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Year 2 - MCD - Microbiology > 6 > Flashcards

6 Flashcards

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1
Q

Epidemiology of skin disease

A

Skin disease in general:
15% of GP consultations are skin related
6% of hospital out patient attendances are skin related
In Europe
- 1% of population is referred to a dermatologist per year
-20% of population have a skin disease requiring medical intervention

Skin infections:

  • High rates in hot humid conditions and poor populations
  • Low rates in dry temperate conditions and rich populations

UK

  • 25% of GP skin consultations
  • 5% of dermatologist consultations
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2
Q

Toxins made by Staph aureus

A
  • Panton Valentine Leuocidin
  • Exfoliative toxin (causes blisters)
  • TSST-1 (Toxic Shock Syndrome Toxin 1) - septicaemia symptoms
  • Enterotoxin (causes diarrhoea when food is contaminated)
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3
Q

Toxins made by Staph aureus

A
  • Panton Valentine Leuocidin
  • Exfoliative toxin (causes blisters)
  • TSST-1 (Toxic Shock Syndrome Toxin 1) - septicaemia symptoms
  • Enterotoxin (causes diarrhoea when food is contaminated)
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4
Q

Manifestations of S. Aureus Skin Infections

A

Top layer: causes Impetigo

Epidermis: ecthyma

Follicullitis can cause aa boil and if mutliple boils are connected its aa caarbuncle

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5
Q

Impetigo

A
  • honey coloured, crusted infection
  • common in children, young people
  • especially around nose and mouth
  • quite contagious
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6
Q

Gold, crusty infection - what is it?

A

sounds like a staph aureus infection - impetigo

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7
Q

Bullous impetigo

A
  • pus within blisters
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8
Q

Ecthyma

A
  • crusted thick lesion

- read more

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9
Q

Abscess

A

-

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10
Q

Staphylococcal scalded skin syndrome

A
  • in children mainly
  • treated by admission to hospital
  • antibiotics
  • superficial dissimation
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11
Q

How does staph aureus present? How do you diagnose it?

A

variety of presentations

swab -> 48h

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12
Q

How do you treat it?

A

methicillin

if resistant it is an MRSA infection

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13
Q

Treponema pallidum

A 
Gram negative spirochaete
Cause of Syphilis
Sexually transmited disease
12 million new cases per year worldwide
Increases transmission of HIV
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14
Q

Syphilis phases

A

Primary (at 3-8 weeks)
Painless ulcer at inoculation site (Genital or oral)

Secondary (at 6-12 weeks)
Disseminated infection
Generalised rash and lymphadenopathy

Latent syphilis (no clinical signs)

Tertiary syphilis (usually years later)
	Skin, neurological and vascular manifestations

Congenital
Acquired perinatally
Early and late manifestations

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15
Q

Diagnosis of syphilis

A

primary:

Dark field microscopy of sample from a chancre
Demonstrates spirochates

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16
Q

Presentation of secondary syphilis

A 
Maculopapular rash (can be widespread or some areas)
Palm and soles involved
Condyloma lata (perianal region)

rash cannot be seen under red light (brothels ;) )

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17
Q

Tertiary syphillis

A
  • bone lesions
  • thoracic aneurysm
  • Gummatous skin lesions
  • neurosyphilis
18
Q

Neurosyphilis

A
  • used to be the commonest cause of dementia

- Lenin died of syphilis

19
Q

Congenital syphilis

A 
Miscarriage
Still birth
Prematurity
Rashes
Brain and neurological problems (tertiary syphilis)
Bone disease

blindness, skin bony lesions, abnormal teeth

20
Q

Treatment of syphilis

A

ABs

penicillin?

