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Infection > Infections Of The Skin and respiratory tract > Flashcards

Infections Of The Skin and respiratory tract Flashcards

1
Q

What are the features of cellulitis?

A

Redness

Swelling exudate

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2
Q

What is the most common bacterial cause of cellulitis?

A

S. Aureus.

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3
Q

What is the presumptive choice of antibiotic treatment of cellulitis?

A

Flucloxacillin

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4
Q

How is erysipelas different to cellulitis?

A

Redness is usually on face or legs in areas of prior ulceration, abrasion or lymphatic damage. Lesion has a distinct raised edge.

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5
Q

What is the most common bacterial cause of erysipelas?

A

S.pyogenes.

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6
Q

What is the antibiotic of choice for erysipelas?

A

Penicillin

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7
Q

What is impetigo?

A

Painless confluent vesicles that progress to dried out yellow crusts.

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8
Q

What is the most common bacterial cause of impetigo?

A

S. Pyogenes.

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9
Q

What abx is used for impetigo?

A

Oral or Im penicillin.

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10
Q

What causes shingles?

A

A reactivation or varicella zoster virus.

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11
Q

What is the treatment for shingles?

A

Disease is usually self limiting.

Symptomatic relief is difficult as pain is neural in origin.

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12
Q

What is gas gangrene?

A

An infection that involves the muscles and adjacent soft tissues.

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13
Q

What causes gas gangrene?

A

C. Perfringens.

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14
Q

What is the management for gas gangrene?

A

Surgical resection of necrotic tissues
IV penicillin
Oxygen

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15
Q

What is necrotizing fasciitis?

A

An infection of the subcutaneous soft tissues involving superficial and deep fascia.

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16
Q

What is the most common cause of necrotizing fasciitis?

A

S. Pyogenes. Infection spreads along soft tissue planes.overlying skin breaks down.

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17
Q

What is the treatment for necrotizing fasciitis?

A

A combination of ampicillin, gentamicin and metronidazole given IV. Surgical exposure of affected fascial planes.

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18
Q

What are the most common causes of pharyngitis?

A

Respiratory viruses: rhinovirus, coronavirus, adenovirus, influenza, EBV

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19
Q

What is the most common cause of bacterial pharyngitis?

A

S.pyogenes.

Rarer: Neisseria gonorrhoea, M.Pneumoniae, C. Diptheriae.

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20
Q

What antibiotic is commonly used to treat streptococcal pharyngitis?

What is the aim of treatment?

A

Oral penicillin or erythromycin.

Aim of treatment is to reduce risk of complications eg rheumatic fever, scarlet fever.

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21
Q

Which viruses commonly cause the flu?

A

Influenza groups A-C

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22
Q

What are the main symptoms of influenza infection?

A

Fever, lethargy, myalgia, common cold like symptoms.

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23
Q

What kind of virus is influenza?

A

An RNA virus

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24
Q

Which major surface antigens are found on influenza?

A

Haemagluttinin and neuraminidase.

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25
Q

What is antigenic drift?

A

Minor changes in antigenic makeup between epidemics. This means that a vaccine can be developed for the virus, but needs to be remade each year.

26
Q

What treatments exist for influenza?

A

Mainly symptomatic relief

Neuraminidase inhibitor- oseltamivir, may reduce duration of symptoms.

27
Q

What is otitis media?

A

An acute inflammation of the middle ear. More common in younger children as their eustachian tubes are shorter and more horizontal.

28
Q

Which bacteria commonly cause otitis media?

A

S.pneumoniae or H.influenzae.

29
Q

What are the symptoms and signs of otitis media?

A

Fever and local pain. Tense red tympanic membrane

30
Q

What are the complications of otitis media?

A

Ear drum rupture

Meningitis
Mastoiditis

31
Q

What is the abx of choice for otitis media?

A

Erythromycin or ampicillin.

32
Q

What is otitis externa?

A

Inflammation of the external auditory meatus.

33
Q

What is the most common cause of otitis externa?

A

Aspergillus niger.

34
Q

What is the treatment for otitis externa?

A

Topical agents such as aluminium acetate.

35
Q

What is acute sinusitis?

