Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ENT > Microbiology of ENT Infections > Flashcards

Microbiology of ENT Infections Flashcards

(74 cards)

Start Studying
1
Q

which type of herpes simplex virus causes oral lesions?

A

type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how is herpes simplex virus acquired and which type is usually acquired in childhood?

A

through saliva contact

type 1 acquired in childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe the features of primary HSV1 infection?

A 
pre-school children
systemic upset
lips,buccal mucosa, hard palate affected
vesicle 1-2mm
ulcers
fever
local lymphadenopathy
3 weeks recovery
spread beyond mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how is HSV1 managed?

A

aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what happens after primary HSV1 infection?

A

latency
inactive for of virus in sensory nerve cells
can reactivate to re-infect mucosal surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what causes a cold sore?

A

reactivation of HSV1 from nerves which causes active infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how are cold sores managed?

A

aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

does HSV1 always reactivate after primary infection?

A

no

only half

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

intra oral vs oral herpetic lesions?

A 
oral = HSV1
intra-oral = HSV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what coloured tube is use for viral PCR?

A

red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what causes herpangina?

A

coxackie virus (not HSV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does herpangina present?

A

vesicles/ulcers on soft palate

similar age range to primary HSV gingivostomatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how is herpangina diagnosed?

A

clinically or viral PCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what causes hand foot and mouth disease?

A

coxackie viruses (enteroviruses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

features of hand foot and mouth?

A

sore throat
mouth ulcers
rash
blisters on hands and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

diagnosis of hand foot and mouth?

A

clinically or viral PCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

main feature of primary syphilis?

A

chancre (painless ulcer at site of entry of the bacterium)
most common site = genital
oral lesions are possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what bacteria causes syphilis?

A

treponema pallidum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are apthous ulcers?

A

non-viral, self limiting recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos
in the absence of systemic disease
confined to mouth
begin in childhood and tend to abate in 3rd decade
each ulcer lasts less than 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

5 causes of recurrent ulcers associated with systemic disease (non-viral)?

A 
behcets disease
gluten sensitive enteropathy or inflammatory bowel disease
reiter's disease
drug reactions
skin diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

clinical presentation of acute pharyngitis?

A

inflammation of the part of the throat behind the soft palate (oropharynx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

clinical presentation of tonsillitis?

A

inflammation of the tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when may mononucleosis/Epstein barre virus (glandular fever) be suspected?

A

if sore throat and lethargy persist into 2nd weeks, especially if person is 15-25 yrs old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

non-infectious causes of sore throat?

