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host and defense - exam 1 > Exam 1 - Florell - Cutaneous Infections > Flashcards

Exam 1 - Florell - Cutaneous Infections Flashcards

1
Q

What does skin do?

A

Keep insides in and outsides out
-Protects from physical agents including UV light

Renewable, heals from injury

Largest sensory organ

TEMPERATURE REGULATION

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2
Q

What layer of the skin prevents water loss and chemical entry?

A

Stratum corneum

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3
Q

What layer repels physical insults?

A

Dermis

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4
Q

What feature of the skin protects underlying structures from injury?

A

Subcutaneous fat pads

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5
Q

___________ examination of the skin can predict histologic feature.

A

Clinical

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6
Q

_________ is a critical component in diagnosis of skin disease.

A

Histology

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7
Q

There are 4 divisions of cutaneous infections. Name them.

A

Bacterial

Viral

Fungal

Infestation

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8
Q

What are two examples of bacterial infections?

A

Impetigo

Folliculitis

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9
Q

What are three viral infections?

A

Herpesvirus

Molluscum contagiosum

Verruca vulgaris

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10
Q

What are three fungal infections?

A

Tinea versicolor

Tinea corporis

Deep fungal infections

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11
Q

What are two infestations?

A

Scabies

Myiasis

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12
Q

Normal skin flora is composed of aerobic ______, aerobic and anaerobic coryneform bacteria, gram _______ bacteria, and yeats.

A

Cocci

Negative

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13
Q

What is the most common coccus on the skin?

A

Staph epidermidis

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14
Q

What are some aerobic cocci found on skin?

A

S aureus

S saprophyticus

S epidermidis

Micrococcus luteus

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15
Q

A major function of the skin flora is the prevent skin ___________.

A

Infections

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16
Q

How does the skin prevent infections?

A

Ecological competition for microorganisms

Hydrolyzing lipid (sebum) produce free fatty acids which are toxic to many bacteria

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17
Q

Most cutaneous infections are caused by?

A

STAPH AUREUS

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18
Q

Honey yellow crusts around mouth/on face?

A

IMPETIGO

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19
Q

Impetigo involves which layers of the skin?

A

Epidermis

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20
Q

Impetigo is caused by what bacteria?

A

Staphylococcal (50-70%), strep, or mixed infection

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21
Q

What happens with impetigo?

A

Thin-walled vesicles become pustular and rupture (dead neutrophils) - leads to straw colored discharge that dries to form gold-yellow crusts

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22
Q

Treatment for impetigo?

A

Antibiotic ointment

Possible systemic antibiotic

23
Q

What is folliculitis?

A

Inflammation of the hair follicle - dome-shaped pustules around hair follicles

Can be bacterial, fungal, or viral

Usually bacterial - Staph aureus is most common

24
Q

Treatment of folliculitis?

A

Antibacterial soap

Topical or systemic antibiotics

25
Q

Viruses are obligatory ____________ parasites.

A

Intracellular

26
Q

A virus consists of what?

A

Central core of nucleic acid

Protein coat (capsid)

Sometimes an envelope

27
Q

DNA viruses include what and what cells do they infect in the cutaneous tissue?

A

Herpesviruse, poxvirus, papovavirus (warts)

Infect keratinocytes

28
Q

RNA viruses include what and infect what cell in the cutaneous tissue?

A

Retroviruses (HIV, HTLV)

Infect CD4+ T-lymphocytes

29
Q

Vesicular applies developed on an erythematous base, confined to a specific dermatome?

A

Shingles

*Herpesvirus

**Can be confirmed with a Tzanck smear

30
Q

A Tzanck smear, what is a positive result, and what is a negative result?

A

Positive: Multi-uncleared keratinocytes, peripheral margin inaction of chromatin (ground-glass appearance)

Negative: This is a problem, re-test ??

31
Q

What is the Herpes (Varicella) Zoster?

A

Reactivation of varicella zoster virus (chicken pox)
-After first infection, VZV remains latent in DRG cells

Immunosuppression, and/or age risk factors = viral replication and travel down sensory nerve into skin (which means it is usually confined to a single dermatome

32
Q

Symptoms of shingles?

