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Pharmacy Year 4 > Necrotising Infections > Flashcards

Necrotising Infections Flashcards

1
Q

Conditions of skin?

A

Dry
Acidic
Salty
Colder

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2
Q

Which areas of skin have different conditions?

A

Crevices are more moist

Sebaceous areas are more oily

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3
Q

Sweat as protection against bacteria?

A

Osmotic pressure

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4
Q

Skin adaption to remove cells?

A

Shedding

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5
Q

What type of organisms are present on skin and why?

A

Gram-positive

Survive well in arid conditions

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6
Q

What is usually the cause of skin infections?

A

Trauma - Bites, cuts, ulcers

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7
Q

Where do skin pathogens come from?

A

May colonise body or be spread from another person

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8
Q

Give 4 examples of deepening skin infections and causative organisms

A

Impetigo - Infects epidermis, S. pyogenes and S. aureus
Erysipelas - Infects dermis and can spread to SC fat, S. pyogenes
Cellulitis - Infects dermis and SC fat, S. pyogenes and S. aureus
Necrotising Fasciitis - Infect SC fat and fascia, S. pyogenes and anaerobes

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9
Q

What is the fascia?

A

Surrounds muscle, connective tissue

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10
Q

Treatment of Nec Fasc?

A

Treated with rigorous broad spec. antibiotics, possibly debridement and surgery

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11
Q

Why does Nec Fasc have to be treated quickly?

A

S. pyogenes moves through skin layers quickly

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12
Q

Presentation of Nec Fasc?

A

Red, hot, swollen, very painful

No real presentation, localised pain may be indicator

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13
Q

Predisposition to Nec Fasc? (8)

A

1) Trauma/surgery
2) Diabetes
3) IV drug use (aseptic)
4) Elderly
5) Smoking
6) Immunocompromised
7) Female
8) Bruising

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14
Q

Nec Fasc mortality?

A

Around 30%

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15
Q

Antibiotic to reduce chance of sepsis?

A

Clindamycin

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16
Q

Virulence factors of S. pyogenes? (4)

A

1) Breakdown of NET
2) Phagocyte apoptosis
3) Prevents neutrophil recruitment
4) Hyaluronic acid to prevent recognition

17
Q

What is needed for pathogen to cause infection?

A

Immune invasion and evasion

18
Q

Most common superficial infection?

A

Impetigo

19
Q

Common cause of impetigo?

A

S. aureus falls from nose onto face, infects when trauma

20
Q

When is impetigo incidence highest? Why?

A

Summer

Insect bites, skin exposure

21
Q

Types of impetigo? Incidence?

A

Non-Bullous, 70%

Bullous, 30%

22
Q

Pathogenesis of bullous impetigo? Characterisation?

A

Exfoliative toxin A targets desmoglein-1 (holds skin layers together, cutting allows spread through skin)
Localised loss of stratum corneum
Infectious vacuoles

23
Q

Treatment of bullous impetigo?

A

Topical fusidic acid TDS 5/7

Widespread: Flucloxacillin QDS 7/7 or clarithromycin BD 7/7

24
Q

When would swabs be taken in impetigo?

A

Treatment resistant

25
Q

What is staphylococcal scalded skin syndrome?

A

Toxins in bloodstream
Widespread loss of stratum corneum
Heals without scarring
Temperature regulation and fluid loss externally managed

Pharmacy Year 4 (13 decks)

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