case 8 Flashcards

1
Q

what does antibiotic choice for treating cellulitis depend on?

A
  • whether it’s a reccurrent infection
  • contamination level e.g. by seawater
  • site e.g. eyes/nose
  • is it an atypical infection?
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2
Q

what is clostridium?

A

genus of gram +ve bacteria, has many species that are important human pathogens including c.difficile.

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3
Q

what does a maculopapular rash consist of?

A

macules (flat lesions) and papules (solid raised lesions).

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4
Q

how do you classify flat lesions?

A

macules- <1.5cm

patches- >1.5cm

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5
Q

how do you classify solid raised lesions?

A

papules- <0.5cm

plaques- >0.5cm

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6
Q

what family causes measles?

A

Paramyxoviridae family

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7
Q

what is a prodrome?

A

early sign or symptom

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8
Q

what are the prodromes of measles?

A

high fever

3Cs-cough, coryza, conjunctivitis

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9
Q

what family causes rubella?

A

Paramyxoviridae family

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10
Q

what are the (early+later) symptoms of rubella?

A

lymphadenopathy-head and neck

then: maculopapular rash-face→trunk→limbs

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11
Q

what are some other terms for the parvovirus b19 infection?

A

Erythema Infectiosum
Fifth disease
Slapped cheek disease

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12
Q

what are the symptoms of parvovirus b19?

A

prodromes: fever, coryza, nausea
then: slapped cheek rash, maculopapular rash-trunk, arthritis

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13
Q

what are the main things that cause a viral maculopapular rash?

A
measles
rubella
parvovirus b19
roseola infantum
enteroviruses
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14
Q

what causes roseola infantum?

A

HHV6/7 (human herpes virus)

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15
Q

what is an example of an enterovirus?

A

coxsackie A

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16
Q

wtf is a vesicle?

A

raised, clear, fluid filled lesion <0.5cm

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17
Q

what is a bulla?

A

raised, clear, fluid filled lesion >0.5cm

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18
Q

what does HSV stand for ?

A

herpes simplex virus

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19
Q

what do HSV1 and HSV2 cause?

A

HSV1: oral or genital herpes
HSV2: genital herpes

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20
Q

what are the types of herpes simplex?

A

2 types: HSV1 and HSV2

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21
Q

what diseases does VZV cause?

A

chickenpox and shingles

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22
Q

what does VZV stand for?

A

Varicella zoster virus

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23
Q

who does chickenpox usually occur in?

A

children

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24
Q

who is shingles more common in?

A

adults and immunosuppressed

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25
what is shingles caused by?
reactivation of the virus that causes chickenpox-can happen anytime after the initial infection.
26
what are the main causes of viral vesicular rash?
herpes simplex varicella zoster virus enterovirus poxvirus
27
what is a purpuric rash?
red or purple, non blanching
28
when does Henoch-Schonlein purpura usually occur?
childhood
29
what causes Henoch-Schonlein purpura?
IgA immune complexes-present in small blood vessel walls-triggers inflammation.
30
what are the main cutaneous signs of polyarteritis nodosa?
``` tender papules and plaques purpura livedo reticularis skin necrosis ulceration ```
31
what are purpura?
purple, non blanching lesions
32
what are some endocrine disorders that can cause skin diseases?
diabetic dermopathy Acanthosis Nigricans Eruptive Xanthomatosis Necrobiosis lipoidica diabeticorum (NLD)
33
diabetic dermopathy: cause, where does it happen, treatment?
no known cause-associated w damage to small blood vessels+nerves that happens w diabetes over bony areas no treatment required
34
what are the causes of Acanthosis Nigricans?
visualisation of insulin resistance | also: certain medication, GI cancers
35
what is the cause and treatment of Eruptive Xanthomatosis?
uncontrolled type 1 diabetes and raised triglycerides-manage their diabetes
36
who does Eruptive Xanthomatosis often occur in?
young men
37
who does Necrobiosis lipoidica diabeticorum (NLD) mainly occur in?
women, but it's v rare.
38
how do you treat Necrobiosis lipoidica diabeticorum (NLD)?
no treatment required unless it's an open sore.
39
what is a pustule?
elevated lesion containing purulent fluid which might be white, yellow or green in colour (pus)
40
what is the time scale for acne drugs?
treatments can take up to 8 weeks to work | have to continue them for at least 12 weeks
41
what does teratogenic mean?
when a drug/agent can disturb development of a fetus and can cause malformation or even death
42
what are the general side effects of acne medications?
dry skin skin thinning mood swings depression
43
what is an extensor surface?
area of skin outside a joint-eg front of knee
44
what are flexor surfaces?
where folded skin touch-inside a joint-opposite the extensor surfaces. eg back of knee
45
DEFINE infection.
Inflammatory response to microorganisms or invasion of normally sterile tissues
46
DEFINE bacteraemia.
Presence of bacteria in the blood
47
DEFINE sepsis.
life-threatening organ dysfunction caused by a dysregulated host response to infection
48
what are the criteria for septic shock?
persisting hypotension despite fluid correction and vasopressors hyperlactaemia-serum lactate>2mmol/L
49
why is identifying sepsis important?
can be triggered by any infection as hours without antibiotics goes up, survival rate goes down rapid progression
50
what are the 3 most common bacterias that cause sepsis?
staph aureus e.coli pseudomonas spp
51
When a patient goes into septic shock they can have raised blood glucose through the actions of...
cortisol catecholamines CRP (c reactive protein)
52
in the gram stain, which colour is positive and which is negative?
purple=positive | pink=negative
53
what gram type is more susceptible to beta lactams and why?
gram positive=because they target the cell wall.
54
what are 2 examples of antibiotics which target the bacterial cell membrane structures?
polymyxins | daptomycin
55
what are 2 examples of antibiotics which target bacterial folic acid metabolism?
trimethoprim | sulfonamides
56
what are 3 examples of vasopressors?
noradrenaline vasopressin metaraminol
57
what is the process of increased keratin production and migration toward the external surface called?
cornification
58
what is flexural psoriasis?
psoriasis found in the folds of ur body.
59
what type of skin has a lower concentration of touch receptors?
hairy (thin)
60
what are differences in sensitivity of different parts of skin related to?
differences to underlying neurophysiology.
61
where exactly are the Meissner's corpuscles found?
Sitting in the dermal papilla
62
what is the embryological origin of the epidermis?
ectodermal
63
what do keratinocytes do?
produce keratin (a fibrous protein)
64
what is palmoplantar skin?
on palms and soles
65
why is palmoplantar skin so much lighter than nonpalmoplantar skin?
melanocyte density is five times lower.
66
what is the most commonly diagnosed cancer worldwide?
skin
67
what are NMSCs?
non melanoma skin cancers-from basal cells (BCC) or keratinocytes (squamous cell carcinoma)
68
what are the 3 key ways transformation into cancer can occur?
chemical carcinogens radiation viral oncogenes
69
what is a virulence factor of streptococcus pyogenes in the development of sepsis?
Protein F-facilitates attachment to various host cells in streptococcus pyogenes.
70
what does seborrheic refer to?
the sebaceous glands-diseases characterized by excessive secretion of sebum or an alteration in its quality, resulting in an oily coating, crusts, or scales on the skin.