Bacterial and Viral Skin Infections

Question 1

May follow impetigo infection

Answer 1

post streptococcal glomerulonephritis

Question 2

Caused by neisseria meningitidis w/highest incidence between 6mo-3yrs. Most rapidly lethal form of septic shock

Answer 2

meningococcemia

Question 3

Presents with high fever, tachycardia, hypotension, pink macules/papules that become hemorrhagic. Pus from nodular lesion shows gram (-) diplococci

Answer 3

meningococcemia

Question 4

Treatment for meningococcemia

Answer 4

Cefotaxine (Claforin) or Ceftriaxone (Rocephin)

Question 5

Often caused by s. aureus and strep viridans. Presents w/fever, chills, anorexia. PE includes heart murmur, arterial emboli, splenomegaly

Answer 5

bacterial endocarditis

Question 6

Nontender, hemorrhagic maculopapular lesions on palms and soles associated with bacterial endocarditis

Answer 6

Janeway lesions

Question 7

Painful, red nodules on fingertips associated with bacterial endocarditis

Answer 7

Osler’s node

Question 8

Treatment for non-MRSA bacterial endocarditis

Answer 8

PCN-G, nafcillin, gentamycin

Question 9

Treatment for MRSA bacterial endocarditis

Answer 9

vanco or zyvox

Question 10

Common May-Sept. Caused by Rickettsia rickettsii spirochete. Presents with fever, chills, weakness, HA, photophobia

Answer 10

Rocky Mountain Spotted Fever

Question 11

Characteristic spread of rash associated with RMSF

Answer 11

begins on extremities and spreads centrally

Question 12

Treatment for RMSF

Answer 12

doxy or chloramphenical

Question 13

multi-stage, multi-system bacterial infection caused by the spirochete Borrelia burgdorferi from a tick bite

Answer 13

lyme disease

Question 14

General progression of lyme’s disease symptoms

Answer 14

flu-like symptoms days to weeks after the bite. After several months, arthritis type symptoms

Question 15

Treatment for early stage Lyme disease

Answer 15

doxy 14-21 days for ages 8+. If pregnant/breast feeding/< 8yrs, amoxicillin

Question 16

Acute, spreading infections of dermal and subcutaneous tissues thru a skin portal caused by S. aureus or Group A strep

Answer 16

Cellulitis

Question 17

What pathogen is suggested by cellulitis characterized by violaceous color and bullae?

Answer 17

strep. pneumoniae

Question 18

Margins are not palpable. Characterized by warmth, erythema, edema, tenderness

Answer 18

cellulitis

Question 19

Treatment for mild case of cellulitis

Answer 19

bactrim, clinda, doxy

Question 20

Treatment for complicated case of cellulitis

Answer 20

hospitalization and IV antibiotics (Ancef, Rocephin), Ampicillin-Sulbactam, Zyvox)

Question 21

begins as a small erythematous patch that progresses to a fiery-red, indurated, tense, and shiny plaque. Known as “St Anthony’s fire”

Answer 21

Erysipelas

Question 22

Classic lesion of erysipelas that differentiates it from cellulitis

Answer 22

raised sharply demarcated margins

Question 23

Treatment for human bites

Answer 23

Augmentin, Moxifloxin, or clinda. tetanus shot

Question 24

Why is risk of infection higher with cat bites?

Answer 24

more penetrating wounds because of sharp teeth

Question 25

Treatment for dog and cat bites

Answer 25

Augmentin, erythromycin, Bactrim

Question 26

progressive, rapidly spreading, inflammatory infection located in the deep fascia, with secondary necrosis of the subcutaneous tissues

Answer 26

necrotizing fasciitis (hemolytic strep gangrene)

Question 27

Often present in the history of necrotizing fasciitis

Answer 27

trauma or recent surgery to involved area

Question 28

Most important signs are tissue necrosis, putrid discharge, bullae, severe pain, gas production, rapid burrowing through fascial planes, and lack of classical tissue inflammatory signs

Answer 28

necrotizing fasciitis

Question 29

Treatment for necrotizing fasciitis

Answer 29

aggressive abx, surgical consult for debridement, ID and hyperbaric specialist

Question 30

Chronic, suppurative disease of apocrine gland-bearing skin.

Onset from puberty to climacteric. Common in axilla and anogenital region

Answer 30

hidradenitis suppurativa

Question 31

History for hidradenitis suppurativa

Answer 31

Intermittent pain and marked point tenderness related to abscess formation

Question 32

Treatment of hidradenitis suppurativa

Answer 32

intralesional triamsinolone, PO prednisone, and oral abx. I&D last resort

Question 33

Used to diagnose herpes simplex if unsure after inspection

Answer 33

Tzanck smear, direct immuno fluorescence antibody, viral culture

Question 34

Non-pharmacologic treatment of herpes simplex

Answer 34

cool compresses, air or heat lamp drying of lesions

Question 35

Period of time that chicken pox is contagious

Answer 35

two days before onset of rash until all lesions have crusted

Question 36

Treatment for varicella (chicken pox)

Answer 36

benadryl for itching and tyelonol for fever. Acyclovir (Zovirax) if systemic

Question 37

Involves dermatomes. Reactivation of varicella virus in cutaneous nerves from earlier varicella. Unilateral and very painful. Usually > 50yrs

Answer 37

Herpes Zoster (Shingles)

Question 38

Complications from herpes zoster

Answer 38

postherpetic neuralgia and temporary motor paresis

Question 39

Treatment for herpes zoster

Answer 39

antivirals 7-10days. Abx crm to prevent secondary infections

Question 40

Treatment of genital warts

Answer 40

podophyllum, 20% in tincture of benzoin, tricholroacetic acid (for vajays), cryosurgery