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Year 2 - ENT (DP) > Microbiology > Flashcards

Microbiology Flashcards

(75 cards)

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1
Q

What are most sore throats caused by?

A

Viruses

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2
Q

What is the most common bacterial cause of a sore throat?

A

GAS (Strep. pyogenes)

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3
Q

What is the clinical term for a ‘sore throat’ caused by GAS?

A

Acute follicular tonsillitis

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4
Q

How is acute follicular tonsillitis treated?

A 
PO Penicillin (500mg qds/1g bd) for 10 days
OR
PO Clarithromycin (500mg bd) for 5 days if penicillin allergic
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5
Q

What are the Centor criteria?

A

Fever
Purulent tonsils
Cervical lymphadenopthy
NO cough

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6
Q

What are some complications of streptococcal sore throat?

A

Peritonsillar abscess (quisny)
Sinusitis/Otitis media
Scarlet fever

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7
Q

What precautions need to be taken when dealing with a patient with quinsy?

A

Infection control
Contact precautions
Droplet precautions

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8
Q

A patient who had a Streptococcal throat infection 3 weeks ago presents with a fever and sore joints. There is evidence of myocarditis and pericarditis

A

Rheumatic fever

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9
Q

A patient who had a Streptococcal throat infection 2 weeks ago. They presented noticing a small amount of blood in their urine. You notice some ankle swelling and on urine dipstick there is protein present.

A

Glomerulonephritis

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10
Q

What causes the late terms complications of Strep. sore throat?

A

Cross-reacting antibodies damaging the heart and glomerulus

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11
Q

What bacteria causes Diphtheria?

A

Corynebacterium diphtheriae

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12
Q

How does diphtheria present?

A

Severe sore throat

Grey/White membrane across pharynx

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13
Q

To what systems is the exotoxin that Corynebacterium diphtheriae damaging?

A

Cardiovascular

Nervous

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14
Q

Where is there an increased incidence of diphtheria?

A

Russia

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15
Q

What type of vaccine is the Diphtheria vaccine?

A

Cell-free purified toxin

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16
Q

How is diphtheria treated?

A

Antitoxin and supportive therapy

Penicillin or Eryhtromycin

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17
Q

What bacteria causes thrush and how does it present?

A

Candida albicans

White patches on red, raw mucous membranes

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18
Q

How is thrush treated?

A

Topical nystatin suspension

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19
Q

What is the main presentation of acute otitis media?

A

Earache

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20
Q

What is the most common cause of acute otitis media and what can cause a secondary infection?

A 
Viral
Secondary bacterial:
     - H. influenzae
     - Strep. pneumoniae
     - Strep. pyogenes
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21
Q

How can acute otitis media be diagnose?

A

Swab

Pus sample if eardrum bursts

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22
Q

How long does acute otitis media take to recover without antibiotics?

A

~4 days (in 80%)

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23
Q

What are indications for treating acute otitis media?

A

Bilateral AOM in kids younger than two
OR
With otorrhoea

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24
Q

What is the empirical antibiotic treatment in AOM?

