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YEAR 3 & 5 CORE CONDITIONS > Dermatology 2 (infections) > Flashcards

Dermatology 2 (infections) Flashcards

1
Q

Who does impetigo usually affect?

A

Children

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2
Q

Which bacteria cause impetigo?

A

Staph aureus

Strep pyogenes

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3
Q

Which bacteria is more common in tropical areas?

A

Streptococcal - more common in warmer/humid climates

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4
Q

What are the 2 types of presentation of impetigo?

A

Non-bullous

  • tiny pustules/vesicles that rapidly evolve
  • honey crusted plaques
  • satellite lesions due to autoinoculation

Bullous

  • thin roof, easily rupture
  • painful
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5
Q

How do you treat impetigo?

A

Flucloxacillin or clarithromycin (especially if bullous)

Good hygiene

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6
Q

What is a complication of impetigo?

A

Staphylococcal scalded skin syndrome (when S. aureus releases epidermolytic toxins)

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7
Q

What are the main risk factors of cellulitis?

A 
Diabetes
Cancer
Immunodeficiency
Venous insufficiency 
Obesity
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8
Q

Which bacteria most commonly cause cellulitis?

A

Staphylococcus aureus
Group A beta-haemolytic streptococci (e.g. Strep pyogenes)
Clostridium perfringens - surgical wounds

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9
Q

Suggest appropriate therapy for each of the following:

a) Staphylococcus aureus
b) Streptococcus pyogenes
c) MRSA -

A

a) Staphylococcus aureus - flucloxacillin or vancomycin/clarithromycin in allergy
b) Streptococcus pyogenes - IV benzylpenicillin with oral switch to amoxicillin after 48 hrs or clarithromycin/clindamycin/vancomycin
c) MRSA - vancomycin with oral switch to clarithromycin, tetracycline or linezolid

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10
Q

What would the area look/feel like? What area of body is usually affected?

A

Erythema, swelling, warmth, pain

Lower limb

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11
Q

What additional presentation would be seen in clostridium perfringens cellulitis?

A

Crepitus (anaerobic organism)

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12
Q

What are some complications of cellulitis if left untreated?

A

Abscess
Gangrene
Necrotising fasciitis
Osteomyelitis

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13
Q

What organisms cause folliculitis?

A

Bacterial - S. aureus
Fungal - Pityrosprorum ovale
Virus - HSV, herpes zoster

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14
Q

What causes scabies?

A

Parasitic infection of sarcoptes scabiei mite that deposits eggs into epidermal burrow

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15
Q

What are the symptoms of scabies? Where are the symptoms usually felt?

A

Intensely pruritic papular eruption

Especially in interdigital and flexural creases

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16
Q

When are the symptoms of scabies worse?

A

at night or after a hot bath/shower

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17
Q

How do you treat scabies?

A

Permethrin - topical over the whole body

Antihistamines

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18
Q

How can you diagnose scabies?

A

Ink burrow test - with a marker pen draw along any bumps then wipe the pen away. If there are scabies, lines of ink will remain in the burrows.

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19
Q

What is the difference between HSV1 and HSV2?

A

HSV1 - oral infections e.g. cold scores (however can cause genital infection if transferred from cold sores)
HSV2 - primarily genital infection

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20
Q

Is herpes simplex curable?

A

No it is a life-long latent systemic infection. It lies dormant in CNS sensory ganglia.

21
Q

What can cause reactivation of herpes simplex?

A

Reactivation from CNS sensory ganglia due to:

  • Injury
  • UV light
  • Stress
  • Hormones
22
Q

How does HSV2 present?

A

Initial prodrome - fever, headache, malaise
Discharge, oedema, dysuria
Many painful blisters
Tender bilateral lymphadenitis

23
Q

What is the incubation time for HSV2?

A

3-7 days

24
Q

What CNS conditions can herpes simplex viruses cause?

A

HSV-1 - encephalitis

HSV-2 - meningitis

25
Q

What is the treatment for herpes simplex virus?

A

Aciclovir

26
Q

What virus is chickenpox caused by?

A

Varicella zoster virus = HHV-3

27
Q

What is the incubation period for VZV and when is someone infectious?

A

Incubation period: 14 days (1-3 weeks)

Infectious 1-2 days before symptoms and 5 days after onset

28
Q

Describe a chicken pox rash

A

Starts with small erythematous macules, that progress to papules and finally clear vesicles. The vesicles burst and crust over.

Highly pruritic
Limb sparing

29
Q

Who should avoid contact with someone with chickenpox?

A

Pregnant women

Give them Ig if they are not immune

30
Q

What are some serious complications of chickenpox?

A

Viral pneumonia

Encephalitis

31
Q

What virus is shingles caused by?

A

Herpes Zoster i.e. reactivation of varicella zoster virus from CNS sensory ganglia

32
Q

How does shingles present?

A

Prodrome = burning, itching, paraesthesia, malaise

Eruptive phase = acute neuritic pain, vesicles and erythematous swellings affecting an isolated dermatome

33
Q

How long is shingles infectious for?

A

Until all vesicles have crusted over

34
Q

Where would a shingles infection cause more serious problems?

A

Ophthalmic VZV can cause blindness

Facial nerve -> Ramsay-Hunt syndrome which can cause facial paralysis and hearing loss in affected ear (due to proximity of vestibulocochlear nerve)

35
Q

What virus causes molluscum contagiosum and which subtype is most common?

A

MCV (a pox virus)

4 subtypes - MCV1 is most common

36
Q

What is the incubation period for MCV?

A

2-12 weeks

37
Q

How does molluscum contagiosum present?

A

Dome-shaped, flesh-coloured or pearly white papules with central umbilication distributed in clusters

38
Q

What fungal infection causes patches of altered skin pigmentation?

A

Pityriasis versicolor caused by Malassezia yeasts

39
Q

What parts of the body are most commonly affected by pityriasis versicolor?

A

Sebum-rich sites e.g. back, chest, face, upper arms

40
Q

Aside from altered pigmentation, what else might be present in pityriasis versicolor?

A

Superficial fine powdery scale (can be seen by stretching the skin)

41
Q

What is first-line treatment for pityriasis versicolor?

A

Antifungal shampoo e.g. ketoconazole shampoo

42
Q

What can occur due to poor steroid inhaler technique? What does it look like?

A

Oral candidiasis

Patches of curd-like, white/yellow plaques on tongue and palate

43
Q

Which type of Candida causes oral and vaginal candidiasis?

A

Candida albicans

44
Q

How does vaginal candidiasis present?

A

Itching, soreness, inflammation, discharge, dyspareunia (pain on intercourse), dysuria

45
Q

Who is particularly at risk of recurrent candida infections?

A

Immunocompromised
Antibiotic use
Diabetics

46
Q

What causes ring-shaped lesions with red scaly border and clear centre?

A

Tinea corporis

AKA ring-worm

47
Q

Who gets tinea pedis and what does it look like?

A

‘Athlete’s foot’ - moist environment and laceration of skin

White, cracked, softened areas between toes
Diffuse scaling on sole/side of foot
Inflammatory vesicobullous eruption on soles

48
Q

What is the fungal infection of a nail called?

A

Tinea unquium

49
Q

What can be used to detect fungal infections?

A

Wood’s light = UV light

Causes fungus to fluoresce

YEAR 3 & 5 CORE CONDITIONS (30 decks)

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