Infection - Skin and Soft Tissue Infection Flashcards
which of these viruses cause warts
a.human papilloma
b.herpes simplex
c.varicella zoster
d.enteroviruses
e.measles
a.human papilloma
how does a rash from viral infection with herpes simplex present
a.papilloma
b.macules
c.papules
d.vesicles
e.ulceration
d.vesicles
how does a rash from viral infection with varicella zoster present
a.papilloma
b.macules
c.papules
d.vesicles
e.ulceration
d.vesicles
how does a rash from viral infection with enterovirus present
a.papilloma
b.maculopapular
c.papules
d.vesicles
e.ulceration
b.maculopapular
d.vesicles
which of these viruses can cause a vesicles and a maculopapular rash
a.herpes simplex
b.varicella zoster
c.human papilloma
d.enterovirus
e.measles
d.enterovirus
measles, rubella and parvovirus b19 present with which type of rash
a.papilloma
b.maculopapular
c.papules
d.vesicles
e.ulceration
b.maculopapular
layers of skin and associated infections
epidermis - impetigo bacterial infection of inflam of skin
hair structures - staphylococcus on skin, particularly follicles folliculitis - acne type spots - congeal into multiple follicles boils and inflammation
dermal infection - erysipelas - group a strep, blockage of lymphatic drainage in that area of skin , conc of infection in small and well demarcated area, sharp line between inflammation and non inflammation , most common on face
subcutaneous - cellulitis
which of these skin infections affects the epidermis and is a bacterial infection of an inflamed area of skin
a.impetigo
b.folliculitis
c.erysipelas
d.cellulitis
a.impetigo
in which of these skin conditions is there acne type spots that form boils spreading to multiple hair follicles accopanied by inflammation (usually caused by staph aureus)
a.impetigo
b.folliculitis
c.erysipelas
d.cellulitis
b.folliculitis
which organism is folliculitis usually caused by
a.staph aureus
b.group a strep
c.group b strep
d. staph epidermis
a.staph aureus
which of these conditions occurs at the dermis and involves blockage of lymphatic drainage to an area of skin leading to infection being in a small and well demarcated area. most commonly on the face with a sharp line between inflammation and non inflammation
a.impetigo
b.folliculitis
c.erysipelas
d.cellulitis
c.erysipelas
what bacteria causes erysipelas
a.staph aureus
b.group a strep
c.group b strep
d. staph epidermis
b.group a strep
which layer of skin is affected by cellulitis
a.epidermis
b.hair cells
c.dermis
d.subcutaneous
d.subcutaneous
2 organisms that cause cellulitis
group a strep -strep pyogenes
staph aureus
both GRAM POSITIVE COCCI
others = pseudomonas, proteus etc usually because of another underlying problem eg diabetic ulcers / surgery
staph aureus is ..
gram positive cocci clumps
group a strep is..
gram positive cocci chains
in group a strep and staph aureus what causes the clinical infection and tissue damage
toxins
group a strep has which toxins
m proteins
hylauronidase
pyrogenic exotoxins
what is given in skin or soft tissue infection to cover group a strep pyogenes and staph aureus
a.coamoxiclav
b.ceftriaxone and ciprofloxacin
c.benzylpenicillin and flucloxacillin
d.gentamicin and lincosamide
e.dexamethosone and amoxicillin
c.benzylpenicillin and flucloxacillin
combine both
which bacteria is usually responsible for necrotising fasciitis
a.staph aureus
b.group a strep
c.group b strep
d. staph epidermis
e.clostridia
b.group a strep
life threatening skin and soft tissue infections
necrotising fasciitis
fournies gangrene
gas gangrene
toxic shock syndrome
tends to be extensive destruction of soft tissue
rapid spread of infection in deep soft tissues - subcutaneous and below
necrotising fasciitis - spread along fascial planes over muscles rapidly
organisms causing them generate toxins that cause hypotension, sickness , hylauronidase- melts connective tissue
which of these life threatening skin infections has a polymicrobial cause
a, necrotising fasciitis
b. fournies gangrene
c. gas gangrene
d, toxic shock syndrome
b. fournies gangrene
what should be done in suspected necrotising fasciitis
a. antibiotics - benzylpenicillin and flucloxacillin
b.surgical debridement in 3 months
c.emergency surgical debridement
d. wound dressing and care
e.IV gentamicin and corticosteroids
c.emergency surgical debridement
surgical emergency
what causes gas gangrene
a.staph aureus
b.group a strep
c.group b strep
d. staph epidermis
e.clostridia
e.clostridia
what bacteria causes toxic shock syndrome
a.staph aureus
b.group a strep
c.group b strep
d. staph epidermis
e.clostridia
a.staph aureus
red flags for life threatening soft tissue infection
speed of onset and trauma
trauma
diabetes
sick shocked patient
pain beyond the expected
damage beyond the redness
crepitus and gas on imaging
management of life threatening infection
surgical emergency
hyperbaric
multiple antibiotics
which antibiotic is given to inhibit toxins in life threatening skin infection
a.coamoxiclav
b.clindamycin
c.benzylpenicillin and flucloxacillin
d.gentamicin and lincosamide
e.dexamethosone and amoxicillin
b.clindamycin
what is given all together for life threatening soft tissue conditions
benzylpenicillin and flucloxacillin
ciprofloxacin
clindamycin - inhibit toxin production
