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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
What is the difference between a carbuncle and a furuncle?
Carbuncles are larger and deeper
26
Where are carbuncles found?
Nape of neck Back Thighs
27
What is erysipelas?
Cellulitis with lymphatic involvement
28
Who is more likely to get erysipelas?
Diabetics | Extremes of age
29
What pathogens cause erysipelas?
Group A strep
30
What is the treatment for erysipelas?
Benzylpenicillin
31
What skin infection is associated with Nikolsky's sign?
Scalded skin syndrome
32
What pathogen causes scalded skin syndrome?
Staph aureus
33
What symptoms are associated with scalded skin syndrome?
Fever Hypotension Skin tenderness
34
The highest mortality of scalded skin syndrome is in neonates. T/F?
False | Highest mortality in adults
35
What antibiotic is used to treat scalded skin syndrome?
Flucloxacillin
36
What causes acne?
Excess sebaceous secretion by follicles and infection by propionobacteria
37
What pathogens are involved in infections of human and animal bites?
Mouth flora Staph Strep
38
What treatment should be given after a human/animal bite?
Swabs for culture and susceptibility Tetanus prophylaxis Co-amoxiclav
39
What diabetic foot infections are non-limb threatening?
Cellulitis without abscess or vascular compromise
40
What diabetic foot infections are limb threatening?
Vascular compromise Abscess Osteomyelitis Gangrene
41
What is the empiric treatment for limb-threatening diabetic foot infections?
Piperacillin-tazobactam
42
What is the empiric treatment for non-limb threatening diabetic foot infections?
Flucloxacillin or co-amoxiclav
43
What is the difference between clean, clean-contaminated and contaminated surgeries?
Clean: no breech of tract Clean-contaminated: planned surgery that breeches tract Contaminated: emergency due to rupture
44
What are the classifications of SSIs?
Superficial, deep, organ
45
What pathogens are involved in SSIs?
``` Staph aureus B-haemolytic strep Gram - bacilli Anaerobes Coagulase negative staph on prosthetic materials ```
46
How are SSIs prevented?
Optimise risk factors of patient De-colonisation of MRSA carries During: aseptic technique After: remove drains, asepsis when caring for wound
47
What pathogen causes warts?
HPV
48
How are warts treated?
Excision, salicylate and lactic acid ointment | Cryotherapy
49
What pathogen causes hand, foot and mouth disease?
Coxsackie A virus
50
What treatment is needed for Coxsackie A virus?
None: self-limiting
51
What are causes of candidiasis?
Antibiotics Steroids Pregnancy Immunosuppression
52
How is candidiasis treated?
Topical clotrimazole | Oral fluconazole
53
Tinea is not infectious. T/F?
False, it can be gotten from other people or animals
54
What is the treatment for tinea pedis/corporis?
Topical terbinafide | Oral terbinafide or itraconazole
55
What is the treatment for tinea capitis?
Oral terbinafide or itraconazole | Ketoconazole shampoo
56
Where does a pityriasis versicolor rash usually appear?
Chest and back
57
What is the treatment for pityriasis versicolor?
Topical ketoconazole shampoo
58
How does scabies present?
Mite burrows into finger webs | Very itchy especially at night
59
What is the treatment for scabies?
Topical permethrin | Wash clothes and bedsheets
60
What is the treatment for lice?
Malathion or permethrin Fine combing Bathing/washing clothes

FIM (44 decks)

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