HIGH YIELD III

Question 1

marked pain out of proportion to local finding

bullae/blistering

tissue necrosis or ecchymosis

gas in soft tissues

Answer 1

necrotizing fasciitis

Question 2

these organisms are responsible for necrotizing fasciitis?

Answer 2

strept group A,C,G

aggressive: group B beta hemolytic strep

C perfringens
B fragilis

Question 3

when should surgery be considered for Nec Fasc?

Answer 3

no response
hypotension, fever
advancement of infection
skin necrosis
gas in tissue

Question 4

what type of nec fasc is this?

inv of muscle
LE, diabetes, obesity
systemic toxicity, watery, red-brown
mixed aerobic/anaerobic infection
tx: surgical debridement and IV abx

Answer 4

synergistic nec celliulits

Question 5

nec infection that involves muscle

C perfringins is a pathogen

open fractures and crash injuries

palpation may elicit crepitus

tx: surgery, IV Abs

Answer 5

clostridial myonecrosis

“gas gangrene”

Question 6

lab testing for nec fasc?

Answer 6

CBC w/ dif
BMP, CMP
ESR > 70mm/hr (lactate and procalcitonin)
gram stain
culture and sensitivity

Question 7

predominant pathogens in diabetic foot infections?

Answer 7

aerobic gram positive cocci (staph aureus)

Question 8

diabetic foot infection considerations?

Answer 8

not every wound is cultured

culture before starting empirical antibiotic therapy in the case of clinical infection

specimens obtained via:
-biopsy, ulcer curettage, aspiration

***plain radiography

categorized

clincally uninfected ulcers

Question 9

how are foot infections categorized?

Answer 9

tissues
arterial perfusion adequacy
presence of systemic toxicity

Question 10

diabetic foot infections aimed at treating?

Answer 10

aerobic gram positive cocci

Question 11

diabetic foot infection tx like broad spectrum empirical therapy is indicated for?

considerations?

definitive therapy is based on?

Answer 11

severe infecitions

abx therapy and antibiotic susceptibility data

C and S data and clinical response

Question 12

diabetic foot therapy?

Answer 12

debridement
off loading
local wound care
vascular status

Question 13

this is what kind of infection?

no symptoms
dry, flaky skin
often resistant to topical medications
most common pathogen: Trichophyton rubrum

Answer 13

fungal infections

Question 14

fungal live in nail bed
must confirm infection with KOH test, culture, or PAS stain
oral antifungals

Answer 14

onychomycosis

Question 15

this drug has an interaction with tamoxifen

should not be prescribed for patients with SLE

Answer 15

terbinafine

Question 16

what is this infection?

initially a fungal infection
secondary bacterial infection with gram neg aerobes
oral and topical antibiotics
oral antifungals
betadine/spacers

Answer 16

gram negative dermatophytosis

Question 17

how are parasitic infections like cutanea larva migrans treated?

Answer 17

ivermectin

thiabendazole

Question 18

most common viral infection of the hand foot and mouth?

Answer 18

coxsackievirus A16

HHV8