DLA8, DLA10- Skin Overview and Infections Flashcards

1
Q

list the 5 layers of epidermis

A
(superficial to deep)
-stratum corneum
(-stratum lucidum, thick skin only)
-stratum granulosum
-stratum spinosum
-stratum basale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

list the natural defense mechanisms of the skin

A
  • keratin
  • AMPs (antimicrobial peptides) host defense
  • skin sloughing
  • Sebum: low pH, lipids (sphinoid bases)
  • Sweat: low pH, high salt, lysozymes (peptidoglycan disruption)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

(1) and (2) are common infections related to poor hygeine

A
  • impetigo

- furuncles = clustered boils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

____ is a common disease contracted from beaches or soil in tropical areas

A

cutaneous larva migrans (nematodes, hookworms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

primary skin infections are caused by (1) to affect (2); examples include: (3)

A

(primary pyodermas)
1- single pathogen
2- normal skin
3- S. aureus, β-hemolytis streptococci, coryneform bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary skin infections are defined as (1), caused by (2).

A

(secondary pyoderma)
1- infection of existing skin lesion (ex. insect bites, scratching, cracks, etc)
2- mix of infectious and non-infectious causes: scabies, psoriasis, poison ivy, atopic dermatitis, eczema, herpeticum, kerion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe mechanism of ‘athletes’s foot’

A
  • toe web infection – secondary pyoderma
  • 1st thought to only be fungal infection
  • Now thought dermatophytes (fungi) first must cause skin damage
  • this allows bacterial growth of coryneform bacteria and brevibacterium (& Gram-)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

compare macule, nodule, papule

A
  • Macule: patch of skin altered in color, no elevation —- if >1cm diameter = patch
  • Papule: small, solid, conical elevation of skin
  • Nodule (tumor): small mass, rounded/irregular shape, palpable (slightly larger and extend deeper than papules)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

define skin patch

A
  • a macule >1 cm in diameter
  • skin color alteration
  • no elevation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

define a bulla/vesicle (includ subtypes)

A
  • small, abnormal elevation of outer layer of skin enclosing watery liquid
  • Blister/Vesicle = 1-5 mm in diameter
  • Bullae > 5 mm in diameter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

examples of vesicle and bullae diseases

A

Vesicles: chickenpox (VVZ), oral herpes (HSV1), hand/foot/mouth disease

Bullae: bullous impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

define a pustule and its associated diseases

A
  • small circumscribed elevation of skin containing pus w/ inflamed base
  • acne, chickenpox (VVZ), smallpox
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

(T/F) pustules are always associated with hair follicles

A

F- they usually are, but not always

ex: folliculite, boils, chickenpox (VVZ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

define wheal (include examples)

A
  • localized area of edema, usually irregular and variable in size and color
  • ex: hive, insect bite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

list the primary skin lesions

A

macule, papule, nodule, vesicle, bulla, pustule, wheal, plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

list the secondary skin lesions

A

scale, crust, fissure, ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

define plaque (include examples)

A
  • large, flat, elevated, solid surface

- ex: psoriasis

18
Q

define scale (include examples)

A
  • thin/thick flake of skin varying in color
  • secondary to desquamated, dead epithelium
  • ex: dandruff
19
Q

define crust (include examples)

A
  • dried residue of exudate

- ex: impetigo residue

20
Q

define fissure (include examples)

A
  • linear crack in skin

- ex: athlete’s foot

21
Q

define ulcer (include examples)

A
  • opening of skin caused by sloughing necrotic tissue
  • extends past epidermis
  • ex: pressure ulcer, stasis ulcer
22
Q

impetigo is a (primary/secondary) pyoderma caused by (2)

A

1- primary

2- S. aureus, Grp. A Strep

23
Q

cellulitis/erysipelas are a (primary/secondary) pyoderma caused by (2)

A

1- primary

2- Grp. A Strep

24
Q

folliculitis is a (primary/secondary) pyoderma caused by (2)

A

1- primary

2- S. aureus, pseudomonas aeruginosa

25
Q

erysipeloid is a (primary/secondary) pyoderma caused by (2)

A

1- primary

2- erysipelothrix rhusiopathiae

26
Q

erythrasma is a (primary/secondary) pyoderma caused by (2)

