Chapter 16: Infectious Diseases Affecting the Skin: Part 2

Question 1

SSSS

Answer 1

Staphylococcal scalded skin syndrome

Question 2

Scalded skin syndrome is a _____ mediated disease

Answer 2

Toxin

Question 3

SSSS occurs primarily in ______ and can be potentially ______

Answer 3

Infants

Fatal

Question 4

SSSS is AKA

Answer 4

Ritter’s Disease

Question 5

Symptoms of SSSS

Answer 5

Skin appears to be burned (scalded)
Begins as generalized redness
Malaise
Irritability 
Fever

Question 6

What may occur in SSSS before other indicators become present?

Answer 6

Nose, mouth and genitalia may be painful

Question 7

Within 48 hours of infection of SSSS…

Answer 7

Symptoms manifest

• Skin becomes red and wrinkled
• Large fluid-filled blisters appear
• Skin is tender to the touch and may feel like sandpaper

Question 8

Causative agent of SSSS

Answer 8

Staphylococcus aureus

Question 9

What is the disease of SSSS due to?

Answer 9

The production of toxins produced by S. aureus

Question 10

SSSS staphylococcal toxins are called..

Answer 10

Exfoliatins

Question 11

What do exfoliating do?

Answer 11

Destroy integral layers of the outer epidermis (breaks linkages between spinosum and granulosum)

Question 12

Toxins are coded either by _____ or on the _______

Answer 12

Plasmid

Bacterial chromosome

Question 13

Staphylococcus aureus is gram….

Answer 13

Positive

Question 14

First step in pathogenesis of SSSS

Answer 14

Toxin is released at the site of the infection, absorbed and carried by the bloodstream to larger areas of skin

Question 15

After the toxin is carried by the bloodstream in SSSS, what happens?

Answer 15

Toxin causes split in epidermis, split occurs just below the dead keratinized outer layer of epidermis

Question 16

What happens after the toxin causes a split in the epidermis in SSSS?

Answer 16

Outer layer of skin is lost

Question 17

What does a loss of the outer layer of skin cause?

Answer 17

Caused marked body fluid loss and increases susceptibility to secondary infection

Question 18

SSSS mortality rates can reach..

Answer 18

40%

Question 19

SSSS disease outcome depends on…

Answer 19

Prompt diagnosis, prompt treatment, patient age, overall health of patient

Question 20

Why is SSSS primarily a disease of infants?

Answer 20

Receptor for bacteria is more common in skin of infants

Question 21

__% of S aureus strains produce exfoliatins

Answer 21

5

Question 22

Transmission of SSSS is usually….

Answer 22

Person to person

Question 23

SSSS is usually isolated, but…

Answer 23

Small epidemics can occur in nurseries

Question 24

Only preventative measure for SSSS

Answer 24

Patient isolation

Question 25

Patient isolation is important because it..

Answer 25

• Helps limit spread of bacterial agent

- Limits exposure to potential secondary pathogens

Question 26

Treatment (primary) of SSSS

Answer 26

Bactericidal antibiotics

-Antistaphylococcals like penicillinase resistant penicillin

Question 27

Other treatment of SSSS

Answer 27

Removal of dead skin to prevent secondary infection

Question 28

Chickenpox is the popular name for..

Answer 28

Varicella (zoster)

Question 29

What is one of the most common rashes among children?

Answer 29

Chickenpox

Question 30

The incidence of chickenpox has..

Answer 30

declined due to vaccine

Question 31

Chicken pox produces a…

Answer 31

Latent infection that becomes reactive after recovery of initial illness

Question 32

Shingles

Answer 32

Secondary portion of chickenpox

Question 33

Most cases of chickenpox are..

Answer 33

Mild and recovery is uneventful

Question 34

Symptoms of chickenpox are more severe in..

Answer 34

Older children and adults (20% of adults develop pneumonia)

Question 35

Chickenpox: skin rash appears on..

Answer 35

Back of head, face and mouth

Question 36

Chickenpox rash is diagnostic..

Answer 36

Maculopapular rash

Question 37

Progression of chickenpox rash

Answer 37

Progresses from red spots called macules to small bumps called papuales to small blisters called vesicles to pus filled blisters called pustules

Question 38

Lesions of chickenpox..

Answer 38

Itch and appear different at times

Question 39

Healing of chickenpox begins..

Answer 39

After pustules break and crust over

Question 40

Varicella infection is a major threat to newborns because it may lead to..

Answer 40

Congenital varicella syndrome, can lead to major birth defects (malformation of hands/feet, eyes, skin, neurological damage)

Question 41

Sequella

Answer 41

Condition as a result of a previous infection

Question 42

Sequella of chickenpox

Answer 42

Shingles

Reye’s Syndrome

Question 43

Shingles

Answer 43

Caused by reactivation of dormant virus, characterized by rash around waist

Question 44

Shingles is AKA

Answer 44

Herpes zoster

Question 45

Reactivation of chickenpox virus (shingles) usually is along..

Answer 45

One dermatome on one side of the body

Question 46

What things can cause shingles (reactivation)?

Answer 46

Decrease in cytotoxic T cells or stress

Question 47

Reye’s Syndrome

Answer 47

Condition evident by vomiting and coma

Question 48

Reye’s síndrome eis predominantly seen in..

Answer 48

Children 5 to 15

Question 49

Reye’s Syndrome is characterized by..

Answer 49

Liver and brain change

Question 50

Mortality of Reye’s Syndrome

Answer 50

30%

Question 51

Is Reye’s Syndrome directly correlated to chickenpox?

Answer 51

No, evidence suggests aspirin therapy increases risk