bacterial infections

Question 0

what tx is most appropriate for most bacterial infections

Answer 0

first generation cephalosporins

Question 1

most common skin infectiosn in immunocomp pats

Answer 1

staphylococci and streptococci

Question 2

impetigo is the most common

Answer 2

most common cutaneous bacterial infection in children

Question 3

pathogens in impetigo

Answer 3

staph aureaus and/or group A (b hemolytic strep)

Question 4

how is impetigo contagious

Answer 4

direct contact or auto-inoculation- source is usually intranasal, perianal, or under fingers

–heat, humidity, crowding, poor hygene

Question 5

two variants of impetigo

Answer 5

nonbullous (crusted)

bullous

Question 6

nonbullous impetigo pathogen

Answer 6

staph aureus > strep

Question 7

what does nonbullous look like

Answer 7

honey colored cursts on face, extremities

Question 8

secondary impetigization

Answer 8

skin trauma or disease often preceded infection

Question 9

fever and systemic systems

Answer 9

rare- probs strep (esp if progresses to cellulitis)

Question 10

bullous impetigo

Answer 10

only difference from non-bullus is that pathogens S.aureus, phage II, type 71 produces exotoxin (exfoliatin) that produces vesicles/bullae

Question 11

what hapens when bullous impetigo erupts

Answer 11

shiny, shallow erosions

Question 12

tx of impetigo

Answer 12

topical mupirocin

Question 13

tx of complicated impetigo

Answer 13

penicillinase-resistant penicillins, 1st gen cephalosporin

Question 14

tx recurrent case

Answer 14

target nares, oral abx, bleech bath

Question 15

complications of bacterial skin infections

Answer 15

ecthyma if untreated (deeper skin infection)
GN (esp with strep A)
staphylococcal scalded skin syndrome

Question 16

how does SSSS happen

Answer 16

s aureus II strain producing exofoliating toxins (ET) A, B–>split skin at superficial granular layer

Question 17

SSSS is preceded by

Answer 17

fever and systemic sx

Question 18

clinical picture of SSSS

Answer 18

tender skin
symmetrical sunburn erythema around facial orifices, neck, flexures
skin superficially blisters–>sloughs off–>moist skin, scales

Question 19

how does SSSS heal

Answer 19

without scarring in 10-14 days

Question 20

px in SSSS

Answer 20

good in healthy children

bad for adults with underlying disease

Question 21

to dx SSSS

Answer 21

clinical
you can do culture, but negative culture does not rule out infection because cause could be bacteria secreting toxin from antoher site

Question 22

hot tub folliculitis

Answer 22

p aeruginosa

Question 23

folliculitis

Answer 23

bacterial infection superficial

Question 24

furncle

Answer 24

bacterial infection of entire follicle and surrounding tissue (boil)

Question 25

what is a furncle like

Answer 25

red, warm, painful, nodule

Question 26

carbuncle

Answer 26

multiple coalescing furuncles, deep tissue

Question 27

tx of furnucles

Answer 27

compress and rupture may be enough or may need to drain

Question 28

tx of superficial folliculitis

Answer 28

topical mupirocin and antibacterial soap

Question 29

hot tub folliculitis

Answer 29

ciprofloxacin instead of cephalexin or acetic acid soap

Question 30

what to do if you have a painful duruncle

Answer 30

cultures-could be community acquired mRSA

Question 31

5 haracteristics that increase mrsa transmission

Answer 31

``` crowding skin-skin contact compromised skin (abrasion) contaiminaed surface decreased cleanliness ```

Question 32

tx for MRSA

Answer 32

incision + drain for simple furuncle topical antibiotics, bleach bath abx nasal w/ muciprocin

Question 33

cellulitis

Answer 33

infection of deep dermis and subcutaneous tissues caused by s pyogenes or s aureus

Question 34

how do you get infected by cellulitis

Answer 34

infects skin from inside or outside - -immunocompetent pts: break in skin barrier allows bacterial entry - -immunosupp pts: infection may arise from bloodborne route

Question 35

what can predipsose to recurrent infections

Answer 35

damage to lympahtic system (pts who have had a lymph node dissection for breast cancer or melanoma)

Question 36

clinical presentation cellulitis

Answer 36

red, warm, painful ,swollen ill-defined painful erythema and swelling vesicles and bullae associated fever, chills, malaise

Question 37

dx of cellulitis

Answer 37

clinical appearance | blood culture usually negative

Question 38

tx of cellulitis

Answer 38

oral abx

Question 39

streptococal perianal disese

Answer 39

recurrent bright perianal erythema in otherwise healthy children

Question 40

erysipelas

Answer 40

more superficial cellulitis with significant lympathic involvment s. pyogenes

Question 41

erysipelas sometimes caused by

Answer 41

hemophilus influenza-->facial infection in non-immunized children requires IV antibiotics

Question 42

erysipelas presents as

Answer 42

well-demarcated, painful erythema, rapidly progressive | usually on face with peau d'orange texture

Question 43

necrotizing fasciitis

Answer 43

flesh eating bacteria syndrome- life threatening, rapidly progressive necrotic infection of subcutaneous tissue, fascia

Question 44

most cases of necrotizing fasciitis are..

Answer 44

``` strep s aureus e coli bacteroides clostridium ```

Question 45

underlying illness includes

Answer 45

alcoholism DM vascular disease cardiac disease

Question 46

clinical course of necrotizing fasciitis

Answer 46

resembles cellulitis early on but with severe pain necrosis within 24-36 hours; blue-grey skin- blisters, thin watery discharge systemic illness can be profound usually involves extremities

Question 47

Fournier's gangrene (post-circumcission)

Answer 47

involvment of perineum and genitalia

Question 48

mortality of necrotizing fasciitis

Answer 48

20-40%

Question 49

dx of necrotizing fasciitis

Answer 49

MRI with surgical exploration

Question 50

tx of necrotizing fasciitis

Answer 50

extensive surgical debridement broad spectrum abx hyperbaric oxygen therapy controversial

Question 51

lyme disease

Answer 51

erythema migrans- classic rash

Question 52

borrelia burgdorferi

Answer 52

caused by deer tick

Question 53

complications of lyme

Answer 53

bell's palsy, arthritis, myocarditis, encephalitis

Question 54

tx of lyme

Answer 54

doxycycline for 1 month (10-21 days)

Question 55

syphilis

Answer 55

treponema pallidum

Question 56

how is syphilis transmitted

Answer 56

sexual contact, mother to fetus in utero, blood transfusion, skin contact wtih damage skin

Question 57

four stages of syphilis

Answer 57

primary secondary latent tertiary

Question 58

testing for syphilis

Answer 58

non-treponemal serology (VDRL, RPR)-->treponemal test to confirm + (FTA-ABS)

Question 59

tx of syph

Answer 59

penicillin G benzathine for alls tages