Radnom non-topic facts

Question 1

Difference between Staphylococcal and Streptococcal Toxic Shock Syndrome

Answer 1

Staph TSS is induced by S. aureus TSST-1 protein.
Presents as a scarlitiniform, diffuse, or macular erythema. Edema on the palms and soles.
Erythema of the conjunctiva and mucosa and strawberry toungue.
Vomitting diarrhea, liver, renal, and possible DIC.

Streptococcal TSS
Caused by Strep pyrogen exotoxins:
SpeA - superantigen
SpeC- superantigen

SpeB - a protease that causes necrotising fasciitis
due to SpeB - Streptococcal TSS involves necrotic lesions, bullae, possible myositis, necrotising fasciitis, and gangrene.

Question 2

Scarlatiniform rash

Answer 2

Initial punctate - erythematous lesions become confluently erythematous. (not papular or vesicular)

Question 3

Scarlet fever skin presentation

Answer 3

Scarlatiniform rash

Facial flushing with peri-oral pallor.

Pastia lines - purpura in the areas around skin folds.

White then red strawberry tongue: Tongue is initially white and hyperkeratotic, with swollen red papilae. Then by day 4-5 the hyperkeratosis sloughs off and the tongue and oral mucosa is bright red.

The rash fades in 4-5 days and is followed by sheetlike desquamtion of the trunk and sheetlike exfoliation of the hands and feet.

Question 4

Treatment of impetigo caused by MRSA

Answer 4

2X Daily compress, soaking, scrubbing, and local dissinfections, followed by Topical Mupirocin.

Question 5

Treatment of normal staph aureus infections

Answer 5

Topical Fucidin ointment.

Systemic Flucloxacillin, orally for 7-10 days

Question 6

Imiquimod cream use and mechanism

Answer 6

For topcial tratment of some malignancies and warts.

Activates TLR-7 and local immune response.