BACTERIAL INFX

Question 1

Skin lesions induced by Gram + staph usually appear as (3)

Answer 1

Pustules, furuncles, honey-colored crusts

• bullae, erythema, desquamation, vegetating pyodermas can also be due to gram staph

Question 2

Two distinctive cutaneous lesions that occur with endocarditis

Answer 2

janeway lesion, osler nodes

Question 3

Painful, erythematous nodule with a pale center lcoated on the fingertips

Answer 3

osler nodes

Question 4

nontender, angular hemorrhagic lesions of the soles and palms

Answer 4

janeway lesion

Question 5

phage type that causes majority of impetigo

Answer 5

types 71 or 55

Question 6

term used to encompass vesicles that might be from a staphylococcal, strep, or combined infection
- characterized by discrete, thin-walled vesicles that rapidly become pustular and then rupture

Answer 6

impetigo contagiosa

Question 7

group A beta hemolytic strep skin infection maybe followed by ___. Important factor predisposing to this disease are the ff serotype of strep (5)

Answer 7

• AGN
• Type 49, 55, 57, 60, M-type 2

Question 8

It is a superficial folliculitis with thin-wall posters at the follicle orifices

Answer 8

superficial pustural folliculitis (impetigo of bockhart)

Question 9

It is a perifollicular, chronic, pusutular staph infection of the bearded region characterized by inflammatory papules and pustules, and a tendency to recur

Answer 9

sycosis vulgaris aka barber’s itch

Question 10

It is an uncommon chronic indolent disorder characterized by nodular, crusted, purulent lesions and sinuses that discharge sulfure granules.

• heals with atropic scars

Answer 10

botryomycosis

Question 11

Most frequent site in tropical disease of pyomyositis is the ___ where as in HIV patients the ____ is most often involved followed closely by the ____

Answer 11

thigh
- deltoid, quadriceps

Question 12

It is a generalized confluence superficially exfoliative disease occurring most often in neonates and children under five years old

Answer 12

SSSS

Question 13

How will you differentiate SSSS from SJS/TEN

Answer 13

involvement of mucouse membrane in sjs/ten
- sjs/ten - skin separates at DEJ
- ssss - granular layer

Question 14

What causes SSSS

Answer 14

Exotoxin type A and B

Question 15

It is an acute febrile multi system illness with one of its major diagnostic criteria being a widespread macular erythematous eruption.

Answer 15

toxic shock syndrome

Question 16

Toxin that causes toxic shock syndrome

Answer 16

TSST-1

Question 17

CDC case def of TSS

Answer 17

-temp >38.9
-erythematous eruption
-desquamation of palms and soles 1-2 wks after onset
- hypotension
- involvement of 3 or more other systems (GI, muscular, mucosa, renal, haptic, hematologic, CNS)
- negative test for rocky mountain, lepto, rubeola
- negative culture of blood, urine, and CSF

Question 18

It is an ulcerative strep or less commonly staph pyoderma.
-the disease begins with a vesicle or vesicopustule which enlargest and in a few days become thickly crusted

Answer 18

Ecthyma

Question 19

a diffuse, erythematous exanthem that occurs during the course of strep pharyngitis
- it affects primarily children who developed the eruption 24 to 48 hours after onset of pharyngeal symptoms

Answer 19

Scarlet fever

Question 20

Symptoms of scarlet fever

Answer 20

Tonsils are red and edematous, covered with exudate
-strawberry tongue with white coating (compared to kawasaki, no exudate)
-cutaneous eruption begins on the neck, then trunk, then ext.
- pastia’s lines - accentuation over the skin fold and a linear but he kill it option

Question 21

Pathogen that causes starlet fever

Answer 21

GAS

Question 22

acute beta-hemolytic Gas infx of the skin involving the superficial dermal lympathics

Answer 22

erisypelas/st.anthony’s fire

Question 23

delayed nonsuppurative sequelae of strep infection includes (3)

Answer 23

erythema nodosum, psgn, rf (only after pharyngitis or tonsillitis)

Question 23

Appears as a spreading patchy erythema that migrates peripherally and often forms polycyclic configurations

Answer 23

erythema marginatum

Question 24

It is characterized by sharply delineated dry brown slightly scaling patches occurring in the intertriginous areas. (axilla genitocrural creases, webs between the fourth and fifth toes)

Answer 24

Erythrasma

Question 25

Causative agent for erythrasma

Answer 25

Corynebacterium minitissimum

Question 26

Corynebacterium triad

Answer 26

erythrasma, pitted keratolysis, trichomycosis

Question 27

Diagnosis of erythrasma

Answer 27

wood’s light - coral red fluorescence

Question 28

tender ulcer, painful inguinal adenitis that may suppurate

Answer 28

chancroid

Question 29

causative agent of chancroid

Answer 29

H. ducreyi

Question 30

DOC for chandroid

Answer 30

azith 1g po
ceftri 250mg im
erythromycin 500mg qid x 7d
cipro 500mg bid x 3d

Question 31

mildly contagious, chronic, granulomatous, locally destructive disease characterized by progressive, indolent, serpingious ulcerations of the groins, pubes, genitalia, and anus
- no lymphadenopathy

Answer 31

granuloma inguinale/donovanosis/granuloma venerum

Question 32

causative agent of granuloma inguinale

Answer 32

k. granulomatis

Question 33

TX for granuloma inguinale

Answer 33

Azith 1g once weekly x 3 weeks
Alt: TMP-SMX 1ds po, cipro 750mg po, doxy 100mg bid, erythro 500mg qid x 2 3 wks

Question 34

suppurative inguinal adenitis with matted LNs, inguinal bubo with secondary ulceration and constitutional symptoms

Answer 34

LGV

Question 35

Due to separation of enlarged inguinal LN from femoral LN by the inguinal ligament seen in LGV

Answer 35

groove sign

Question 36

causative agent of LGV

Answer 36

C. trachomatis

Question 37

DOC for LGV

Answer 37

Doxy 100mg BID x 3 wks
alt: erythro 500mg QID x 21d