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Pharm > Cellulitis and skin tx > Flashcards

Cellulitis and skin tx Flashcards

1
Q

What is cellulitis?

A

Acute, spreading pyogenic inflammation of the dermis and subq tissue

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2
Q

What is cellulitis a complication of?

A

Wound or ulcer

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3
Q

Describe cellulitis feeling.

A

Warm, tender, swollen, and erythematous

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4
Q

Is cellulitis sharply demarcated from unaffected skin?

A

No

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5
Q

Who is affected by impetigo? And when?

A

Children

Hot, humid weather

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6
Q

What are some common signs of impetigo? What are they secondary to?

A

Puritis, scratching

Staph infection

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7
Q

How do you treat impetigo?

A

Benzathine PCN

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8
Q

How do you administer benzathine?

A

Single IM injection

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9
Q

What is staphylococcal scalded skin syndrome (SSSS)?

A

Severe manifestation of S. aureus infection

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10
Q

What is SSSS caused by?

A

Exfoliative exotoxin

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11
Q

Can SSSS produce epidemics? If so, where?

A

Yes, in neonatal nurseries

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12
Q

What is the rate of mortality for SSSS?

A

3%

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13
Q

How do you treat SSSS? What is the name of this drug?

A

Penicillinase resistant PCN

Nafcillin

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14
Q

What is folliculitis?

A

Pyoderma in the hair shafts

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15
Q

What is the etiology of folliculitis?

A

S. aureus
Pseudomonas
Candida

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16
Q

What is the tx for folliculitis?

A

Local/topical abx or antifungals

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17
Q

What is a furuncle?

A

Deep inflammatory nodule

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18
Q

What is a carbuncle?

A

Larger nodule that extends into subQ fat (abscess)

19
Q

What causes furuncles and carbuncles?

A

S. aureus

20
Q

What are predisposing factors for furuncles and carbuncles?

A

Obesity, blood dyscrasias, steroid tx, DM

21
Q

Tx for furuncles and carbuncles

A

Antistaphlococcal abx
Clindamycin 150-300 mg po q6 hours (if PCN allergic)
Vancomycin, linezolid, or daptomycin (MRSA)

22
Q

What were chancriform lesions previously associated with?

A

Wool and animal hides

23
Q

What are chancriform lesions caused by?

A

Spores of Bacillus anthracis

24
Q

Are chancriform lesions painless or painful?

A

Painless

25
Q

What happens to the chancriform lesions as they grow??

A

They become hemorrhagic and necrotic

26
Q

What is the tx for chancriform lesions?

A

Ciprofloxacin 500 mg po q12 h 7-10 days

60 for bioterror

27
Q

What is erysipelas?

A

Its a distinctive type of superficial cellulits

28
Q

What is erysipelas characterized by?

A

Prominent lymphatic involvement

29
Q

Describe the characters of erysipelas.

A

Raised border, sharply demarcated

30
Q

How do you treat early cases of erysipelas?

A

Penicillin
Pen V 250-500 mg po q 6
Erythromycin 250-500 mg po q 6

31
Q

How do you treat extensive or hospitalized cases of erysipelas?

A

Pen G 2 mill units IV q 6
Nafcillin 2g IV q 4
Cefazolin 1-2 g IV q8

32
Q

What are some initiating sources of cellulitis?

A 
Skin trauma
Bites
Wounds
Hot tubs/pools
Edema
33
Q

What % of cellulitis aspirates are gram + organisms, and what are some examples?

A 
80%
S. aureus
Group A or B streptococci
Viridians streptococci
E. faecalis (rare)
34
Q

Are cultures/bx useful for cellulitis?

A

Not really -> only really reveal typical skin flora

They are reserved for special cases

35
Q

For diabetic pts what do you add to tx?

A

Anaerobic coverage

36
Q

What areas does necrotizing fasciitis affect?

A

Extremities, abdominal wall, perianal, and groing

37
Q

What is Fournier’s gangrene?

What is the mortality rate?

A

NF of the genitalia

10-20%

38
Q

What to gangrenous areas look like and feel like?

A

Swollen, hot, and VERY painful

disproportionate pain is important clue

39
Q

Does NF progress slowly or rapidly? And over what period of time?

A

Rapidly over several days

40
Q

What leads to the necrosis?

A

Thrombosed subQ vessels

41
Q

What is something that can proceed NF?

A

Anesthesia

42
Q

What is the mortality rate of NF?

A

20-50%

43
Q

What abx do you give for NF?

A

Ampicillin, gentamicin, clindamycin, and metronidazole

Pharm (32 decks)

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