Microbiology

Question 1

what are the two types of HSV?

Answer 1

HSV 1

HSV 2

Question 2

which type of HSV is more commonly associated with oral lesions?

Answer 2

HSV 1

Question 3

when is HSV 1 usually acquired?

Answer 3

childhood

Question 4

what type of HSV is more commonly associated with genital lesions?

Answer 4

HSV 2

Question 5

how is HSV transmitted?

Answer 5

by oral secretions

Question 6

who is usually affected by primary gingivostomatitis?

Answer 6

pre school aged children

Question 7

what is primary gingivostomatitis?

Answer 7

primary infection with HSV 1

Question 8

how does primary gingivostomatitis present?

Answer 8

vesicles around the mouth
fever
lymphadenopathy

Question 9

how is primary gingivostomatitis managed?

Answer 9

aciclovir

Question 10

where does facial HSV remain latent?

Answer 10

the trigeminal ganglion

Question 11

where does genital HSV remain latent?

Answer 11

the sacral ganglion

Question 12

what occupations are associated with herpetic whitlow?

Answer 12

dentist

anaesthetist

Question 13

how is herpetic whitlow prevented?

Answer 13

wearing gloves if at risk

Question 14

what is a very serious complication of HSV infection?

Answer 14

herpes simplex encephalitis

Question 15

how is HSV confirmed in the lab?

Answer 15

swab and PCR

Question 16

how does herpangina present?

Answer 16

vesicles on the soft palate

Question 17

what causes herpangina?

Answer 17

coxsackie viruses

Question 18

how is diagnosis of herpangina made?

Answer 18

clinical

PCR

Question 19

what causes hand foot and mouth disease?

Answer 19

coxsackie viruses

Question 20

who is commonly affected by outbreaks of hand foot and mouth disease?

Answer 20

families

Question 21

how is diagnosis of hand foot and mouth disease made?

Answer 21

clinical

PCR

Question 22

what is acute pharyngitis?

Answer 22

inflammation of the oropharynx

Question 23

what is tonsillitis?

Answer 23

inflammation of the tonsils

Question 24

what should be considered if sore throat with lethargy lasts over a week?

Answer 24

glandular fever

Question 25

when should a patient with a sore throat be referred immediately?

Answer 25

stridor difficulty breathing dehydration systemically unwell

Question 26

what is the most common cause of bacterial sore throat?

Answer 26

group A strep

Question 27

what are two late complications of bacterial sore throat?

Answer 27

rheumatic fever | glomerulonephritis

Question 28

what criteria can be used to determine if someone with a sore throat needs antibiotics?

Answer 28

CENTOR | fever PAIN

Question 29

what are the four criteria in the CENTOR criteria?

Answer 29

tonsillar exudate tender cervical lymph nodes history of fever absence of cough

Question 30

what are the five criteria in the FeverPAIN score?

Answer 30

``` fever purulence attend rapidly inflamed tonsils no cough or coryza ```

Question 31

what antibiotic is usually given for bacterial sore throat?

Answer 31

phenoxymethylpenicillin

Question 32

if someone on a DMARD gets a sore throat what should be done?

Answer 32

FBC withhold the DMARD

Question 33

what complication of DMARDs can present with sore throat?

Answer 33

neutropenia

Question 34

what causes diphtheria?

Answer 34

corynebacterium diphtheriae

Question 35

how does diphtheria present?

Answer 35

severe sore throat | membrane across the pharynx

Question 36

how can diphtheria be prevented?

Answer 36

vaccine

Question 37

how is diphtheria managed?

Answer 37

antitoxin supportive care penicillin

Question 38

what is another name for glandular fever?

Answer 38

infectious mononucleosis

Question 39

which age group gets glandular fever?

Answer 39

young adults

Question 40

how does glandular fever present?

Answer 40

``` fever lymphadenopathy sore throat malaise lethargy ```

Question 41

what are some signs that may be seen in complicated glandular fever?

Answer 41

jaundice rash leucocytosis splenomegaly

Question 42

why should patients with glandular fever avoid sports?

Answer 42

risk of spleen rupture

Question 43

what causes glandular fever?

Answer 43

EBV

Question 44

how is lab confirmation of glandular fever achieved?

Answer 44

EBV IgM monospot test blood count LFTs

Question 45

how is glandular fever managed?

Answer 45

bed rest paracetamol corticosteroids in complicated cases

Question 46

what causes thrush?

Answer 46

candida albicans

Question 47

how does thrush present?

Answer 47

white patches on red patches in the mouth

Question 48

when should thrush be investigated?

Answer 48

if recurrent

Question 49

what things increase risk of thrush?

Answer 49

antibiotics immunosuppression smoking inhaled steroids

Question 50

how is thrush managed?

Answer 50

nystatin or fluconazole

Question 51

what is acute otitis media?

Answer 51

infection of the middle ear

Question 52

what causes AOM?

Answer 52

spread of an URTI up the eustachian tube

Question 53

who is commonly affected by AOM?

Answer 53

children

Question 54

how does AOM present?

Answer 54

earache

Question 55

what are the most common bacterial causes of AOM?

Answer 55

h influenzae strep pneumoniae strep pyogenes

Question 56

what management is needed for bacterial AOM?

Answer 56

first line = amoxicillin | second line = erythromycin

Question 57

what is otitis externa?

Answer 57

inflammation of the ear canal

Question 58

how does otitis externa present?

Answer 58

redness and swelling pain discharge hearing changes

Question 59

what are three bacterial causes of otitis externa?

Answer 59

staph aureus proteus spp pseudomonas

Question 60

what are two fungal causes of otitis externa?

Answer 60

aspergillus | candida

Question 61

how is fungal otitis externa treated?

Answer 61

topical clotrimazole

Question 62

how is bacterial otitis externa treated?

Answer 62

gentamicin drops

Question 63

what is malignant otitis externa?

Answer 63

extension of otitis externa into bone

Question 64

what is the major risk of malignant otitis externa?

Answer 64

can be fatal

Question 65

how does malignant otitis externa present?

Answer 65

pain headache facial nerve palsy

Question 66

what can be seen in malignant otitis externa?

Answer 66

bone exposed in the ear canal

Question 67

what investigations are done for malignant otitis externa?

Answer 67

inflammatory markers imaging biopsy and culture

Question 68

what are the risk factors for malignant otitis externa?

Answer 68

diabetes | radiotherapy to the head and neck

Question 69

when are antibiotics given for acute sinusitis?

Answer 69

severe or deteriorating cases >10 days

Question 70

what antibiotics can be given for acute sinusitis?

Answer 70

``` 1st = phenoxymethylpenicillin 2nd = doxycycline ```