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infectious dz Flashcards

1
Q

two agents responsible for impetigo

A

strep pyogenes
staph aureus

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2
Q

starts as small vesicles, that rupture to expose red moist base with HONEY CRUSTED LESION; very contagious

A

impetigo

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3
Q

tx of impetigo? (2) if bullous or extensive non-bullous?

A

warm soapy washes with antibacterial or chlorhexadine
mupirocin 2% TID (or Retapamulin)
oral dicloxacillin or cephalexin if disseminated or bullous

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4
Q

most common form of impetigo also honey crusted

A

non-bullous

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5
Q

location of most bullous impetigo and most likely agent of bullous impetigo

A

trunk
s. aureus– the toxin forms the bullous

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6
Q

if an adult has bullous impetigo what should you test them for

A

HIV

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7
Q

if giving oral abx for impetigo and pt has PCN allergy, what should you give

A

erythromycin or clarithromycin
if MRSA– clindamycin, bactrim, doxycycline

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8
Q

if youre seeing redness and not sure if its cellulitis what can you do?

A

touch it— it will be hot!

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9
Q

non-necrotizing inflammation of the dermis and hypodermis related to acute infection that does not involve the fascia or muscles that starts from break in skin; also from impaired or occluded lymphatic drainage and edema (post mastectomy, vein harvest).

A

cellulitis

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10
Q

3 bacterial causes of cellulitits

A

Group A strep
S. aureus (adults)
HIB (kids)

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11
Q

4 descriptors of cellulitis; 3 sx they might have

A

redness, warmth, edema, pain
may have fever, leukocytosis, elevated ESR

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12
Q

3 abx for uncomplicated cellulitis

A

Cephalexin, Dicloxacillin, or Clindamycin

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13
Q

3 bacteria involved with dog bite cellulitis

A

PASTERURELLA CANIS, S aureus, or S pyogenes

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14
Q

abx for dog bite cellulitis? if allergic to PCN?

A

augmentin
PCN allergy: clinda + cipro

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15
Q

how is human and cat bite tx?

A

same as dog

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16
Q

2 bacterias that are involved in cat bite

A

PASTEURELLA MULTOCIDA
and pasturella septica

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17
Q

rapidly progressive inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues

A

necrotizing fasciitis

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18
Q

cause of Type 1-3 necrotizing fasciitis

A

1: polymicrobial
2: group A strep
3: gas gangrene or clostridial myonecrosis

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19
Q

Ulcerations covered by adherent crusts, deeper form of impetigo d/t poor hygiene; preexisting tissue damage and immunocompromised;

A

ecthyma

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20
Q

which is more aggressive ecthyma or erysipelas

A

erysipelas

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21
Q

bacteria causing ecthyma

A

Group a strep (pyogenes) which gets contamined with s. aureus

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22
Q

An acute, inflammatory form of cellulitis, differing due to STREAKING from lymphatic involvement; More superficial than cellulitis, with better demarcation.

