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Quiz 3 > session 8: skin, eye, wounds > Flashcards

session 8: skin, eye, wounds Flashcards

0
Q

GAS

A

-streptococci: divided into 3 groups on the basis of their hemolytic reactions on blood agar plates

Alpha: green zone, partial breakdown of Hb
Beta: clear zone, total breakdown
Gamma: no breakdown of RBC, no change in agar

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1
Q

necrotizing fasciitis ( flesh eating disease)

A
  • caused by S. pyogenes or GAS
  • all affected tissue is removed ( degraded) and IV antibiotic started
  • aftermath is reconstructive surgery and plastic surgery
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2
Q

Beta hemolytic streptococci

A
  • divided into subgroups dependent on cell wall carbohydrate ( lance filed’s typing)- most disease producing
  • S. pyogenes and S. agalactide are the 2 major pathogen (A and B)
  • C is several organism
  • D is enterococci
  • G is several organisms
  • also can be sub typed using M. proteins in the cell wall
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3
Q

Streptococcus pyogenes

A
  • Beta hemolytic: important pathogen in skin infections in Group A or GAS
  • includes pharyngitis, tonsillitis, impetigo, cellulitis, flesh eating disease
  • post infection complications includes acute glomerulonephritis and rheumatic fever: heart tissue and antibody attacks it
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4
Q

streptococcus pyogenes toxins and enzymes

A
  • catalase: breaks down hydrogen peroxide, Staph is positive, Strep is negative
  • streptokinase: dissolve blood clots, spreads tissues
  • hyaluronidase: breaks down connective tissues
  • deoxyribonucleases: degrade DNA: bacteria chew up cell and break down
  • proteases: break down proteins ( IgA protease- antibody component by component)
  • erthyrogenic toxin: cause scarlet fever, rash, spe toxins: exotoxins which are superantigens, responsible for tissue and muscle breakdown
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5
Q

Erysipelas

A
  • infection in the deeper layer of the skin ( dermal layer)
  • can progress to septicaemia and fatal outcome
  • can begin as pharyngitis
  • treatment is antibiotic: IV penicillin
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6
Q

Toxic shock syndrome

A
  • life-threatening, multi-system effects
  • production of a superantigen ( TSST-1 in S. aureus)
  • fever, vomiting, sunburn like rash, often involves scalded skin syndrome (SSS) due to exfoliate toxin ( loosen the junction between cells to slough)
  • first identified with tampon usage, now common in surgery and IV users
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7
Q

Staphylococcus Sp.

A

Gram positive cocci in clusters
-non motile, non spore forming and can or not have capsules

3 important species to know:

  • S. aureus ( primary pathogen)
  • S. epidermis ( opportunistic)
  • S. saphrophyticos ( primary pathogen in UT, young women)
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8
Q

S aureus

A

coagulase positive staphylococci

  • aureus means yellow
  • produce coagulase ( catalyze fibrinogen to fibrin, soluble to insoluble)
  • produce catalase ( breaks down hydrogen peroxide)
  • salt tolerant ( survive on surface for a while)
  • yellowish colonies
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9
Q

Catalase test

A

can cause boils and abscesses

  • one drop of hydrogen peroxide on a slide, add bacteria and mix
  • formation of bubbles=gas ( enzyme is present and breaking down the peroxide, releasing oxygen gas)
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10
Q

Eyelids infection with S. aureus

A

blepharitis- inflammation of eyelid margins

stye/horaeola- infection of eyelid glands and follicles

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11
Q

Impetigo

A

often in newborns and young children

  • caused by S. aureus and S. pyogenes
  • infection of epidermal layer ( facial)
  • treatment is topical antibiotics, keeping it clean, it will heal itself
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12
Q

Staphylococcus scalded skin syndrome (SSS)

A

neonatal or 2 degree to toxic shock syndrome- due to exfoliative toxin and skin lesion
-bacteria attacks the junctions of epidermal cells and cause loosening of skin

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13
Q

psudomonas aeroginosa

A

in hot tubs!

  • gram (-) bacilli; in soil and water
  • produce endotoxins and exotoxins
  • often opportunistic pathogen ( burn patients)
  • difficult to treat ( antibiotic resistant)
  • produce blue green irridescent pigment called pyocyanin ( smells like wild strawberries) has pus
  • colonizer of lungs in CF
  • also cause swimmer’s ear, usually doesn’t cause infections in healthy individuals
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14
Q

warts

A

a benign tumour

  • caused by papilloma virus ( DNA, non-enveloped)
  • virus cause proliferation of skin cells “tumour growth”
  • transmitted by direct contact: genital warts, plantars warts,
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15
Q

Herpesviruses

A

Herpes means to crawl or creep

  • 8 viruses total
  • HSV-1 is cold sores and herpes simplex
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16
Q

HSV 1

A
  • very common, more than 90% infected, most in childhood
  • transmitted through oral contact or direct contact
  • cause cold sores
  • remain latent in ganglia, flare up with stress
  • often trigeminal nerve ganglion
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17
Q

Herpes whitlow

A

occupational hazard of health care workers

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18
Q

Herpes gladitonium

A

wrestlers

19
Q

conjunctiva

A

thin layer of mucous membrane lining the eyelids and covering the surface of the eye