A

One to several days of pain, then papules of erythema, then vesicles and crusts

Treatment: Antivirals

33
Q

Describe the Herpesvirus?

A

DSDNA

Herpes simplex type 1 and 2

Examples: Varicella, cytomegalovirus, Epstein-Barr

Causes: Herpes labialis, genital herpes, herpetic whitlow (happens to dentists that are exposed to oral herpes), eczema herpeticum (this is one is life threatening)

34
Q

Tell me about Oral Hairy Leukoplakia.

A

Associated with Epstein-Barr Virus

Occurs most commonly in HIV-infected patients, but can also be seen in other immunodeficiency states

Treatment: Low morbidity, no treatment necessary, but antivirals like acyclovir, valacyclovir, or famciclovir may help

35
Q

What virus causes molluscum contagiosum?

A

Poxvirus

36
Q

Who is primarily affected by the poxvirus and how is it transmitted?

A

Young children, sexually-active adults, systemic T-cell immunosuppression (HIV)

Transmitted by direct skin-to-skin contact, esp. if the skin is wet

37
Q

How can molluscum be confirmed and what is the treatment?

A

HISTO - Henderson-Paterson bodies

Treatment: It resolves itself w/in 2 years

38
Q

What are the following?

Verruca vulgaris?

Verruca plantaris?

Verruca plana?

Condyloma?

A

Common wart

Warts on balls of feet

Warts on arm

Genital warts

39
Q

If a rash is scaly, what should be done?

A

KOH prep looking for fungal elements

40
Q

What is the most common site for tinea versicolor to infect?

A

This is a fungus

Upper trunk is most common

*Excess heat and humidity predispose the area

Treatment: Topical or systemic antifungal agents

41
Q

What does annular mean?

A

Having the form of a ring

42
Q

Dermatophyes can only survive on what?

A

Dead keratin - skin or hair or nails

*Cannot survive in mouth or vagina where the startup corneum does not form

**Tx is oral or topical antifungal agents

43
Q

What forms the “Mariner’s Wheel?”

A

Paracoccidiomycosis

44
Q

What does umbilicate mean?

A

Having an umbilicus or navel

Central depression

45
Q

What does vulgaris mean?

A

Being of the usual type; common

46
Q

Paracoccidioidomycosis is what and how is it treated?

A

Deep fungal infection

  • Manifestation of a systemic infection
  • Introduced via puncture, abrasion, or trauma
  • Types: coccidiomycosis - SW US, paracoccidoidomycosis - South America, Histoplasmosis - Central US, North American blastomycosis, etc.

**Tx - Systemic antifungal agents

47
Q

Most opportunistic fungal disease is seen in pts with what?

A

Leukemia or other hematologic neoplasia

48
Q

What is a key risk factor for invasive deep fungal infection?

A

Neutropenia

-Also prolonged corticosteroid therapy, and solid organ transplantation

49
Q

What are some life threatening infections?

A

Candidiasis

Aspergillosis

**Tx - Systemic antifungal agents

50
Q

What layer of the skin can scabies mites be found?

A

Stratum corneum

51
Q

What are scabies?

A

Itch mite - intense itching

Oval, flat mite with dorsal spines

Female deposits eggs in stratum corneum

Contracted by contact, contaminated linens

**Tx - Permethrin 5% cream, oral ivermectin

52
Q

What symptoms does scabies cause?

A

Popular lesions, burrows, excoriations.

Found on finger webs, wrists, hands, groins - Circle of Hebra

53
Q

What is the Circle of Hebra?

A

Anatomic circle encompassing the axillae, elbow flexures, wrists, hands, and genital region

54
Q

What is myiasis?

A

Infestation of human tissue by fly larvae

Most commonly caused by the human botfly - female glues eggs to the body of mosquito, stablefly, or tick

When the vector bites a human, larvae emerge and enter the puncture

Larvae grow quite large and are removed via injection and scalpel or petrolatum

host and defense - exam 1 (14 decks)

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