A

erysipelas

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23
Q

location of ecthyma vs erysipelas

A

ecthyma: usually <10 lesions on LE
erysipelas: lower legs, face, ears

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24
Q

bacteria responsible for erysipelas

A

group A strep on face
Non-group A strep on legs

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25
facial erysipelas develops from ______
nasopharyngeal strep, as a result of recent strep pharyngitis
26
tx of localized ecythema
topical mupirocin ointment TID
27
tx of extensive ecythema (same as for erysipelas)
#1 oral/iv PCN G or VK cephalexin, dicloxacillin, clindamycin Admit if its erysipelas
28
kiesselbach's plexus and cranial cavity
in some ppl, some nasal veins join with sagittal sinus making potential pathway into cranial cavity
29
an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation; common complication of obesity and DM
Intertrigo
30
most common cause of intertrigo? what else can cause it?
Most common-- candida can also be bacterial or viral
31
2 tests to diagnose intertrigo
KOH--- budding yeast with pseudohyphae Wood's lamp
32
"beefy red" macerated moist plaques and erosion with peripheral scaling and red satellite lesions; can be itchy; will have hx of moisture & friction area
intertrigo
33
3 tx of intertrigo & what to do if it doesnt go away?
correct causes-- AC, absorbent powders etc nyastin, miconazole, clotrimazole esp with class III to VI steroid for short duration if no improvment then biopsy
34
a chronic superficial infection (stratum corneum) of the intertriginous areas of the skin
erythrasma
35
organism responsible for erythrasma
CORYNEBACTERIUM MINUTISSIMUM
36
dx of erytherasma (2)
wood's lamp CORAL RED gram stain: G+ filamentous rods
37
3 tx of erythrasma
ERYTHROMYCIN clarithromycin clinda or TCN
38
groin tinea cruris vs cutaneous candidasis
tinea involves the folds but not the penis itself cutaneous will be on penis but not folds
39
groin tinea vs candida hx
tinea-- heat sweat hx or coexisting low immunity or obesity candida-- generalized itchy with increased severity; warm and moist
40
Symmetric red rash in the groin, red patches with central clearing in inguinal creases. Penis and scrotum spared (typically)
tinea cruris
41
Satellite lesions are commonly found; Penis and scrotum affected and inguinal creases spared.
genital candida
42
dx of tinea cruris and candida
tinea: KOH for hyphae, pseudohyphae or budding yeast candida: KOH for fungal hyphae
43
tx of groin tinea vs candida
tinea: topical terbinafine is best; PO if extensive candida: expanded sprectrum azole-- PO fluconazole or topical polyene (nystatin)
44
Most common vector-borne illness in US, multisystem illness usually caused by spirochete Borrelia burgdorferi
Lyme dz
45
sx of lyme dz
Erythema migrans-- rash bulls eye flu like illness-- fever, chills, malaise, myalgias, arthralgia, HA tender local adenopathy
46
risk of lyme dz is ____ if tick feeds for 72 hrs
25%
47
tx if there is tick attachment only
doxycycline 200mg ONCE
48
tx of early localized lyme dz (3) & duration
doxycycline 100mg BID amoxicillin 500 mg TID Cefuroxime 500 mg BID all used 14-21 days
49
how fast does EM appear after tick bite
7-14 days
50
dx of early localized lyme (2)
dont do serology if there is EM can get acute and covalescent Ig titers if cause of sx is unknown
51
how to screen for lymes if no EM or they dont recall a tick bite
ELISA or EIA first; if its positive or equivocal, then to Western Blot to confirm
52
how do you tx oter tick borne dz
PO doxycycline
53
As a result of direct contact with infected person or pet; questionable if contracted from linens/cloths; Insidious onset followed by scratching, which destroys burrow removing mite. After 6-8 weeks can be wide spread
scabies
54
nocturnal pruritis is characteristic of ______
scabies
55
what is responsible for scabies
Sarcoptes scabiei hominis mite
56
dx of scabies
skin scraping to a slide with saline (NOT KOH)
57
how to differentiate scabies from dyshidrosis on fingers
dyshidrosis isnt really itchy
58
2 tx for scabies that is pregnancy B and safe in over 2months old
Permethrin -- synthetic pyrethrin Lindane-- gamma benzene hexachloride
59
permetherin duration in adults vs kids
12 hours in adults, kids 8 hrs
60
tx of scabies in large groups
ivermectin-- antihelminitic used in healthy and HIV; pruritis is rapidly controlled
61
tx of scabies in pts with thick, crusted lesions
Ivermectin + Permetherin
62
tx of scabies that has a lower cure rate and used daily for 5 days
Crotamiton lotion
63
who should you tx with scabies? (2)
all intimate contacts family members
64
Crusted lesions, grey scales and dystrophic nails HIV patients, cognitive impaired, elderly and/or immunocompromised individuals from Sarcoptes scabiei hominis
norwegian scabies
65
Most contagious STI caused by Pthirus pubis; with itching as #1 complaint
Pediculosis pubis
66
dx of lice (2)
complaints of itching & visualization of nits/eggs wood lamp causes nits to fluorescence
67
Infects the scalp more in kids; scratching causes inflammation and secondary bacterial infection; caused by Pediculus humanus capitis
Pediculosis capitits
68
4 tx of lice
Lindane shampoos & lotions Synergized pyrethrins shampoos & lotion permethrin for head lice nit removal
69
duration of tx with lice
repeat in 7-10 days
70
Lactrodectus mactans is the...
black widow
71
neurotoxic; one of the most potent venoms secreted by an animal; sx start w/in 20 mins of bite
black widow bite
72
Local pain, then localized or generalized severe muscle cramps, abd. pain, weakness, and tremor. Large muscle groups (such as shoulder or back) are often affected for 2-3 days.
minor black widow bite
73
nausea, vomiting, fainting, dizziness, chest pain, respiratory difficulties, significant hypertension, and death
severe black widow bite
74
bite that can mimic appendicitis, cholecystitis & MI
black widow
75
3 tx of black widow envenomations
RICE & analgesics Latrodectus Antivenin Muscle relaxants
76
tx of black widow bite that significantly shortens symptom duration, regardless of species; IM or IV; prepared in horse serum; requires call to state DoH to get it
Latrodectus Antivenin
77
med for healthy 16-60 y/o to help with sxs
muscle relaxants-- calcium gluconate or diazepam
78
Loxosceles reclusa is
brown recluse spider; violin pattern on back
79
cytotoxic & hemolytic; can be necrotic w/in 4 hrs
brown recluse bite
80
Blue-gray halo, cyanotic bulla, irregular edges, increased pain after getting bitten; in severe cases RBC destruction, thrombocytopenia, blood clots, acute renal failure, coma
brown recluse spider bite
81
tx of brown recluse (5)
RICE & analgesics tetanus prophylaxis! Dapsone w/in 48 hrs of bite PO prednisone if necrosis >2cm surgical debridement if central area of necrosis
82
do not apply heat, steroids, suction, tourniquet with ____
brown recluse spider bites
83
angular chelitis is caused by
yeast +/- bacterial
84
tx of angular cheilitis
nyastin (maybe w steroid?)
85
if worried about pseudomonas in shoe, what should you treat with
fluoroquinolone-- ciprofloxacin

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