A

Amoxicillin (5 days)
OR
Clarithromycin

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25
How does acute sinusitis present and what causes it?
Mild discomfort over frontal/maxillary sinuses: | - Due to congestion
26
What concurrent infection is typically the cause of acute sinusitis?
URTIs (viral)
27
What secondary infections can arise in acute sinusitis and what indicates these?
Secondary bacterial: - Severe pain - Tenderness - Purulent nasal discharge
28
What bacteria can cause acute sinusitis?
H. influenzae Strep. pneumoniae Strep. pyogenes
29
How long does acute sinusitis take to resolve without antibiotics and in what % of patients?
14 days | 80%
30
What is the antibiotic treatment of acute sinusitis (if indicated)?
1st line -> Penicillin V | 2nd line -> Doxycycline (NOT IN KIDS)
31
A patient presents with a red, swollen ear. They said a few days ago it was very itchy and it now quite painful. On cleaning their ear there seemed to be a lot of wax. On examination you note a swollen, red helix and external auditory canal plus some pus and little black specs.
Otitis externa (fungal)
32
What are some bacterial causes of otitis externa?
Staph. aureus Proteus spp. Pseudomonas
33
What are some fungal causes of otitis externa?
Aspergillus niger | Candida albicans
34
What is the 1st line treatment for otitis externa?
Topical aural toilet (acetic acid)
35
When would you carry out a swab in otitis externa?
If unresponsive
36
How is otitis externa treated medically?
``` Topical clotrimazole (if fungal) Topical gentamicin (if pseudomonas) ```
37
What is the classic triad of symptoms of infectious mononucleosis and what percentage of patients have this triad?
Fever Enlarged lymph nodes Sore throat/Pharyngitis/Tonsillitis 70%
38
What sign of glandular fever has an ~5% chance of occurring?
Jaundice/Hepatitis
39
What drugs will cause 100% of glandular fever patients to have a rash?
Ampicillin | Amoxicillin
40
What other signs of glandular fever points to its diagnosis?
``` Haematology: - Leucocytosis - Atypical lymphocytes (due to immune reaction) Splenomegaly (50%) Palatal petechiae ```
41
How long do the symptoms of infectious mononucleosis last?
Fever/Pharyngitis -> 2-4 weeks Lymphadenopathy -> ~4 weeks Lethargy lasts a couple months
42
What causes anaemia in infectious mononucleosis? How is it treated?
Auto-immune reaction | Steroids
43
What other haematological complication can occur in infectious mononucleosis?
Thrombocytopaenia
44
Why must contact sport be avoided for 6 weeks in infectious mononucleosis?
Risk of splenic rupture
45
What cancer has an increased incidence in infectious mononucleosis and what may precipitate this further?
Lymphoma | If immunosuppressed
46
What is the cause of infectious mononucleosis?
Epstein-Barr virus (EBV): | - Herpes family
47
Where does EBV tend to lie?
Epithelium of pharynx
48
What are the two phases of primary EBV infections and what ages do they occur?
``` Age 1-6 years: - 40% - Rare clinical signs Age >10: - Often causes mono ```
49
Over the age of 30, 98% of people are positive for what EBV markers?
EBV IgG
50
Are antivirals indicated in infectious mononucleosis?
No
51
When are corticosteroids given in infectious mononucleosis?
If: - Airway obstruction - Haemolytic anaemia
52
What are some laboratory confirmation tests for infectious mononucleosis?
``` EBV IgM Heterophile antibody: - Paul-Bunnell test - Monospot (Used in Ninewells) FBC and film LFTs ```
53
How can we differentiate between cytomegalovirus infection and infectious mononucleosis?
CMV: - Clinically similar - No heterophile antibodies - Fewer atypical lymphocytes
54
What bacteria causes toxoplasmosis and how is it spread?
Toxoplasma gondii (Protozoan cat parasite) Spread: - Via uncooked meat - Cat litter contact
55
What effect can CMV and toxoplasmosis have on foetuses?
Congenital infections | Foetal damage
56
What clues indicate the seroconversion illness of a primary HIV infection that help differentiate it from EBV?
High risk history | Diarrhoea
57
What type of HSV is acquired in childhood and what does it tend to cause?
HSV 1 | Oral ulceration
58
What percentage of UK adults are HSV positive?
70%
59
What is the name of the worst-case disease caused by the primary HSV 1 infection?
Primary gingivostomatitis
60
Which of the following is not a feature of the worst-case primary HSV 1 infection: - Vesicles/Ulcers on lips, buccal mucosa and hard palate - Fever - Local lymphadenopathy - Systemic upset - Itch
Itch
61
How is a primary HSV 1 infection treated (if indicated)?
Aciclovir
62
Is HSV 2 rarely or commonly seen in oral lesions?
Rarely
63
Where does the inactive HSV 1 lie?
Sensory nerve cells -> CN V
64
True or false; Aciclovir doesn't prevent latency of HSV 1?
True
65
When HSV 1 reactivates, where are the lesions typically present and where are they rare?
Commonly: - Lip edges Rarely: - Intra-orally
66
What percentage of people with latent HSV get recurrences?
50%
67
What people are at risk of herpetic whitlows and how can they be prevented?
Dentists and anaesthetists: | - WEAR GLOVES
68
A 4 year old boy presents with a sore throat. On examination his temperature is 38.9. You notice a number of vesicles on his soft palate. There are a few ulcerations that you estimate are approximately 2cm big. What is the diagnosis, the causative organisms and how can it be diagnosed in a lab?
Herpangina: - Coxsackie virus (Enterovirus) PCR of swab in viral transport medium
69
A 5 year old girl is brought in by her mother after she noticed a number of small vesicles in her mouth, on her palms and soles of her feet. She noted that her twin 3 year old sons were brought in the previous week with the same condition
Hand, foot and mouth disease (Coxsackie virus)
70
Which of the following is not a feature of apthous ulcers: - Painful - Recurring - Round - Inflammatory halos - Only in mouth - Can be viral - No systemic upset - Last less than 3 weeks - Disappear by 20s
Can be viral: | - They are totally non-viral
71
A 38 year old Middle-Eastern man presents to the GP with a painful mouth and scrotum. His eyes are also painful and red. On examination there are a number of apthous lesions on his buccal mucosa and the scrotum
Behcet's disease
72
What other systems can Behcet's disease affect?
``` GI Tract Pulmonary MSK CVS CNS ```
73
A patient with recurrent apthous ulcers also notes some diarrhoea and weight loss
Coeliac disease
74
What bacteria causes syphilis?
Treponema pallidum
75
What is the first stage of syphilis?
A chancre: | - Painless, indurated ulcer at bacteria entry point

Year 2 - ENT (DP) (11 decks)

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