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Microbiology of ENT infections Flashcards

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1
Q

What type of herpes simplex is aquired in childhood?

A

Type 1

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2
Q

What type of HSV causes oral lesions?

A

HSV1

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3
Q

How is HSV transmitted?

A

Infection through saliva contact

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4
Q

What are the sympoms of primary gingivostomatitis?

A 
Systemic upset
Lips Buccal mucosa
Hard palata
Vesicles
Ulcers
Fever
Local lymphadenopathy
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5
Q

How is HSV1 treated?

A

Aciclovir

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6
Q

How does a cold sore occur?

A

Reactivation from nerves causes active infection

Various stimuli

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7
Q

Are recurrent intra-oral lesions causes by HSV?

A

Probably not

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8
Q

How is HSV confirmed?

A

Swab lesion in viral transport medium

Detection of DNA by PCR

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9
Q

What causes herpangina?

A

Coxsackie virus

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10
Q

What are the symptoms of herpangina?

A

Vesicles/ulcers on soft palate

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11
Q

How is herpangina diagnosed?

A

CLinically or by PCR

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12
Q

What causes hand, foot and mouth disease?

A

Coxsackie viruses

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13
Q

Is syphilis painful?

A

No

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14
Q

What bacteria causes syphilis?

A

Treponema pallidum

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15
Q

Where is syphilis most common?

A

Genital

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16
Q

What is the presentation of syphilis?

A

Painless indurated ulcer at site of entry of bacteria

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17
Q

What are apthous ulcers?

A

Recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos

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18
Q

Where are aphthous ulcers confined to?

A

Mouth

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19
Q

What are the symptoms of Behcet’s disease?

A 
Recurrent oral ulcers
Genital ulcers
Uveitis
Visceral organ involvement
Commonest in middle east and asia
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20
Q

Who gets acute throat infections?

A

Children 5-10

Young people 15-25

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21
Q

What is the clinical presentation of a thoat infection?

A

Pain at the back of the mouth

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22
Q

What are causes of non-infectious sore throats?

A 
Physical irritation
GORD
Chronic irritation
Alcohol
Hay fever
Look for red flags
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23
Q

What is an absolute indication for admission to hospital with a sore throat?

A

Stridor

Respiratory difficulty

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24
Q

What are some complications of sore throats?

A

Otitis media
Peri-tonsillar abscess
Para-pharyngeal abscess
Mastoiditis

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25
What is the management of sore throat?
Self care advice Prescribing antibiotics only where apporpriate Manage immunosupressed people
26
What is self care?
``` Regular analgesia Medicated lozenges Avoidance of hot drinks Adequate fluid intake to avoid dehydration Mouthwashes/gargles/spray ```
27
What is the most common cause of bacterial sore throat?
Streptococcus pyogenes
28
What is the treatment for strep throat?
Penicillin
29
What is the treatment for strep throat?
Penicillin
30
What are late complications of strep pyogenes?
Rheumatic fever | Glomerulonephritis
31
What is the criteria for the CENTOR criteria?
``` Tonsilar exudate Tender anterior cervical lymph nodes History of fever (>38) Abscence of cough (Score out of 4) ```
32
What is the criteria for Fever PAIN?
``` Fever (last 24 hours) Purulence Attend rapidly (w/in 3/7) Inflamed tonsils No cough/corryza ```
33
How are patients with a sore throat who are on a DMARD investigated?
FBC Arrange contact with them later with the result Withold the DMARD
34
What can cause Neutropenia?
Carbimazole | CHemotherapy
35
Treatment of bacterial throat infection?
Phenoxymethylpenicillin
36
What causes diphtheria?
Corynebacterium diphtheriae
37
What is the clinical presentation of diptheria?
Severe sore throat with grey white membrane across the pharynx
38
Is diptheria vaccinated against?
Yes
39
What is the treatment of diphtheria?
Antitoxin and supportive | Penicillin/Erythromycin
40
What is the presentation of infection mononucleosis?
``` Fever Enlarged lymph nodes Sore throat, pharyngitis, tonsillitis Malaise, lethargy Jaundice/Hepatitis Rash Haematology Splenomegaly Palatal petechiae ```
41
What are some other signs of mono?
``` Protracted but self limiting illness Anaemia, thrombocytopenia Splenic rupture Upper airway obstruction Increased risk of lymphoma, especially in immunsuppressed ```
42
What causes infectious mononucleosis?
EBV
43
What is the treatment for Mono?
``` Bed rest Paracetamol Avoid sport Antivirals not effective Typically don't use steroids ```
44
How is EBV confirmed?
``` EBV IgM Heterophile antibody -Paul-bunnel test -Monospot test Blood count and film Liver function tests ```
45
What is the presentation of candida?
White pathces on red, raw mucous membranes in throat/mouth
46
What causes candida?
Endogenous
47
When should candida be investigated?
If recurrent
48
What is the treatment of candida?
Nystatin | Fluconazole
49
What is acute otitis media?
URTI involving the middle ear
50
Who gets acute otitis media
Infants and children
51
What is the presentation of otitis media?
Earache
52
What are the most common bacteria causing infections of middle ear?
H.Influenzae Step. pneumoniae Strep. pyogenases
53
How is a middle ear infection diagnosed?
Swab of pus if eardrum perforates
54
What is the treatment of middle ear infections?
80% resolve in 4 days 1st - amoxicillin 2nd - Erythromycin
55
What are the symptoms of malignant otitis?
Pain Headache Severe
56
What are the signs of malignant otitis?
Granulation tissure at bone-cartilage junction of ear canal Exposed bone in ear canal Facial nerve palsy
57
Investigations of malignant otitis?
Plasma viscosity | CRP
58
What is otitis externa?
Inflammation of the outer ear canal
59
What are the symptoms of otitis externa?
``` Redness and swelling of the skin of the ear canal Itchy Sore Painful Discharge Hearing may be affected ```
60
What can cause otitis externa?
``` Staph aureus Proteus spp Pseudomonas Aspergillus niger Candida albicans ```
61
What is the management of otitis externa?
Topical aural toilet Swab Treat depending on culture

ENT Lectures (14 decks)

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