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ENT > Microbiology > Flashcards

Microbiology Flashcards

(55 cards)

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1
Q

List viruses that are common causes of oral ulceration

A

Herpes Simplex - type 1
Coxsackie virus - herpangia and hand, foot and mouth
Primary syphilis

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2
Q

What type of herpes simplex causes oral disease

A

Type 1

This type is acquired in childhood

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3
Q

How do you become infected by HSV1

A

Saliva contact

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4
Q

Describe primary gingivostomatitis caused by HSV1

A

Occurs in pre-school children
Ulcers and vesicles on the lips, buccal mucosa and hard palate
Systemic upset - fever, lymphadenopathy
Kids may struggle to eat

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5
Q

How can you treat primary gingivostomatitis caused by HSV1

A

Aciclovir treatment

May take up to 3 weeks to recover

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6
Q

Can herpes become latent?

A

YES

after primary infection it’s inactive form can stay in nerve cells and reactivate to re-infect the mucosal surfaces

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7
Q

What is the major complication of herpes infection

A

herpes simplex encephalitis (high mortality)

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8
Q

How do you diagnose HSV in the lab

A

Swab the lesion - may need to pop it to get fluid
Use viral swab with appropriate transport medium
PCR carried out to detect viral DNA

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9
Q

What is herpangia

A

You get vesicles/ulcers on the soft palate
Caused by coxsackie
Diagnosed by swab and PCR

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10
Q

Describe hand foot and mouth disease

A

Caused by coxsackie viruses
Get gingival stomatitis
Blisters on hand, feet and in the mouth (surprise, surprise)
Can be diagnosed by PCR but often not needed

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11
Q

Describe the presentation of a syphilis ulcer

A 
Called a chancre 
Appears at the site of bacterium entry 
Thick and boggy ulcer 
Occurs in mouth or on genitals 
Sexually transmitted
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12
Q

What are apthous ulcers

A

Non-viral ulcers that are usually self limiting
Recurrent, painful ulcers that are confined to the mouth
Round/oval with inflammatory halo
Do not come with systemic disease

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13
Q

Which systemic diseases can cause recurrent, non-viral ulcers

A 
IBD or coeliac 
Reiter's disease - arthritis 
Drug reactions 
Skin disease - pemphigus/goid 
Behcet's disease
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14
Q

Which age groups are commonly affected by acute throat infections

A

Children age 5-10

Young people 15-25

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15
Q

What are the most common causes of sore throat

A

Mostly viral or bacterial
Common cold, influenza and strep
Less common is HIV and diphtheria

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16
Q

If sore throat and lethargy persist into a second week, what is suspected

A

Infectious mononucleosis

Especially if aged 15-25

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17
Q

What causes infectious mononucleosis

A

Epstein-Barr virus

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18
Q

List some non-infectious causes of sore throat

A

Reflux
Smoking - chronic irritation
Hay fever
Physical irritation

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19
Q

What can a sore throat lead on to

A

Otitis media
Peri-tonsillar abscess
Para-pharyngeal abscess
Mastoiditis

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20
Q

At what point would a sore throat need referred

A

If throat cancer is suspected - persistent
Sore throat lasting 3-4 weeks
Dysphagia
Red, white patched or ulceration that lasts more than 3 weeks
Respiratory difficulty - emergency

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21
Q

What self-care advice should be given to patients with a sore throat

A

Regular analgesia
Medicated lozenges
Avoid hot drinks
Ensure good fluid intake

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22
Q

What is the most common cause of bacterial sore throat

A

Strep pyogenes

AKA Group A strep

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23
Q

How can you treat a strep pyogenes sore throat

24
Q

What are some complications of strep pyogenes infection

Study These Flashcards
A

Rheumatic fever

Glomerulonephritis

25
Describe the histological appearance of strep pyogenes
Gram positive Cocci chains Beta haemolysis - golden
26
List some of the CENTOR criteria for diagnosing a group A strep sore throat
``` Age under 15 Tonsillar exudate Tender anterior cervical lymph nodes History of fever Absence of cough ``` If scoring 3 or 4 should get antibiotics
27
List causes of neutropenia
``` Drugs - carbimazole Chemotherapy Leukaemia Aplastic anaemia HIV with low CD4 Immunosuppressants ```
28
List the clinical features of diphtheria
Severe sore throat | Grey/white membrane across pharynx
29
How do you treat diphtheria
Antitoxin Supportive treatment penicillin/erythromycin
30
What is infective mononucleosis also known as
Glandular fever
31
What are the symptoms of infective mononucleosis
``` Fever Enlarged lymph nodes Sore throat, pharyngitis, tonsillitis Malaise Lethargy - will last months Jaundice Rash Atypical lymphocytes Splenomegaly ```
32
List potential complications of infective mononucleosis
Anaemia Thrombocytopenia Treated with steroids Splenic rupture - avoid sport for 6 weeks Upper airway obstruction Increased risk of lymphoma
33
EBV rarely causes infection in children - true or false
True | If infected in childhood you are usually asymptomatic
34
How do you treat infective mononucleosis
Bed rest Paracetamol Avoid sport Steroids for some complications (rare as can make it worse)
35
How do you confirm EBV infection in the lab
``` EBV IgM Paul-Bunnel test Monospot test Blood count and film LFTs ```
36
How does a candida infection present
White patches on red, raw mucous membranes
37
When should you do further investigation for a candida infection
If recurrent | May indicate a T cell problem
38
How can you treat a candida infection
Nystatin or fluconazole
39
What is acute otitis media
An upper respiratory infection involving the middle ear by extension of infection up the Eustachian tube Present with ear pain
40
Which bacteria are the most common causes of otitis media
Haemophilus influenza Strep pneumoniae Strep pyogenes
41
How do you treat a middle ear infection
Majority resolve in 4 days without antibiotics Amoxicillin first line Then erythromycin
42
What is malignant otitis externa
Infection of the outer ear that extends into the bone Can be fatal Get severe pain and headache
43
What are the clinical signs of otitis externa
``` Redness and swelling of the canal May be itchy Pain Discharge or increased ear wax Hearing can be affected ```
44
List bacterial causes of otitis externa
Staph aureus Proeteus Pseudomonas - swimmers
45
List fungal causes of otitis externa
Aspergillus niger | Candida albicans
46
Describe the presentation of acute sinusitis
Mild discomfort over frontal or maxillary sinuses due to congestion Patient often has a URTI Severe pain and tenderness with purulent discharge suggests bacterial infection
47
How do you treat sinusitis
Usually lasts 2.5 weeks If case is severe or deteriorating and lasts more than 10 days, give antibiotics Phenoxymethylpenicillin or doxycycline
48
What type of antibiotics would you give for otitis media and externa
Media needs oral | External uses topical (drops)
49
What virus causes glandular fever
EBV
50
What are the signs of glandular fever
``` Sore throat - red/inflamed Exudate on tonsils Cervical lymphadenopathy Tiredness Atypical lymphocytes ```
51
What is a common cause of swimmers ear?
Apergillus niger = black mould | Not picked up from water itself but the wet environment created by swimming makes it easier to grow
52
What type of infection is swimmer's ear
otitis externa
53
Which criteria are used to determine the likelihood of a strep sore throat
Centor criteria
54
What are the rare complications of a strep sore throat
glomerulonephritis | rheumatic fever
55
What is the most common causative organism of bacterial tonsillitis
Strep pyogenes

ENT (9 decks)

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