A

1- primary

2- corynebacterium minutissium

27
Q

intertrigo is a (primary/secondary) pyoderma caused by (2)

A

1- secondary

2- usual skin flora

28
Q

psuedofolliculitis of the beard is a (primary/secondary) pyoderma caused by (2)

A

1- secondary

2- usual skin flora

29
Q

furuncles/carbuncles are a (primary/secondary) pyoderma caused by (2)

A

1- primary

2- S. aureus

30
Q

describe differentiating between Streptococcus and Staphylococcus by microscopy

A

Staph (aureus): Gram+, grape-like clusters, Catalase+, yellow pigment on blood agar (β-hemolytic), penicillin G resistant

Strep (group A, S. pyogenes): Gram+, chain arrangement, Catalase-, no pigment production (although β-hemolysis), penicillin G sensitive

31
Q

Staphylococcus:

  • Gram (+/-)
  • (non-/motile)
  • catalase (+/-)
  • oxidase (+/-)
  • (aerobic/facultative anaerobic/obligate anaerobic)
  • (high/moderate/low) salt tolerance
A

-Gram+
-non-motile (no flagella)
-catalase+
-oxidase-
-aerobic, some are facultative anaerobic
-high salt tolerance (mannitol salt+, good for sweaty skin)
(some are β-hemolytic on blood agar)

32
Q

what are and how are the Staphylococcus species divided

A

Coagulase+: S. aureus

Coagulase-: most remaining medically relevant Staph

33
Q

what are and how are the Streptococcus species divided [include where Group A species fall into]

A
  • α-hemolytic (partial): pneumoniae, viridans
  • β-hemolytic (complete): pyogenes (Group A, bactracin sensitive), agalactiae (grp. B, bact. resist.)
  • γ-hemolytic (none): enterococcus
34
Q

S. pyogenes, aka (1), are (α/β/γ)-hemolytic and bacitracin (sensitive/resistant)

A

1- group A strep.
2- β-hemolytic
3- bacitracin sensitive

35
Q

describe the method and purpose of PYR test

A

(pyrrolidonyl arylamidase)

  • identification of β-hemolytic Group A/S. pyogenes (+) and enterococci
  • Note: β-hemolysis –> PYR => + for grp.A/S. pyogenes (bacitracin sensitive) and - for grp. B/S. agalactiae (bacitracin resistant)
  • positive test is bright red, negative is no color change/rxn
36
Q

describe the agars used for C. perfringes

A
  • Blood agar: β-hemolysis with outer layer of α-hemolysis (double zone)
  • EYA (egg yolk agar): 1) Lecithinase (phospholipase toxin) => white opaque zone around colonies, 2) Lipase => pearly, iridescent sheen to colonies
37
Q

(1) test is used to differentiate C. perfringes after a (2)+ test on a (3) agar. The (3) plates is divided in halves with (4), and a positive result is if (5) occurs.

A
1- Nagler test
2- lecithinase+ (clostridium spp)
3- EYA (egg yolk agar)
4- type A antitoxin (and a side w/o)
5- toxin is produced on non-antitoxin side, seen as cloudiness
38
Q

how is a dermatophytic infection identified

A
  • scraping skin scales / infected nails (aspirate if needed)

- mix sample with KOH on slide –> only the hyphae structure remains

39
Q

list the diagnostic tests for Mycobacterial skin infections

A
  • Ziehl-Neelson / Acid-fast stain
  • growth on Lowenstein-Jensen agar (4-8 wks)
  • growth speed
  • pigment production (light/dark)
  • sequencing of rpoB, hsp65 genes (gold standard)
  • NAAT
40
Q

describe the test used to determine erysipelothrix rhusiopathiae infection

A

(erysipeloid)

  • H2S production test
  • does microbe reduce S-containing compounds to Sulfides
  • add Fe compounds –> sulfide production is positive if solution has black precipitate
41
Q

Bone and joint infections usually require (1) as investigation and (2) therapy over (3) amount of time

A

1- analysis of fluid in joint or bone by culture (infectious arthritis, osteomyelitis) [note- radiography will be helpful]
2- antimicrobial therapy
3- wks-mos