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FIM > 29. Skin and Soft Tissue Infections > Flashcards

29. Skin and Soft Tissue Infections Flashcards

1
Q

What pathogens cause cellulitis?

A

Staph aureus
Strep pyogenes
Less commonly C or G B haemolytic strep

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2
Q

What are the risk factors for cellulitis?

A 
Previous cellulitis
Diabetes
Obesity
Peripheral vascular disease
Lymphoedema
Skin breaks
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3
Q

What are the clinical features of cellulitis?

A 
Erythema
Pain
Swelling
Hot to touch
Patient may be systemically unwell
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4
Q

What samples should be taken from a patient with cellulitis?

A

Blood cultures

Skin swabs

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5
Q

How should cellulitis be managed?

A

Mark boundaries

Empiric flucloxacillin

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6
Q

What directed treatment should be given if cellulitis is caused by strep pyogenes?

A

Benzylpenicillin

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7
Q

What is necrotising fasciitis?

A

Destruction of skin, subcutaneous and peri-muscular fat by liquefactive necrosis

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8
Q

What are the types of necrotising fasciitis?

A

Polymicrobial
Group A beta haemolytic strep
Gas gangrene

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9
Q

How does a patient with necrotising fasciitis present?

A

Pain is out of proportion to their wound

Very systemically unwell

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10
Q

How should necrotising fasciitis be managed?

A

Urgent surgery for debridement
Tissue for culture
Blood cultures

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11
Q

What is the empiric treatment for necrotising fasciitis?

A

Vancomycin
Piperacillin-tazobactam
Clindamycin

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12
Q

What is Fournier’s Gangrene?

A

Necrotising fasciitis in the perineum

Can involve scrotum, penis and abdominal wall

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13
Q

What is gas gangrene?

A

Necrotising myositis

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14
Q

What pathogen causes gas gangrene?

A

Toxin-producing clostridia

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15
Q

What is the link between colon cancer and gas gangrene?

A

C. septum from the GIT can spread haematologically

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16
Q

What are the clinical features of gas gangrene?

A

Acute onset of severe pain
Fluid or gas filled blisters on skin
Foul odour and crepitus

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17
Q

How is gas gangrene diagnosed?

A

Gas seen in tissues on X-ray
Wound swab, blister fluid or tissue for culture
Blood cultures

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18
Q

What is the treatment for gas gangrene?

A

Debridement
Empiric: benzylpenicillin for clostridia
Hyperbaric oxygen

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19
Q

What pathogens cause impetigo?

A

Staph aureus

Group A strep

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20
Q

Impetigo is highly contagious. T/F?

A

True

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21
Q

What antibiotic treatment is used for impetigo?

A

Flucloxacillin

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22
Q

What pathogen causes folliculitis?

A

Staph aureus

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23
Q

What pathogens cause abscesses?

A

Staph aureus or polymicrobial

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24
Q

What is the treatment for abscesses and furuncles?

A

Drain

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25
Q

What is the difference between a carbuncle and a furuncle?

A

Carbuncles are larger and deeper

26
Q

Where are carbuncles found?

A

Nape of neck
Back
Thighs

27
Q

What is erysipelas?

A

Cellulitis with lymphatic involvement

28
Q

Who is more likely to get erysipelas?

A

Diabetics

Extremes of age

29
Q

What pathogens cause erysipelas?

A

Group A strep

30
Q

What is the treatment for erysipelas?

A

Benzylpenicillin

31
Q

What skin infection is associated with Nikolsky’s sign?

A

Scalded skin syndrome

32
Q

What pathogen causes scalded skin syndrome?

A

Staph aureus

33
Q

What symptoms are associated with scalded skin syndrome?

A

Fever
Hypotension
Skin tenderness

34
Q

The highest mortality of scalded skin syndrome is in neonates. T/F?

A

False

Highest mortality in adults

35
Q

What antibiotic is used to treat scalded skin syndrome?

A

Flucloxacillin

36
Q

What causes acne?

A

Excess sebaceous secretion by follicles and infection by propionobacteria

37
Q

What pathogens are involved in infections of human and animal bites?

A

Mouth flora
Staph
Strep

38
Q

What treatment should be given after a human/animal bite?

A

Swabs for culture and susceptibility
Tetanus prophylaxis
Co-amoxiclav

39
Q

What diabetic foot infections are non-limb threatening?

A

Cellulitis without abscess or vascular compromise

40
Q

What diabetic foot infections are limb threatening?

A

Vascular compromise
Abscess
Osteomyelitis
Gangrene

41
Q

What is the empiric treatment for limb-threatening diabetic foot infections?

A

Piperacillin-tazobactam

42
Q

What is the empiric treatment for non-limb threatening diabetic foot infections?

A

Flucloxacillin or co-amoxiclav

43
Q

What is the difference between clean, clean-contaminated and contaminated surgeries?

A

Clean: no breech of tract
Clean-contaminated: planned surgery that breeches tract
Contaminated: emergency due to rupture

44
Q

What are the classifications of SSIs?

A

Superficial, deep, organ

45
Q

What pathogens are involved in SSIs?

A 
Staph aureus
B-haemolytic strep
Gram - bacilli
Anaerobes
Coagulase negative staph on prosthetic materials
46
Q

How are SSIs prevented?

A

Optimise risk factors of patient
De-colonisation of MRSA carries
During: aseptic technique
After: remove drains, asepsis when caring for wound

47
Q

What pathogen causes warts?

48
Q

How are warts treated?

A

Excision, salicylate and lactic acid ointment

Cryotherapy

49
Q

What pathogen causes hand, foot and mouth disease?

A

Coxsackie A virus

50
Q

What treatment is needed for Coxsackie A virus?

A

None: self-limiting

51
Q

What are causes of candidiasis?

A

Antibiotics
Steroids
Pregnancy
Immunosuppression

52
Q

How is candidiasis treated?

A

Topical clotrimazole

Oral fluconazole

53
Q

Tinea is not infectious. T/F?

A

False, it can be gotten from other people or animals

54
Q

What is the treatment for tinea pedis/corporis?

A

Topical terbinafide

Oral terbinafide or itraconazole

55
Q

What is the treatment for tinea capitis?

A

Oral terbinafide or itraconazole

Ketoconazole shampoo

56
Q

Where does a pityriasis versicolor rash usually appear?

A

Chest and back

57
Q

What is the treatment for pityriasis versicolor?

A

Topical ketoconazole shampoo

58
Q

How does scabies present?

A

Mite burrows into finger webs

Very itchy especially at night

59
Q

What is the treatment for scabies?

A

Topical permethrin

Wash clothes and bedsheets

60
Q

What is the treatment for lice?

A

Malathion or permethrin
Fine combing
Bathing/washing clothes

FIM (44 decks)

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