A

Infection of axillary, frontal, ethmoid or sphenoidal sinuses with bacteria from nasopharynx following impaired drainage in upper respiratory tract infection.

36
Q

What are the most common bacterial causes of acute sinusitis?

A

S.pneumoniae and H.influenzae.

37
Q

What is the treatment for acute sinusitis

A

Decongestants to improve drainage.

38
Q

What is laryngitis?

A

Caused by one of the respiratory viruses and is a self limiting condition of hoarseness and loss of voice. No specific treatment required.

39
Q

What are the symptoms of acute bronchitis?

A

Cough, production of creamy white sputum.

No CXR findings.

40
Q

What is acute bronchitis caused by

A

M. Pneumoniae

41
Q

What is tracheobronchitis?

A

Acute bouts of coughing which is not accompanied by significant sputum production. Caused by influenza virus.

42
Q

What is an acute exacerbation of chronic bronchitis?

A

A chronic productive cough changes to become productive of larger quantities of newly purulent sputum.

43
Q

What commonly causes an acute exacerbation of chronic bronchitis?

A

S. Pneumoniae or H influenzae

44
Q

What is the treatment for bronchitis?

A

Oral ampicillin or erythromycin

45
Q

What are the symptoms of community acquired pneumonia?

A

Fever
Cough- may or may not have sputum
CXR signs- areas of consolidation, fluid in air spaces, effusion or cavity.
Impairment of respiratory function

46
Q

What are the causative organisms of CAP?

How do their presentations differ?

A

Strep Pneumoniae- sudden onset pleuritic pain, fever, rusty sputum. Cold sores.

Klebsiella pneumoniae- thick, viscous red sputum.

S. Aureus- pneumonia following influenza

M.pneumoniae- non productive cough and pharyngitis in young adult

Legionella- non productive cough, confusion and diarhhoea.

47
Q

What are the 4 stages of disease in pneumonia?

A

Congestion
Red hepatisation
grey hepatisation
Resolution

48
Q

What are the 4 types of pneumonia?

A

Lobar- confined to one lobe- commonly S. Pneumoniae

Bronchopneumonia- patchy consolidation around larger airways. Commonly S.pneumoniae, H. Influenzae, S. Aureus.

Also:interstitial pneumonia, aspiration pneumonia

49
Q

What is the presumptive therapy for CAP?

A

Amoxicillin
Clarithromycin
Or doxycycline

50
Q

How is severity of pneumonia assessed?

A 
CURB 65 score-
confusion
Urea> 7mmol
RR>30
BP-<90/60
>65 years.
51
Q

What is the definition of pneumonia?

A

An infection of the lower airways which is accompanied by X ray changes.

52
Q

Which organisms commonly cause hospital acquired pneumonia?

A

P. Aeruginosa
S. Aureus.
Enterobacteriacae

53
Q

How does pulmonary tuberculosis commonly present?

A

Acute bronchopneumonia, pulmonary cavitation, miliary TB

Often- weight loss, night sweats, fever, haemoptysis.

54
Q

How is TB transmitted?

A

Air borne in droplets.

55
Q

What virulence factors does mycoplasma tuberculosis have?

A

Thick, lipid containing cell wall, rendering it resistant to phagocytosis. This causes them to become walled off by fibrosis and form a granuloma with central caseating necrosis.

56
Q

What characteristic X Ray sign can be seen in TB?

A

Gohns focus

57
Q

Which special stain is used to identify TB?

A

Zhiel Nielsen Stain (ZN stain)

58
Q

What is the treatment for TB?

A 
Combination of 4 antibiotics to prevent resistance-
RIPE
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
59
Q

What is empyema?

A

An accumulation of purulent fluid in the pleural space. Caused by direct extension from underlying pneumonia, infection resulting from penetrating thoracic trauma or haematogenous spread.

60
Q

What organisms can cause empyema?

A

S.aureus, enterobacteriacae, streptococci and obligate anaerobes.

61
Q

How is empyema diagnosed?

A

May be evident on CXR , also there will be dullness to percussion.

62
Q

What abx is used in empyema?

A

Depends on results of gram stain but should include an agent active against obligate anaerobes eg metronidazole

Infection (12 decks)

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