Infect - ortho, skin, tissue

Question 1

what are three functions of the skin

Answer 1

physical barrier
homestasis
immunological function

Question 2

what are the normal flora of the skin

Answer 2

coagulase neg staph (epidermis), staph aureus, proppionbacterium, corynebacterium

Question 3

what is the pathogenesis of soft tissue and skin infection (SSTI)

Answer 3

localised infection - penetration with contamination
neurological migration of HSV1/2
systemic infection

Question 4

what is the cause, presentation and treatment of viral warts

Answer 4

HPV
proliferation and ricking of stratum corner, granulosum and spinosum
topical creams and HPV Vaccine

Question 5

what can ingrown hairs forming pus and swelling lead to

Answer 5

pilonidal cysts or abscesses

Question 6

what is the description, cause and treatment of impetigo

Answer 6

superficial skin infection - crusting mouth or nose - s. aureus
highly contagious
topical or oral antibiotics

Question 7

what is erysipelas, bacterial cause and treatment

Answer 7

rash over face - upper dermis infection but can involve lymphatics
strep A pyogenes
oral antibiotics

Question 8

what is cellulitis and its cause

Answer 8

infection affecting inner layers of skin - dermis and subcutaneous fat into lymphatics

Question 9

what is the cause and pathogenesis of cellulitis

Answer 9

s. aureus, GAS, GBS - bacteria enter through breaks in skin

Question 10

what are the clinical features of cellulitis

Answer 10

rubor, calor, dolor, tumour
inflammation signs
loss of skin creases

Question 11

describe a facial subtype of cellulitis

Answer 11

orbital

infection of soft tissue around and behind the eye via infection from the skin or sinuses

Question 12

what is necrotising fascitis

Answer 12

flesh eating bug, life threatening - tracking along fascia, cut of blood supply and necrosis

Question 13

what are the 4 main types of necrotising fascitis

Answer 13

1 - synergistic/poly microbial (risk diabetes, alcohol etc)

2 - group a strep mediated (younger people)

3 - vibrio vulnificus (sea water)

4 - fungal - rare

Question 14

where would you see fournier gangrene

Answer 14

type 1 necrotising fascitis

Question 15

what are the two types of pathogenesis of necrotising fascitis

Answer 15

type 1 - ischaemic, colonisation then infection resulting in further necrosis

type 2 - infection, toxin release, disruption blood supply = necrosis

Question 16

what is the presentation and treatment of necrotising fasciitis

Answer 16

swelling, pain, sepsis, necrosis

debridement and antibiotics

Question 17

what is the pathogenesis of gangrene

Answer 17

poor blood flow, necrosis, colonisation, infection and more necrosis

Question 18

what are the risk factors and cause of gangrene

Answer 18

atherosclerosis, smoking, DM, autoimmune

skin via staph, strep, enteric bacteria such as e coli

Question 19

name three types of gangrene

Answer 19

dry - mummified
wet - boggy, swollen
gas - crepitus

Question 20

what is a diabetic foot

Answer 20

spectrum disease from superficial to deep bone formation

Question 21

what is the pathogenesis of diabetic foot

Answer 21

damage to blood vessels, damage to nerves, high blood sugars
caused be deep or superficial bacteria

Question 22

what is osteomyelitis and the mechanism of infection

Answer 22

infection of the bone 
contagious from diabetic foot 
haematogenous - bacteria 
trauma 
sickel cell - salmonella

Question 23

which condition would you see blood cultures of bacteria and pathological fracture

Answer 23

osteomyelitis

Question 24

wha is the difference between acute and chronic osteomyelitis

Answer 24

acute - associated with inflammation, sepsis

chronic - more than a month - acute flares

Question 25

what is sequestrum and involucrum

Answer 25

infection results in bone death

new bone formation

Question 26

what is septic / pyogenic arthritis and the diagnosis

Answer 26

infection of the joint
bacterial cause
confirmation of joint aspiration

Question 27

what are the causes of prosthetic joint infection

Answer 27

microbes or bug on foreign surface - establish biofilm

early (s. aureus/epidermis) and late (e coli)

Question 28

what are the causes of syphillis

Answer 28

STI/congenital

treponema pallidum

Question 29

what are the three types of syphillis

Answer 29

primary - chancre, painless non itchy ulcer, lymphadenopathy

secondary - 4-6 weeks after chancre, rash everywhere

tertiary - 3-15 years after infection - neurological, gummatous, cardiovascular

Question 30

what is the treatment for syphillis

Answer 30

penecillin