20
Q

Keratitis

A

inflammation of cornea, leads to blindness

21
Q

bacterial keratitis and herpes keratitis

A

bacterial- more pus due to neutrophils

herpes- scarring of eye surface

22
Q

C. trachomatis

A
  • ocular: Types A-C, not ever sexually transmitted
  • genital: types D-K, LGV

inclusion conjunctivitis: infection in eye with genital chlamydia
opthalmia neonatorum: gonorrhoeae in newborn eye

23
Q

Staphylococcus epidermis

A

dominates in skin infection
-diptheroids: coryneobacterium: aerobes on surface
propionibacterium: anaerobes, live under the surface in follicles and glands
some yeasts: madlessezia furfur

24
Q

skin lesions

A

vesicle: raised blister with fluid up to 1 cm in diameter
bulla: raised blister with fluid greater than 1 cm
macule: slightly raised flat area with no fluid
pustule: deep pocket of pus up to 1 cm in diameter, very painful

25
Q

fifth disease, slapped cheek syndrome B-19

A
  • parvovirus B19, DNA, non-enveloped
  • mild disease of childhood
  • pregnant women get complications- fetal death
  • virus includes nucleated RBC destruction, loss in RBC by 30%, abortion for fetus
26
Q

parasitic disease of the skin

A

Hookworms: burrow through the skin ( dermatitis)
Leishmania: 2 skin manifestation- cutanous and mucoculanous
Schistosoma: swimmer’s itch
Scabies: tunnel under outer skin layer ( mite)
Myiasis: larva under skin ( common in tropical area)

27
Q

IV catheter: 4 sources of infections

A
  1. microbial contamination at insertion site
  2. HUB
  3. contaminated infusate
  4. hematogenous seeding from a distent site
28
Q

Abscesses

A

localized lesion with accumulation of pus anywhere in the body

  • result of external infection or internal infection ( after peritonitis)
  • often polymicrobial (appendicitis): ‘intra-abdominal abscess”
29
Q

osteomyelitis

A
  • infection of the bone: by nearby site of infection, like fracture or from circulating microbes
  • cause is S. aureus in blood
  • cause is polymicrobial ( gram positive or gram negative)- nearby site
30
Q

surgical infection of upper and lower body

A

upper body: primarily staph. sp

lower body and abdominal infections: primary faecal flora, gram negative, enterococci

31
Q

wound abscesses

A
  • localized accumulation of pus
  • area of inflammation surrounds the pus and walls it off from surrounding tissue, trying to prevent spread of infection
  • difficult to treat with antibiotics since they diffuse poorly in inflamed tissue
  • surgical draining is treatment
32
Q

anaerobic wounds

A

-common in crushed wounds, puncture wounds

33
Q

consequences of wounds

A
  1. delayed healing
  2. formation of abscesses
  3. dissemination or spread of the infection into nearby tissues or the blood lymph
34
Q

symptoms of bite infection

A

most common symptoms:

  • localized cellulitis
  • pain at site of injury
  • purulent discharge, often gray and foul smelling
35
Q

symptoms of bite infection in less than 10% of victims

A

temperature is above 37.2
regional adenopathy- swollen lymph nodes
puncture wounds most infected

36
Q

snake bites

A
  • venom causes tissue necrosis where infection can develop

- pseudomonas aeruginosa is the common cause of infections, but can include slamonella, CNS

37
Q

human bite and clenched fist injuries

A
  • more infected than animal bits
  • both aerobic and anaerobic bacteria implicated ( oral flora)
  • Eikonella corrodens is an important pathogen
38
Q

cellulitis

A
  • acute spreading infection of the skin
  • involves subcutaneous tissues
  • originates from superficial skin lesions or trauma ( boils or ulcers)
  • majority of cases caused by S. aureus and S. pyogenes
39
Q

IVDU

A
  • intravenous drug users

- often get cellulitis or lymphangitis with s. aureus

40
Q

anaerobic cellulitis

A

area of traumatized tissue or poor blood circulation

  • diabetes very prone to it in feet
  • foul smelling exudate, marked swelling and gas
41
Q

Cat or dog bites can result in an infection of ….

A

pasteurella multocida, cause lymphangitis and septic shock

42
Q

Gas gangrene

A
  • caused by Clostridium perfringens ( gram positive spore forming bacilli)
  • it’s usually in soil and feces
  • usually a result of traumatized tissues with poor blood supply, with anaerobic conditions in wounds ( war wound)
  • buttocks and perineum common sites
  • organism multiply in subcutaneous tissues and invade deeper tissues, thrive on dead tissues
  • produce gas as a by-product of metabolism crackling sound on palpation
  • destroys tissue cells and WBC, collagenase, etc.
43
Q

burns

A
  • infections results from a disruption in the normal homeostasis
  • mortality rate with burns are greater than 40% of body surface area is high
  • important to maintain blood flow to affected area
  • usually both gram positive and negative infections
  • cause pseudomonas

-p. aeruginosa commonly infects burn wounds

44
Q

proplonibacterium acnes

A
  • gram positive, anaerobic, diptheroid bacilus, cause acne

- blocks channels transporting sebum to surface

Quiz 3 (3 decks)

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