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CP2 Dermatology > Bacterial and viral infections > Flashcards

Bacterial and viral infections Flashcards

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Dermatology Board Prep flashcards
1
Q

What are commensal bacteria and name 4 examples?

A

Bacteria present on skin but not causing disease

  • stapylococci
  • micrococci
  • corynebacteria
  • propionibacteria
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2
Q

3 mechanisms by which staphylococci can cause infection

A
  1. primary infection occurs on previously seemingly normal skin - direct invasion of epidermis
  2. 2ndary infection occurs in skin which has been damaged in some way already e.g. wound infection
  3. staphylococi produce toxins which themselves can induce disease
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3
Q

Where is S. aureus commensal?

A

In nasal canal

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4
Q

Name 2 topical antibiotics to treat bacterial infections?

A

fusidic acid

mupirocin

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5
Q

Name 2 oral antibiotics to treat bacterial infections?

A

flucloxacillin

clindamycin

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6
Q

3 types of primary staphylococcial infection

A
  • impetigo
  • bullous impetigo
  • folliculitis
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7
Q

What does impetigo look like?

A

classic golden crust

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8
Q

What age group impetigo common in?

A

young children

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9
Q

How do you treat impetigo?

A

responds well to topical antibiotics unless infection is very widespread.

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10
Q

What other bacterium is impetigo sometimes caused by

A

streptococcal infection

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11
Q

Which group is bullous impetigo especially common in?

A

infants

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12
Q

Describe what folliculitis looks like

A

pustules around hair follicles with surrounding inflammation - red

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13
Q

What other test must you do with folliculitis?

A

nasal swab and treat with mupirocin nasal ointment if positive

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14
Q

How do you manage folliculitis?

short and long term

A

topical antibiotics
may need short course of oral flucloxacillin
if recurrent and severe may respond to a 3 month course of tetracycline/erythromycin

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15
Q

Name 4 types of secondary staphylococcal infection?

A
  • wound infection
  • cellulitis (may be primary)
  • infected eczema
  • infected leg ulcer
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16
Q

which types of secondary staphylococcal infection can also be caused by streptococcal infection?

A

cellulitis and infected eczema and infected leg ulcer

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17
Q

What is ecthyma?

A

deep infection caused by staph/strep and may be more common in immunosuppressed/ diabetes etc

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18
Q

How do you treat ecthyma?

A

longer course antibiotics - can scar

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19
Q

How do you treat a wound infection

A

oral antibiotics, remove foreign bodies such as stitches if possible, allow any puss to drain

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20
Q

How do you treat cellulitis

A

systemic antibiotics - oral or IV and check for cause such as tinea pedis

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21
Q

What would bilateral cellulitis suggest?

A

UNUSUAL as infection is unilateral and inflammation is bilateral SO would suggest a different diagnosis such as varicose eczema

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22
Q

How to treat an infected leg ulcer?

A
  • potassium permanganate

- compression bandaging if appropriate once initial infection is under control

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23
Q

What is staphylococcal scalded skin syndrome?

A

rare condition in infants, may follow minor infection such as impetigo. Redness goes to peeling in flexures. Bacterial toxins damage the skin barrier

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24
Q

Management of staphylococcal scalded skin syndrome?

A

antibiotics for underlying infection IV fluclox, fluid, analgesia, emollient, may require ICU

25
Q

Are group A strep always pathogenic?

A

yes

may co-infect with staph

26
Q

Name a group A strep

A

strep pyogenes

sorry dunno any else well done if you got one.

27
Q

Nature of onset of group A strep infections?

A

acute onset and rapid spread

28
Q

Managment of strep infections?

A

penicillin V BUT doesn’t cover S. aureus so fluclox if suspect both.

Clindamycin also good

29
Q

What is erysipelas and describe what is looks like?

A

Form of cellulitis caused specifically by streptococci.

Acute well demarcated red plaque, beefy bolstered edge. Painful

30
Q

Treatment of erysipelas?

A

Penicillin V

31
Q

Which conditions have hypersensitivity to streptococcal antigens?

