Skin and Soft tissue

Question 1

Skin infection

Answer 1

• Typically Cellulitis - affects lower limb
• Inflammation - Calor, Dolor, Rubor, Tumour, Loss of function

Question 2

Soft tissue infection

Answer 2

Intradermal pathogen leads to Cephalus

Question 3

Main cellulitis pathogens

Answer 3

Strep pygoenes
SA - most important

Question 4

Main differential of cellulitis

Answer 4

DVT

Question 5

Impetigo in children features

Answer 5

• Honey coloured crusty coloured lesion on chin and cheeks of young person
• Itchy growing spots which they keep scratching

Question 6

investigations for impetigo

Answer 6

• Black charcoal swab
  Catalase test after swab -
• Positive : Staph aureus
• Negative: with beta haemolysis on blood agar - diagnose S. Pyogenes - Group A beta haemolytic strep

Question 7

Cellulitis

Answer 7

• Skin infection that does not breach skin
• Breaches up until the epidermis But doesnt go further than the skin

Question 8

Treatment for cellulitis

Answer 8

Empirical antibiotics - flucocoxicllin then review

Question 9

Blood culture for cellulitis

Answer 9

High volume sample
More than one site
More than one time

Question 10

Group A B haemolytic strep for cellulitis - what do you do

STREP PYOGENES

Answer 10

Once you’ve identified its strep with negative catalyse test - shows beta haemolysis then lacefield typing
Treatment is flucocoxicllin or benzylpenicillin first line

Question 11

Infected cannula site

Answer 11

Big risk for cellulitis - give empirical antibiotics like flucox or benzylpenicillin

Question 12

In MRSA what do you have?

Answer 12

• Resistant strain to typical amox + flucocixicillin
• Give IV vancomycin or Teicoplanin for minimum 2 weeks
• SE of these is nephrotoxicity + ototoxicity - hearing problems
• Patients need close monitoring