis and iatrogenic life-threatening diarrhea

C. Difficile

During Pikeville tire clean up, Dustin steps on a rusty nail in the Levisa Fork. Luckily KYCO requires a vaccination against _____ that is caused by what clostridium species?

Tetanus; C. Tetani

Botulism is associated with diarrhea, dilation, dry mouth, nystagmus and is caused by what clostridium species

C. Botulinum

Neisseria is a gram negative diplococci, N. Gonorrheae ferments ____ while N. meningitidis ferments _______

Glucose only; glucose & maltose

What highly contagious gram negative diplococci causes hyper-purulent conjunctivitis?

N. Meningitidis

T/F: N. Gonorrheae can penetrate an intact cornea and can cause ophthalmia neonatorium if the mother delivers vaginally and has the infection?

True

What gram negative cocci is likely the cause of chronic follicular conjunctivitis?

Moraxella catarrhalis

Moraxella catarrhalis can cause _____, is oxidase _____ and resistant to _____.

UTRI; positive; penicillin

What oxidase negative gram negative cocci has widespread resistance and can cause nosocomial infections due to catheters or endophthalmitis in diabetics?

Acinetobacter

All of these non-enteric gram negative rods have the potential to cause microbial keratitis

Pseudomonas, stenototrophomonas, achromobacter, chryseobacterium, delftia

What gram negative rod is a rising isolate in ocular disease, causing corneal ulcers, corneal infiltrative events and conjunctivitis

Stenotrophomonas

corneal ulcers caused by P. Aeroginosa are

Aggressive and can perforate

What is the primary pathogen for microbial keratitis?

pseudomonas

Haemophilus influenzae can have what ocular effects?

Conjunctivitis and preseptal cellulitis

Bordetella pertussis is associated with what condition?

Whooping cough

Whooping cough has what effects on infants and elderly?

It is life-threatening in infants and can create chronic cough in the elderly.

Gram negative enteric rods can be identified with

MacConkey and Oxidase tests

All gram negative enteric rods cause

Diarrhea and fever

Resistance in gram negative enteric rods is

Transmitted by plasmids and transferred within species

E. Coli is the most common cause of ______

UTI

Ella and I go to made to crave and get lettuce in our bowls. The lettuce happened to be contaiminated with a gram negative enteric rod. Later, Ella and I are on the fifth floor clinic and I have panophthalmitis and Ella has keratitis and conjunctivitis. What is likely the bacteria responsible?

E. Coli

Elizabethkingia tends to be multidrug resistant and causes ______ infections.

Nosocomial

What gram negative enteric rods can cause microbial keratitis?

E. Meningoseptica and Serratia marcesens

KYCO class of 2028 gets tired of having to worry about remembering Patiences punctal plugs during slit lamp and puts her through autoimmune testing, and she is diagnosed with Sjogrens. What 2 bacteria may be found in her conjunctiva?

E.coli and Shigella

What gram negative enteric rod can penetrate the intact corneal epithelium?

Shigella

What bacteria produces hydrogen sulfide?

Salmonella

S.typhi is able to ______ and typhoid fever has _____

Survived in macrophage; a 7 stage progression that can be fatal

What oxidase + curved rod with a single flagellum is responsible for rice water diarrhea?

Vibrio cholera

What S shaped rod with a single flagellum is responsible for bloody diarrhea by invading the epithelium?

Campylobacter jejuni

What is produced by H. pylori?

Urease

What spiral shaped gram negative rod is responsible for gastric ulcers by living deep in the mucosa and producing urease/toxins that neutralize the stomach pH?

H. Pylori

SIBO can be diagnosed by

A positive lactulose test

A patient who presents with rosacea could also have

SIBO - Small intestine bacterial overgrowth

What bacteria requires L-Cysteine for growth?

Legionella

Acute lobar pneumonia and retinal exudate/hemes in elderly men is associated with

Legionnaires disease

Bella decides to play with Pixie (her cat) all night before she sits to be your patient for proficiency. You notice during set up her neck has huge lumps on each side and when checking her palpebral conj you notice follicles. What bacteria could Bella have acquired?

Bartonella henselae

Bartonella henselae is

Gram negative pleomorphic

What would be a good tool to determine if a bacteria is mycobacteria?

Acid fast

What are two gram positive chain former bacteria?

Actinomyces and Norcardia

King James has a crazy 5 day bender and doesn't take out his contacts and sleeps in them for a long time. He gets microbial keratitis. What gram + chain former bacteria is the cause?

Norcardia

Identification characteristics of Mycoplasma

No cell wall, lipid bilayer, pleomorphic, smallest known free living self replicating prokaryotic cell

Mycoplasma is associated with what condition and ocular manifestation?

Walking Pneumonia and conjunctivitis

MAC is associated with _____ that is ______

Post-lasik keratitis; difficult to treat

Actinomyces is associated with

Post-lasik microbial keratitis

I'm tired of writing questions. Just things you should know about Mycobacteria tuberculosis

Very hardy - lots of resistance, gohn complex visible on chest X-ray, chronic granulomatous uveitis, needs 6mo multi drug tx, and the BCG vax can cause 80% reduction in severe forms

You discover Dad Sean has microbial keratitis during proficiency (sucks for him...but YAY no goldmann!). What protocol is it important you follow to properly treat him?

Culture his cornea and scleral case and order a sensitivity test

Describe TB Test results

Pos: >5mm in immuno-compromised, >10mm in healthcare workers, >15mm if no risk. Follow up with anergy

What condition is associated with Shigella and what might an ocular finding be?

Montezuma's Revenge - Bacillary Dysentry (4 Fs); Keratitis

micro: patience’s question review Flashcards

(119 cards)