Test 186  (Microbiology)

1. The following are true about Reiter's syndrome:

a. it is commoner in people with HLA-B27

b. it is more common in males than females

c. it is most commonly seen in patients with gonococcal 
    urethritis

d. iritis is commoner than conjunctivitis in affected patients 

e. it is associated with circinate balanitis

 
Answera.T   b.T  c.F   d.F  e.T
Reiter's syndrome is a triad of non-gonococcal urethritis, conjunctivitis, and arthritis. It is a condition predominantly affecting young men who are HLA-B27 positive. Systemic findings associated with Reiter's syndrome include keratoderma blennorrhagica (a scaling dermatitis with special predilection for the soles of the feet), aphthous ulcers, and circinate balanitis. It may follow Gram-negative dysentery or non-gonococcal urethritis secondary to Chlamydia trachomatis 

2. Prophylactic antibiotic is recommended in patient with cardiac 
    murmur undergoing:

a. orbital floor fracture repair

b. dacryocystorhinostomy

c. trabeculectomy

d. cataract extraction

e. pterygium excision

 

Answera.T  b.T  c.F  d.F  e.F
Prophylactic antibiotic is recommended in patient with cardiac murmur undergoing operations that can lead to significant septicaemia in order to prevent infective endocarditis. Both orbital floor fracture and dacryocystorhinostomy are associated with septicaemia due to the amount of bleeding and high load of bacterial commensals in the sinuses and nasal cavity. Pterygium excision, trabeculectomy and cataract extraction are relatively 'clean' procedures.

 
 

3. The following conditions are associated with bacterial infection:
 

a. acne rosacea

b. marginal keratitis

c. phlytenular conjunctivitis

d. Vogt-Koyanagi-Harada syndrome

e. Mooren's ulcer

 
Answer
a.F   b.T  c.T  d.F  e.F
Marginal infiltrate or ulcer can occur as a host response to the organism or its toxins.  Phlyctenular conjunctival lesion is associated with tuberculosis and also staphylococcal infection. 
.

 

. 4. Bacteria that can penetrate intact corneal epithelium include:

a. Pseudomonas aeruginosa

b. Staphylococcus aureus

c. Neisseria gonorrhoea

d. Corynebacterium diptheriae

e. Listeria monocytogenes

Answer
a.F  b.F  c.T  d.T  e.T
Bacteria must usually adhere to the epithelial surface before they can initiate clinical disease. The intact epithelium is an effective barrier to
most organisms, with the exception of Neisseria gonorrhoea, Corynebacterium diphtheriae, Listeria monocytogenes, and Haemophilus
aegyptius, which can, through specialized surface attachments, penetrate an intact epithelium.

5. Demodex folliculorum:

a. is a tick inhabiting the hair follicles

b. is visible with slit-lamp

c. produces clear cylinder case at the base of hair follicles

d. can be easily removed with lid hygiene

e. is most commonly seen in children

 
Answer
a.F   b.F  c.T  d.F  e.F
It is a demodectic mite and may be implicated in blepharitis. It is not visible with slit-lamp. Its presence increases with age. The presence of translucent cylinders resembling clear plastic insulation or cuffs enclosing the base of a lash for a distance of about 1 mm is suggestive of the presence of Demodex in the follicle. Treatment is difficult.

 

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