L24-Infections of the soft tissues and musculoskeletal system

Question 1

What are the defence at the skin

Answer 1

Normal integrity of the skin
Rapid cell turnover
Normal flora of the skin
Antimicrobial effect of the lipid layer (sebum-derived) of normal skin (pH 5.5)

Question 2

What are the pathogens in Dermatophytosis

Answer 2

Dermatophytic fungus: Trichophyton spp., Microsporum spp., Epidermophyton floccosum

Question 3

How is Dermatophytosis diagnosed

Answer 3

KOH wet mount, fungal culture

Question 4

What is the treatment for dermatophytosis

Answer 4

topical +/- systemic antifungal agents

Question 5

What is paronychia

Answer 5

Superficial infection of the nail fold (usually because of long time exposure to water)

Question 6

What is the cause of acute paronychia

Answer 6

Staphylococcus aureus

Question 7

What is the cause of chronic paronychia

Answer 7

Candida spp., especially Candida albicans

Question 8

What is pyoderma and what are the two common types of pyoderma

Answer 8

Pus in the skin

Impetigo, folliculitis

Question 9

What is the infection which occur in children and the spread is facilitated by overcrowding and poor hygiene

Answer 9

Impetigo

Question 10

What are the pathogens that cause Impetigo?

Answer 10

Strep pyogenes, Staph aureus

Question 11

What is the site of infection of folliculitis

Answer 11

Abscess formation around hair follicles

Question 12

What is the pathogen of folliculitis

Answer 12

Staph aureus

Question 13

What is the infection which occur at the back region of elderly, diabetic, or immunocompromised patients

Answer 13

Carbuncles

Question 14

Name the two types of abscesses infection of skin

Answer 14

Furuncles

Carbuncles

Question 15

What might furuncle complicate

Answer 15

Folliculitis

Question 16

What is the predisposing factor for cellulitis

Answer 16

Perceded by trauma or an underlying skin lesion

Question 17

What is the speed of spreading of cellulitis

Answer 17

Acute spreading infection

Question 18

What are the causative agents of cellulitis

Answer 18

beta haemolytic streptococci, especially streptococcus pyogenes

Question 19

What is the subtype of cellulits which present symptoms of very painful, red lesions with distinct border and spreads rapidly; nowadays affect lower limbs more often

Answer 19

Erysipelas

Question 20

What is the treatment of pyoderma, cellulitis and erysipelas

Answer 20

Beta lactam antibiotics

Question 21

What is the tissue level involvement of necrotizing soft tissue infections

Answer 21

Multiple tissue levels (dermis, subcutaneous fat, deep fascia)

Question 22

What is the first type of causative agent of necrotising fascittis

Answer 22

Type 1: anaerobic bacteria (e.g. Bacteroides, Clostridium)+ facultative anaerobes (e.g. streptococci, Enterobacteriaceae) Classically occur after intra-abdominal or pelvic surgery before the day days of peri-operative antibiotics prophylaxis. Many arise de novo in perineal area; Fournier’s gangrene

Question 23

What is the second type of casuative agent of necrotising fasciitis

Answer 23

Streptococcus pyogenes and staph aureus

Question 24

What is the third type of causative agent of necrotising fasciitis

Answer 24

Vibrio spp., occurs after exposure to water or consumption of seafood containing the pathogens

Question 25

What is the classical presentation of necrotising fasciitis

Answer 25

skin becomes cyanotic and finally dusky and black

Question 26

What is the causative agent of clostridial myonecrosis

Answer 26

Clostridium perfringens

Question 27

What is the pathogenesis of clostridial myonecrosis

Answer 27

1) muscle injury and contamination with soil or other foreign material containing spores of Clostridium perfringens 2) coagulative necrosis of muscle fibers

Question 28

What is the classical presentation of clostridial myonecrosis

Answer 28

serosanguineous discharge, foul odour of the wound

Question 29

What is the antibiotic treatment for clostridial myonecrosis

Answer 29

penicillin, clindamycin, or metronidazole

Question 30

What indicates a wound infection?

Answer 30

Purulent drainage (pus) from the incision Pain, tenderness, localized swelling, redness, dehiscence of wound Organisms isolated from an aseptiically obrained culture of tissue or fluid from the wound Gram smwear of the wound tissue

Question 31

What are the four wound classes

Answer 31

Clean Clean contaminated Contaminated dirty

Question 32

What are the causative agent of surgical wound infection on skin (brain surgery)

Answer 32

Staph aureus | Strep spp

Question 33

What are the causative agent of surgical wound infection after an intestinal surgery (abdominal surgery)

Answer 33

E coli, Enterobacter Proteus Klebsiella

Question 34

What are the two routes of spread of acute osteomelitis

Answer 34

Haematogenous osteomyelitis | Contiguous focus osteomyelitis

Question 35

What are the possible cause of prosthesis-related infection

Answer 35

Pathogens are usually introduced during operation or from post-operative wound infection Haematogenous spread