A
  • erythema nodosum
  • erythema multiforme
  • guttate psoriasis
  • vasculitis
  • glomerulonephritis
32
Q

Describe erythema nodosum and what causes it

A

tender red nodules/lesions

  • strep infection
  • drugs - sulphonamides, OCP
  • sarcoidosis/ IBD
33
Q

How to treat erythema nodosum?

A

Treat underlying cause and can use NSAIDs

34
Q

Describe erythema multiforme and what causes it

A

target lesions, 3 different colours

  • strep
  • HSV
  • drugs

(2 tone suggests urticaria)

35
Q

How to treat erythema multiforme?

A

remove trigger and it settles within a couple of weeks without specific treatment

36
Q

Describe a vasculitis caused by group A strep

A

non-blanching purpura

e.g. HSP, meningococcal, hep C, drugs, lupus

37
Q

What investigations must you do in vasculitis and why?

A

must screen for organ involvement - esp kidneys: BP, urinalysis and U&E

obv treat underlying cause

38
Q

S+S of necrotising fasciitis

A
  • tenderness
  • systemic sepsis
  • rapidly spreading erythema/ necrosis
  • high fever
39
Q

Organism involved in necrotising fasciitis?

A

group A strep often, sometimes S. aureus and other bacteria

40
Q

Management of necrotising fasciitis?

A

Surgical emergency - debridement and IV antibiotics

life threatening

41
Q

Describe what a cold sore looks like

A

Vesicles on lip in a cluster

42
Q

Where do cold sores occur and what causes them?

A

HSV type 1 (and now 2) and usually on lip, can occur anywhere on body

43
Q

How to treat cold sores?

A

topical/systemic aciclovir but only effective at first sign of eruption (pins and needles/ burning sensation)

44
Q

What is eczema herpeticum?

A

HSV superinfecting eczema

45
Q

Treatment of eczema herpeticum?

A

Systemic aciclovir, IV in severe cases. Topical steroids for eczema BUT NOT JUST TOPICAL STEROIDS ALONE as worsens.

mortality rate if not treated adequately

46
Q

What is primary varicella zoster and describe what is seen?

A

Chickenpox. High fever and widespread rash, crops of vesicles turning into crusted papules

47
Q

How does chickenpox affect different groups?

A

self limiting in children

can have organ involvement in immunosuppressed or adults

48
Q

Treatment of chickenpox

A

nothing in children

systemic aciclovir in adults

49
Q

When are you infectious with chickenpox?

A

2 days prior to rash for 7 days

Respiratory droplet infection - latent for 7-14 days

50
Q

What is shingles and what does it look like?

A

varicella lies dormant in dorsal root ganglion and can present as shingles - self-limiting
looks like vesicles, sometimes red in dermatomal grouping

51
Q

Complications of shingles?

A
  • can be superinfected with bacteria
  • vesicles on nasal tip suggest involvement of nasalciliar nerve which can lead to occular disease
  • vesicles on pinna/near earish associated with facial palsy and nerve damage
  • post-infective neuralgia
  • encephalitis
52
Q

How do you treat post-shingles neuralgia?

A

Analgesia

if persists can use amitryptiline or antiepileptics (?)

53
Q

What causes viral warts?

A

HPV

54
Q

Types of viral warts and what they look like?

A
  • filiform warts - finger like projection
  • mosaic warts - under foot difficult to treat
  • garden warts - common, dehabilitating, on hands etc crusty elevated papules
  • plain warts - may coalese
55
Q

Treatment of viral warts?

A

Will clear in immunocompetent
Cryotherapy
Scrape - never excise can grow in scar

56
Q

What is mollescum contagiosum and what is it caused by?

A

small umbilicated papules on trunk,erythema and crusting can be seen

pox virus

57
Q

Which group is affected by mollescum contagiosum?

A

children, may be worse in atopics

58
Q

Treatment of mollescum contagiosum?

A

self limiting, treatment not usually required, settles in months-years

CP2 Dermatology (5 decks)

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