21
Q

Human Herpes virus family

A
  • DNA viruses

HHV1 - oro genial herpes
HHV2 - oro genital herpes
HHV3 - chicken pox, shingles

all 3 remain latent in nerves

HHV4 - EBV infectious mononucleosis infecting B-cells
HHV5 - CMV
HHV6 - Roseola
HHV8 - Kaposis sarcoma

22
Q

herpes simplex

A

HHV1 (mouth) and HHV2 (genital) -> however can also occur elsewhere

painful vesicular rash
heals in about 2w 
usually no scarring 
eczema herpeticum
herpes encephalitis

first outbreak may cause whole mouth inflammation (stomatitis)

23
Q

Eczema herpeticum

A
  • i.v. acyclovir treatment

-

24
Q

border between skin and lip

A

vermilion border

25
Q

Eczema herpeticum

A
  • i.v. acyclovir treatment
  • czema herpeticum is a disseminated viral infection characterised by fever and clusters of itchy blisters or punched-out erosions. It is most often seen as a complication of atopic dermatitis/eczema.
26
Q

Varicella zoster

A

= chicken pox

  • in children it is relatively mild
  • in older children or adults can be severe
  • incubation period of a week
  • starts with malaise, fever then the rash comes, most concentrated on face, body, trunk, less on arms and legs
  • can be in mouth
  • gets better but lives in dorsal root ganglion
  • can become bullous with blistering

FEEL UNWELL + HAVE A SPECIFIC RASH

27
Q

Herpes diagnosis

A
  • swab
  • PCR
  • results

tell patients that it can come back recurrently, treat with acyclovir.

28
Q

Severe dangerous varicella zoster

A
  • can cause encephalitis
  • can cause pneumonia, especially in the elderly
  • mortality rate for an old person is high
29
Q

varicella zoster - where is it in the latent state?

A
  • dorsal root ganglion

- when reactivated the rash is covering a dermatome

30
Q

Facial herpes zoster

A
  • if in trigeminal nerve
  • can cause ophthalmicc herpes zoster
  • painful, blindness, chronic facial pain

=> patients (70 yo) should have a shingles vaccine

31
Q

Superficial skin fungal infections

A

Dermatophytes (type of mould)
eg Trichophyton rubrum
Grow in keratin
Long hyphae, grow from tip

Yeasts
eg Candida
Grow on warm wet surfaces
single cell and bud

32
Q

Tinea unguium

A
  • nail fungus

nails become yellow and crumbly

33
Q

Tinea capitis

A
  • affects scalp
  • almost always pre-pubertal children
  • post puberty no more susceptible
  • can be wide spread or local
34
Q

Kerion

A

(Type of tinea capitis)

cluster? local tinea capitis

35
Q

Tinea manuum

A

fungal infection of hands

36
Q

Tinea pedis

A

fungal infection of feet

37
Q

tinea cruris

A
  • means scrotum but scrotum is not infected

- fungus in the groin region

38
Q

tinea facei

A
  • fungal infection of the face
39
Q

candida intertrigo

A
  • yeasts like hot sweaty environments
  • satellite regions arounnd
  • take scrapings, cliipings or plucking and send away to be vulture.
  • if too deep, cream is not enough and you need taablets
  • candida usually reponds to clotrimazole
40
Q

Scabies

A
  • sarcoptes scabei
  • female burrows into the skin and lays eggs
  • burrows are within the stratum corneum, top layer of epidermis
  • patient might scratch
41
Q

Which sites to look scabies for?

A

4-5 mm
s shaped or squiggly line
black dot is the mite

look very carefully in certain sites for this!
you can use a dermatoscope you can see it in more detail

armpits
around genital area (inflammatory bumps rather than burrows)
cubital fossa
waist
wrist
between fingers

after 4w itchy rash over the entire body looking like eczema, allergy associated with scabies

42
Q

How do you treat scabies?

A
  • cream, leave on for 12h then wash off
  • do this for 5d
  • change bedding
  • change clothes

transmission is from skin to skin contact (many minutes are required e.g. in bed together)

Permethrin 5% cream is usually recommended as the first treatment. Malathion 0.5% lotion is used if permethrin is ineffective.

can cause glomerulonephritis in the 3rd world causes renal failure

Year 2 - MCD - Microbiology (6 decks)

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