A 
GORD
chronic irritation from smoking
alcohol
hay fever
(look for red flags)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
primary care management of sore throat?
history and clinical exam | throat swabs not routinely carried out in primary care
26
how is sore throat managed generally?
usually self limiting | - usually within 3 days - 1 week
27
4 common secondary causes of sore throat?
otitis media (most common) peri-tonsillar abscess para-pharyngeal abscess mastoiditis
28
which cases of sore throat may need referral/admission?
suspicion of throat cancer (persistent with neck mass) sore throat lasting over 3-4 weeks with pain on swallowing or dysphagia for more than 3 weeks red or red/white patches or ulceration or swelling of the oral/pharyngeal mucosa for >3 weeks stridor/respiratory difficulty is an emergency
29
what does penicillin treat?
strep pyogenes
30
self care for sore throat?
``` regular analgesia medicated lozenges avoid hot drinks fluid intake mouthwash/spray ```
31
do most sore throats needs antibiotics?
no | 2/3rds are viral
32
most common bacterial cause of sore throat?
strep pyogenes (group A beta haemolytic strep)
33
clinical presentation of strep pyogenes sore throat?
acute follicular tonsilitis
34
management of strep pyogenes sore throat?
penicillin
35
describe strep pyogenes?
gram +ve cocci chains | beta haemolysis
36
name 2 late complications of strep pyogenes infection
``` rheumatic fever (fever, arthritis and pancarditis) glomerulonephritis (haematuria, albuminuria and oedema) ```
37
what is CENTOR criteria?
scoring system for likelihood of group A beta haemolytic strep cause of sore throat
38
what are the components of CENTOR criteria?
``` tonsillar exudate tender anterior cervical lymph nodes history of fever (>38) absence of cough one point each (out of 4 points) - 0, 1 or 2 = 3-17% risk - 3 or 4 = 32-56% risk ```
39
management of sore throat for people who are taking DMARDs?
FBC (withhold DMARD while awaiting result) seek urgent specialist advice/referral if patient has low WCC or deteriorates - give symptomatic relief and consider an antibiotic (take into account DMARD interactions)
40
what can cause neutropaenia?
drugs like carbimazole chemotherapy known/suspected leukaemia immunosuppression of any kind
41
management of sore throat in co-existent neutropenia?
urgent FBC withhold causative drug until result is back consider antibiotic
42
when may phenoxymethylpenicillin be considered?
fever PAIN score 4 or 5 | CENTOR 3 or 4
43
what bacteria causes diptheria?
Corynebacterium diptheriae
44
clinical presentation of diptheria?
severe sore throat with grey-white membrane across the pharynx - bacteria produces exotoxin which is cardiotoxic and neurotoxic
45
can diptheria be prevented?
yes | vaccine
46
how is diptheria managed?
antitoxin and supportive | penicillin/erythromycin
47
presentation of infectious mononucleitis (glandular fever)?
``` fever enlarged lymph nodes sore throat, pharyngitis, tonsillitis malaise lethargy jaundice/hepatitis rash splenomegaly palatal petechiae (non blanching palatal rash) ```
48
cause of infectious mononucleosis?
Epstein barre virus | part of the herpes family
49
haematology of mononucleosis?
leucocytosis (lymphocytosis) | presence of atypical lymphocytes in blood film
50
possible complications of mononucleosis?
anaemia, thrombocytopaenia splenic rupture upper airway obstruction increased lymphoma risk
51
are steroids given for viruses?
no | generally steroids make viruses worse
52
what are the 2 phases of primary infection with Epstein barr virus?
primary infection in childhood rarely results in symptoms | primary infection in those >10 often causes infectious mononucleosis
53
management of mononucleosis?
``` bed rest paracetamol avoid sport (spleen rupture) antivirals not effective steroids used very rarely ```
54
lab confirmation of EBV?
``` EBV IgM heterophile antibody - paul bunnel test - monospot test blood count and film LFTs ```
55
what 3 illness can cause similar illness to EBV?
cytomegalovirus toxoplasmosis primary HIV
56
clinical presentation of candida?
white patches on red, raw mucous membranes in throat/mouth
57
what can cause candida in the mouth?
``` endogenous post antibiotics immunosuppression smokers inhaled steroids ```
58
treatment of candida?
nystatin or fluconazole
59
what is acute ottis media?
URTI involving middle ear by extension of infection up the eustachian tube usually in infants and children presents with earache
60
most common causes of middle ear infection?
usually viral with secondary bacterial infection | most common bacteria = haemophilus, strep pneumoniae and strep pyogenes
61
diagnosis of middle ear infection?
swab of pus if eardrum perforates | otherwise samples cant be obtained
62
how is middle ear infection managed?
80% resolve within 4 days without antibiotics 1st line = amoxicillin 2nd line = erythromycin
63
what is malignant otitis?
extension of otiyis externa into the bone surrounding the ear canal fatal without treatment
64
how does malignant otitis present?
pain and headache (more severe than clinical signs would suggest) granulation tissue at the bone -cartilage junction of the ear canal exposed bone in the ear canal facial nerve palsy (drooping face on side of lesion)
65
how is malignant otitis investigated?
``` PV raised CRP raised imaging biopsy culture (usually shows pseudomonas aeriginosa) ```
66
risk factors for malignant otitis?
diabetes | radiotherapy to head and neck
67
what is otitis externa and how does it present?
``` inflammation of outer ear canal redness and swelling of skin of ear canal may be itchy can be sore and painful can have discharge or increased ear wax - hearing can be affected if blocked ```
68
bacterial causes of otitis externa?
staph aureus proteus spp pseudomonas aerginosa
69
fungal causes of otitis externa?
aspergillus niger | candida albicans
70
management of otitis externa?
topical aural toilet swab to microbiology and antimicrobial prescription only for severe cases - clotrimazole for aspergillus niger - gentamicin drops
71
how does acute sinusitis present?
mild discomfort over frontal or maxillary sinuses due to congestion severe pain and tenderness with purulent nasal discharge indicates secondary bacterial infection seen in patients with viral URTIs
72
management of acuet sinusitis?
illness usually lasts 2.5 weeks antibiotics if severe/deteriorating cases lasting over 10 days 1st line = phenoxymethylpenicillin 2nd line = doxycycline (not in children)
73
Fever PAIN criteria?
likelihood of group B strep
74
what are the components of fever PAIN criteria?
``` Fever (last 24 hrs) Purulence Attend rapidly (within 3 days) v. Inflammed tonsils No cough/coryza one point each - 0 or 1 = 13-18% risk - 2 or 3 = 34-40% risk - 4 or 5 = 62-65% risk ```

ENT (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions