Microbiology

Question 1

bacterial conjuncitivits presents as

Answer 1

pus
red
crusty
painful

Question 2

What is the cause of bacterial conjunctivitis in neonates

Answer 2

chlamydia
gonorrhoea
staph aureus
(from coming out of the birth canal)

Question 3

What is the cause of bacterial conjunctivitis in adults

Answer 3

staph aureus
H. influenza
strep pneumonia

Question 4

What is the investigation for bacterial conjunctivitis

Answer 4

swab for culture with local anaesthetic before

Question 5

What is the treatment for bacterial conjunctivitis

Answer 5

topical Abx - chloramphenicol QD

- fusidic acid if allergic

Question 6

What does viral conjunctivitis present as

Answer 6

red
watery
painful

Question 7

What is the causes of viral conjunctivitis

Answer 7

adenovirus - most common, usually from an URTI
HSV
HZV

Question 8

What sign is usually present in viral conjunctivitis caused by HZV

Answer 8

hutchinson’s sign

Question 9

What is Hutchinson’s sign

Answer 9

tip of the nose involvement, shows nasociliary nerve involvement

Question 10

What is the investigation for viral conjunctivitis

Answer 10

viral swab - not always needed

Question 11

What is the treatment for viral conjunctivitis

Answer 11

adeno and HSV = self limiting

HZV - aciclovir (within 72hrs)

Question 12

What does chlamydial conjunctivitis present as

Answer 12

chronic
bilateral red eye that doesn’t respond to treatment
follicles (rice grains) on undersurface of upper eyelid
scarring of undersurface of eyelid
may also have urethritis/vaginitis

Question 13

What is the investigation for chlamydial conjunctivitis

Answer 13

contact tracing

Question 14

What is the treatment for chlamydial conjunctivitis

Answer 14

topical oxytetracycline

Question 15

What does bacterial keratitis present as

Answer 15

v painful
red
may have hypopyon

Question 16

What is bacterial keratitis associated with

Answer 16

contact lens wearers
corneal damage Hx
dry eyes

Question 17

What is a hypopyon

Answer 17

white cell infiltrates present in the anterior chamber that leaves a white meniscus

Question 18

What is the cause of bacterial keratitis

Answer 18

staph aureus

acanthamoeba/pseudomonas in contact lens wearers

Question 19

What is the investigation for bacterial keratitis

Answer 19

corneal scrape

acanthamoeba - microscopy/culture

Question 20

What is the treatment for bacterial keratitis

Answer 20

admission for hourly drops
ofloxacin
if resistant - gentamicin and cefuroxime

Question 21

What is the cause of herpetic keratitis

Answer 21

HSV

Question 22

What is the major complication of herpetic keratitis

Answer 22

dendritic ulcer

Question 23

How is a dendritic ulcer seen

Answer 23

on immunofluorescence with a blue light

Question 24

What is the treatment for herpetic keratitis

Answer 24

aciclovir

Question 25

What must not be given in herpetic keratitis

Answer 25

steroids | this will cause thinning of the cornea if there is a dendritic ulcer and cause the cornea to burst

Question 26

What is the cause of adenoviral keratitis

Answer 26

adenovirus usually from URTI

Question 27

What is the presentation of adenoviral keratitis

Answer 27

bilateral | contagious

Question 28

What is the treatment for adenoviral keratitis

Answer 28

can get abx prophylaxis to prevent secondary infection | steroids may speed up recovery

Question 29

Orbital cellulitis is caused by

Answer 29

extension from a paranasal infection most commonly extension from a facial orbital infection post-op

Question 30

What does orbital cellulitis present as

Answer 30

v painful swollen proptosis if severe pyrexia

Question 31

What is a major complication of orbital cellulitis

Answer 31

compartment syndrome - compresses the nerve and causes loss of vision

Question 32

what is the investigation for orbital cellulitis

Answer 32

CT

Question 33

What is the treatment for orbital cellulitis

Answer 33

v broad spectrum Abx cover - coliform, staph, strep, anaerobes, H. influenza may need drainage

Question 34

What is endophthalmitis

Answer 34

inflammation of the entire globe

Question 35

What is the cause of endophthalmitis

Answer 35

surgery/endogenous | staph epidermidis usually

Question 36

What is the presentation of endophthalmitis

Answer 36

``` v painful v red reduced vision sudden onset sight threatening ```

Question 37

What is the investigation for endophthalmitis

Answer 37

aqueous humour/vitreous humour for culture

Question 38

What is the treatment for endophthalmitis

Answer 38

amakacin/vancomycin + topical abx

Question 39

What is chorioretinitis

Answer 39

inflammation at the back of the eye

Question 40

What is the cause of chorioretinitis

Answer 40

``` CMV in AIDs toxoplasma gondii (protozoa from cats) toxoplasma canis (worm from cats/dogs) ```

Question 41

What is the investigation for toxoplasma gondii and toxoplasma canis

Answer 41

serology

Question 42

What is the cause of dacrocystitis

Answer 42

blockage of the lacrimal canaliculi causes a build up of lacrimal fluid which leads to infection

Question 43

What is the treatment for dacrocystitis

Answer 43

penicillin