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My Dermatology > Microbiology and Pharmacology > Flashcards

Microbiology and Pharmacology Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the main virulence factors and their functions?

A
  • adhesin: enables the binding of organism to the host tissue
  • impedin: enables the organism to avoid host defence
  • aggressin: damage to host directly
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2
Q

What are the main features of Staph?

A
  • colonises skin and mucous membranes
  • can cause superficial lesions and systemic issues such as toxic shock which is caused by TSST-1
  • PVL is in extreme skin infections and leads to sepsis and necrotising fasciitis
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3
Q

What are the main features of TSST-1?

A

this is a super antigen which stabilises immune reaction and causes both release of cytokines and toxic menstrual shock

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4
Q

What are the main features of Strep?

A
  • normally in the pharynx
  • Lancefield classification of surface antigens
  • is bacterial sore throat, impetigo, cellulitis and necrotising fasciitis (strep A destroys connective tissue)
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5
Q

How do drugs move into the skin?

A

if the drug is hydrophobic then it can move in by massive diffusion and remain in the lipid layer around the corneocytes

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6
Q

How is the rate of drug absorption described mathematically?

A

by Fick’s Law according to the vehicle

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7
Q

What is an excipient?

A

this is a substance that can be put in the vehicle that can enhance solubility

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8
Q

What is a good way to administer a drug for a long time at a steady plasma concentration?

A

trans-dermal patch

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9
Q

What is the best way to improve partitioning?

A
  • hydration of the skin by occlusion with type of vehicle or cling film
  • inclusion of excipients to increase solubility of the drug
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10
Q

What effects do glucocorticoids have on the skin?

A
  • anti-inflammatory
  • immunosuppressive
  • vasoconstricting
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11
Q

What conditions are glucocorticoids used to treat?

A

atopic eczema, psoriasis and pruritus

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12
Q

What are the side-effects of long-term steroid use?

A
  • steroid rebound
  • skin atrophy
  • systemic effects
  • infection
  • steroid rosacea
  • stretch marks
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13
Q

How do glucocorticoids act?

A
  • signal via GRalpha receptors
  • enter cells by diffusion and then they combine with GRa
  • the receptor moves to nucleus and assembles into a homodimer
  • binds to glucocorticoid response elements in the promoter region
  • switch on or off of genes
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14
Q

What is TTD?

A

transdermal drug delivery is good for steady state drug delivery and avoids first-pass metabolism
however, only some drugs are suitable

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15
Q

What are the + and - for subcutaneous drug administration?

A

+ slow absorption
+ slow constant release
- injection volume limited

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16
Q

What are the advantages of topical treatments?

A

there is direct application and reduced systemic effects

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17
Q

What are the disadvantages of topical treatments?

A

they are time consuming, correct dosage can be difficult and they are messy

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18
Q

What are the features of creams?

A
  • non-greasy
  • semisolid emulsion of oil in water
  • high water content
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19
Q

What are the features of ointments?

A
  • semi-solid grease or oil
  • no preservative
  • occlusive and restrict water loss from the skin
  • very greasy
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20
Q

What are the features of lotions?

A
  • liquid
  • might sting
  • good for scalp or hair-bearing areas
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21
Q

What are the features of gels?

A
  • thickened solutions
  • semi-solid
  • treat scalp, face and other hair-bearing areas
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22
Q

What are the features of pastes?

A
  • semi-solid
  • contain finely powdered material
  • stiff and greasy to hard to apply
  • protective, occlusive and hydrating
23
Q

What are the features of foams?

A
  • colloid with 2 or 3 phases
  • increased penetration of active agents
  • can spread easily
24
Q

What are emollients?

A

they enhance the rehydration of the epidermis for dry conditions esp eczema

25
Q

What are the risks of emollients?

A
  • skin is slippy

- risk of fire from paraffin content

26
Q

What are the actions of topical steroids?

A
  • vasoconstrictive
  • anti-inflammatory
  • antiproliferative
27
Q

What are topical steroids used for?

A
  • eczema
  • psoriasis
  • keloid scars
  • other non-infective dermatoses
28
Q

How many grams of steroid for a whole adult?

A

20-30g

29
Q

What are the most common side-effects of topical steroids?

A
  • skin thinning
  • pupura
  • stretch marks
  • rosacea
  • acne
  • telangiectasia
30
Q

What do calcineurin inhibitors do?

A

they suppress lymphocyte activation so are used in eczema treatment

31
Q

What do antiseptics do?

A

they are used for recurrent infections, antibiotic resistance and wound irrigation

32
Q

What are antiviral agents used for?

A

herpes simplex, herpes zoster and eczema herpeticum

33
Q

What are topical antifungals used for?

A

candida, dermatophytes (ringworm) and pityriasis versicolor

34
Q

What are keratolyticxs used for?

A

to soften keratin eg in corns or viral warts

35
Q

What is the treatment for warts?

A

keratolytics and mechanical paring

36
Q

What is the treatment for psoriasis?

A

emollients plus tar, vit D, keratolytic, topical steroid and dithranol

37
Q

What can scalp psoriasis be treated with?

A

greasy ointments, tar shampoo, steroids in alcohol base or vet D analogues

38
Q

What colours are the different types of Staph on agar plates?

A
  • S.aureus is golden on agar

- Coagulase negative staph is white on agar

39
Q

What is the only coagulase positive Staph?

A

S. aureus

40
Q

What is the best drug for a Staph aureus infection?

A

flucloxacillin

41
Q

What are two extra things that S. aureus can have that can make the infection worse?

A
  • SSSST which is staphylococcal scalded skin syndrome toxin

- PVL producing staph is a worse infection due to toxins

42
Q

What are some examples of skin diseases caused by staph aureus?

A

cellulitis, infected eczema or impetigo

43
Q

What is the treatment for MRSA?

A

vancomycin

and co-trimoxazole or doxycycline

44
Q

When should S.epidermidis be considered?

A

if it is in association with an implanted artificial material that is causing recurrence of infection

45
Q

What is the most relevant strep to skin?

A

beta haemolytic (split into A and B based on antigenic structure)

46
Q

What diseases are group A strep associated with?

A

infected eczema
impetigo
cellulitis

47
Q

What is the classical disease caused by group A beta haemolytic strep?

A

erysipelas

48
Q

When do you take swabs of an ulcer?

A

ONLY if there are signs of infection or cellulitis

49
Q

What are the main features of a tinea infection?

A
  • this is ringworm
  • found when the skin is soggy and it is in keratinised tissues
  • it heals from the inside out so gives a ring appearance
  • males
50
Q

What is the most common microbiological cause of tinea?

A

trichophyton rubrum

51
Q

What is the treatment for tinea?

A

clotrimazole cream or a topical nail paint

52
Q

Where is candida usually seen and how is it treated?

A
  • skin folds, under the breasts, nappy area of babies

- treatment is clotrimazole cream

53
Q

What is the treatment for scabies?

A

malathion lotion

54
Q

What is the most common cause of a UTI in a woman of child bearing age?

A

Staph saprophyticus

My Dermatology (6 decks)

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