Microbiology

Question 1

Herpetic whitlow

Answer 1

HSV infection of skin at the nailfold

Question 2

Auditory meatus and external canal are lined by what?

Answer 2

Lined by epidermis and contains sebaceous and ceruminous glands

Question 3

Middle ear mucosa?

Answer 3

Columnar lined mucosa, contains ossicles

Question 4

Where are the cochlea and vestibular apparatus contained?

Answer 4

Inner ear

Question 5

Nasal vestibule

Answer 5

Squamous

Question 6

Nose, sinus

Answer 6

Schneiderian mucosa- Identical to respiratory mucosa, pseudostratified ciliated columnar, mucinous glands

Question 7

Serous cells when they are stained?

Answer 7

Serous cells stain darkly

Contain digestive enzymes, including amylase

Question 8

What colour do the mucinous components stain?

Answer 8

They stain clear grey

Question 9

often flat or cuboidal with clear cytoplasm. Have some contractile properties

Answer 9

Peripheral myoepithelial cells

Question 10

Otitis Media

Answer 10

Inflammation of middle ear
Usually viral. Occasionally bacterial – Strep. Pnuemoniae, H. Influenzae and Moxarella Catarrhalis. If chronic – Pseudomonas Aeruginosa

Question 11

Occasional bacterial causes of otitis media?

Answer 11

Streptococcus pneumoniae
Haemophilus influenza
Moxarella Catarrhalis

Question 12

Cause of chronic otitis media?

Answer 12

Pseudomonas aeruginosa

Question 13

Chronic otitis media and perforated tympanic membrane

Answer 13

Cholesteatoma

Question 14

Abnormally situated squamous epithelium with high cell turnover rate and abundant keratin production

Answer 14

Cholesteatoma

Question 15

Which bone do vestibular schwannoma tumours occur in?

Answer 15

Temporal

Question 16

If vestibular schwannoma is bilateral what should you consider?

Answer 16

If vestibular schwannoma is bilateral then you should consider NF2

Question 17

Which bone is often affected in NF1?

Answer 17

Sphenoid

Question 18

Inheritance pattern of NF1?

Answer 18

Autosomal dominant

Question 19

17q11.2

Answer 19

Neurofibomin (NF1)

Question 20

Neurofibromin gene?

Answer 20

1711q.2 (NF1)

Question 21

Ch22q12

Answer 21

NF2

Question 22

Nasal polyps

Answer 22

Numerous aetiologies – allergy, infection, asthma, aspirin sensitivity, nickel exposure
If young – consider cystic fibrosis

Question 23

What mediates rhinitis and sinusitis and what type of hypersensitvity reaction is it?

Answer 23

IgE mediated type 1 hypersensitivty

Question 24

Which organs are currently involved in Wegener’s granulomatosis?

Answer 24

Respiratory tract and kidneys

small vessel vasculitis

Question 25

Who is usually affected by Wegeners?

Answer 25

Whites over 40

Question 26

42 year old white man with history of sinusitis for almost two years. Then developed lung mass. Complained of aches and pains, malaise and myalgia

Answer 26

Wegeners granulomatosis

Question 27

pANCA

Answer 27

Microscopic polyangitis

Question 28

cANCA

Answer 28

Wegeners granulomatosis

Question 29

Nasopharyngeal carcnimoa has strong association with what?

Answer 29

Has strong association with EBV

Question 30

Laryngeal polyp

Answer 30

Reactive change in laryngeal mucosa secondary to - vocal abuse, infection and smoking. Occ. in hypothyroidism. Nodules and polyps are largely interchangeable terms. Nodules are usually seen in young women and are bilateral on middle 1/3 to posterior 1/3 on vocal cord. Polyps are unilateral and pedunculated.

Question 31

Non-chromaffin paraganglioma

Answer 31

carotid bodies, aortic bodies, jugulotympanic ganglia, ganglia nodosum of vagus and clusters around oral cavity, nose, nasopharynx, larynx and orbit.

Question 32

Chromaffin paraganglioma

Answer 32

sympathetic nervous system and can secrete catecholamines. Usually adrenal medulla or paravertebral – organ of Zuckerkandl

Question 33

Which type of paraganglioma would secrete chatecholamines?

Answer 33

Chromaffin positive

Question 34

Complications of streptococcal sore throat

Answer 34

``` Scarlet fever Peritonsillar abscess (quinsy) Sinusitis/Otitis media Late complications: Rheumatic fever Nephropathy ```

Question 35

Quinsy

Answer 35

Peritonsillar abscess

Question 36

Rheumatic fever

Answer 36

Pancarditis Fever Arthritis

Question 37

Diptheria treatment

Answer 37

Anti-toxin and supportive penicillin/erythromycin

Question 38

Candidi albicans

Answer 38

Candida/thrush

Question 39

Most common bacterial causes of middle ear infections

Answer 39

Haemophilus influenza Streptococcus pneumoniae Streptococcus pyogenes

Question 40

1st and 2nd line treatment for middle ear infections

Answer 40

1st line: amoxicillin (clarithromycin if penicillin allergic) 2nd line: co-amoxiclav or azithromycin

Question 41

ABx for sinusitis

Answer 41

First line penicillin | Second line doxycycline (NOT IN CHILDREN!!)

Question 42

You might see otitis externa in which sports people?

Answer 42

Swimmers (they always have wet ears)