which antibiotic is used for gram negative in skin and soft tissue infection
a.benzylpenicillin
b.fliucloxacillin
c.ciprofloxacin
d.clindamycin
c.ciprofloxacin
which of these organisms has a waxy cell wall that retains stains after washing with alcohol and acid
a.staph aereus
b.strep a
c.mycobacterium leprae
d.strep b
e.staph epidermis
c.mycobacterium leprae
which of these is a rapid spreading severe soft tissue infection which is associated with the perineum
a, necrotising fasciitis
b. fournies gangrene
c. gas gangrene
d, toxic shock syndrome
b. fournies gangrene
associated with preexisting illness - diabetes, obesity, previous surgery
which condition is found often in people with preexisting illness eg. diabetes, obesity, and previous surgery
a, necrotising fasciitis
b. fournies gangrene
c. gas gangrene
d, toxic shock syndrome
b. fournies gangrene
what causes gas gangrene
gas forming organisms in the soft tissue
classically caused by c.diff
which of these is caused by c.diff which is often found in soil so is often the cause of infection in lower limb gunshot wounds and agricultural injuries
a, necrotising fasciitis
b. fournies gangrene
c. gas gangrene
d, toxic shock syndrome
c. gas gangrene
feel a crepitus bully feeling under the skin
alert signs of a life threatening soft tissue infection
quick onset
rapid deterioration
precipitating factors - injury, diabetes, obesity
inflammation and tenderness- visible infection
sickness
what is the first line treatment in life threatening skin and soft tissue infection
SURGERY
then antibiotics - start with lots of wide spectrum if recovery then narrow ir down
which of these bacteria is gram stain NOT used for as they have a very waxy lipid rich cell wall
a.staph aereus
b.strep a
c.mycobacteria
d.strep b
e.staph epidermis
c.mycobacteria
stained with oromin - fluorescent stain
washed with alcohol and acid
AFB
acid and alcohol mast bacilli
\eg mycobacteria
eg mycobacteria TB
what causes leprosy
a.staph aereus
b.strep a
c.mycobacterium leprae
d.strep b
e.staph epidermis
c.mycobacterium leprae
which type of leprosy is well demarcated and tends to be a intense inflammatory reaction
a. tuberculoid leprosy
b.lepromatous leprosy
a. tuberculoid leprosy
less serious as there is good cell mediated immunity raised against it
in lepromatous leprosy you get very little
in which type of leprosy is there destruction of the tissues particularly in the extremities eg fingers, toes and tip of nose
a.tuberculoid
c.lepromatous
c.lepromatous
how is diagnosis of dermatophyte infection made
clinically
mildy inflamed skin, daily eruption, well demarcated
most commonly on feet- athletes foot
itchy rash between the toes - throw away shoes and wash socks
what happens to dermatophytes under uv light when they are infected
a.fluoresce
b.do not flouresce
a.fluoresce
what is the first line treatment for dermatophyte infection eg. athletes foot
a.benzylpenicillin and flucloxacillin
b. debridement emergency surgery
c.terbinafine
d.co amoxiclav
e.dexamethasone topically
c.terbinafine
anti fungal cream
how does mycetoma- fungal infection in the deeper tissues (much more severe)- differ to life threatening bacterial infection
more chronic insidious process
associated with mycetoma organisms getting into feet directly through skin eg barefoot farmer in low resource countries
which of these is a ectoparasite that burrows under the skin causing an intense itchy reaction particularly in finger and toe webs
a.staph aereus
b.strep a
c.mycobacterium leprae
d.sarcoptes skyvia
e.staph epidermis
d.sarcoptes skyvia
can see small red burrow lines in finger webs
SCABIES
tends to occur in those institutionalised eg hospitals or care homes
what is a severe case of scabies with crusty infection and lots of sarcoptes scabies mites known as
a.hungarian scabies
b.norwegian scabies
c.finnish scabies
b.norwegian scabies
what is given for servere scabies infection
a.benzylpenicillin and flucloxacillin
b. debridement emergency surgery
c.terbinafine
d.co amoxiclav
e.ivermectin
e.ivermectin
which of these antibiotics are more likely to cause c.diff of the gut
a.clindamycin, ciprofloxacin
b.clindamycin, ceftriaxone
c.clindamycin, penicillin
a.clindamycin, ciprofloxacin
which of these antibiotics is a mutagen so causes resistant bacteria to develop and causes cardiac arrhythmias and connective tissue damage
a.clindamycin
b, ceftriaxone
c. penicillin
d. ciprofloxacin
d. ciprofloxacin
try to avoid where possible
colitis caused by c diff- pseudomembranous colitis
what type of antibiotic is ciprofloxacin
a.macrolide
b.b lactam
c.penicillin
d.quinolone
d.quinolone
inhibits bacterial Dan synthesis
inhibits super coiling of DNA
an important feature of ciprofloxacin is that to has activity against
a.pseudomonas
b.staph aureus
c.staph epidermis
d.c diff
a.pseudomonas
a main use of ciprofloxacin
often used in combination as doesn’t cover many gram positive
how does clindamycin work
a.inhibit making of peptidoglycan cell wall
b.inhibit bacterial DNA synthesis
v.inhibiti bacterial RNA synthesis
d.inhibit bacterial protein synthesis
d.inhibit bacterial protein synthesis
bind to 50th subunit
clindamycin is good against -
a.gram positives
b.gram negatives
a.gram positives
good in combo with ciprofloxacin
