Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Year 1 - Semester 2 - Part 2 > Skin and Soft Tissue Infections > Flashcards

Skin and Soft Tissue Infections Flashcards

1
Q

What is the epidermis ?

A

Hard, Horny layer of dead cells
- constantly being replenished

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

First Impressions of SSTIs

A

What do I need to be worried about ?
- type of infection

Is this going to kill my patient ?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

SSTI

A

Skin and Soft Tissue Infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Features of the epidermis - defensive barrier

A

Surface is dry

Acidic pH

Sweat secretion (salty)

Rich blood and lymphatic supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the epidermis produce ?

A

Antimicrobial substances
- fatty acids
- sebum
- defensins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IS the skin a sterile environment ?

A

NO

Normal skin microbiota is present
- many different bacteria colonising you

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

State some normal skin microbiota

A

Staphylococci
Streptococcus pyogenes
Propionibacterium acnes

Corynebacterium sp.
Candidia sp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Staphylococcus epidermidis

A

Coagulase negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Staphylococcus aureus

A

Coagulase positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Function of normal microbiota

A

Important roles for educating the innate and adaptive arms of the cutaneous immune system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is associated with skin diseases ?

A

Dysbiosis is associated with some skin diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Abscess

A

Collection of pus; pustule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cutaneous vesicle

A

Blister; bullae; fluid filled sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pyoderma

A

Pus forming skin infection

(pus in the skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Impetigo

A

Vesicles developing into rupturing pustules, then forming dried crusts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ecthyma

A

Rupturing vesicles leading to erythematous lesions and dried crusts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Folliculitis

A

Inflammation at hair follicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Furuncle

A

Boil, deep folliculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Carbuncle

A

Collection of boils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Erysipelas ?

A

Erythema and Inflammation affecting deeper dermis and subcutaneous fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cellulitis

A

Erythematous inflammation affecting deeper dermis and subcutaneous fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acne

A

Infection of sebaceous follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Necrotising Fascitis ?

A

Cellulitis with necrosis affecting skin, deeper fascia and sometimes muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dehiscence

A

Wound rupture along surgical suture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

State some routes of infections

A

Skin
Wounds
Bites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What do the skin, wounds and bites - routes of infection have in common ?

A

Breach in the defensive barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Skin - routes of infection

A

Pores
Hair follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Wounds - routes of infection

A

Scratches
Cuts
Burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Bites - routes of infection

A

Insects
Animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Things to consider when taking a patient history

A

Onset, Evolution, Duration and Location of lesions

Contacts with a similar rash

Past medical history - noting skin conditions

Previous treatments including antimicrobial therapy

Skin trauma or insect bites

Systemic features - fever

Co-morbidities present

Pre-dispositions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pre-dispositions

A

Foreign travel
Saltwater exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Why is it important to understand if a patient has previously been prescribed antibiotics ?

A

ABx can cause the pathogen to become more virulent

ABx will affect their normal flora

Failure of an ABx to treat symptoms can provide information for future treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What organisms cause skin infections ?

A

Viral pathogens
Fungal pathogens
Toxin mediated

BACTERIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

State some bacterial infections

A

Staph aureus
- coagulase positive

Streptococci (e.g. S. pyogenes)

E coli / Pseudomonas spp. / Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What type of bacteria is more prevalent in skin infections ?

A

Gram + bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Superficial skin infections

A

Impetigo
Erysipelas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Deep skin infections

A

Cellulitis
Necrotising Fasciitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Co-morbidities and other interventions

A

S. aureus infection in a patient with diabetes mellitus
- uses increased blood sugar for proliferation

Catheter Related infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Clinical management of bacterial skin infections

A

Draw a line around the infected area, to identify whether it is spreading or reducing.

This gives an indication if the treatment is working or not.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Blood/ wound cultures

A

Not always necessary, but will take 24-48 hrs to return, so empiric therapy is usually required before.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What causes impetigo ?

A

Staph aureus
Strep pyogenes

Common bacterial infection in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Feature of impetigo

A

Highly contagious
- normally superficial (epidermis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

State the 2 main types of impetigo

A

Non-bullous
Bullous (blisters)

44
Q

Feature of non-bulbous impetigo

A

Characteristic golden/brown crust

Thin walled vesicles/pustules

Satellite lesions may develop

45
Q

Feature of bullous impetigo

A

Flaccid, fluid filled vesicles and blisters

Thin flat yellow/ brown crust

46
Q

Management of impetigo

A

Advise hygiene measures
- wash affected areas with soap+water
- avoid scratching affected areas

Treatment

47
Q

Treatment of impetigo

A

Hydrogen peroxide cream if it’s in one area.

Antibiotic cream or tablets if it is more widespread

Antibiotic tablets if bullous impetigo or very unwell.

48
Q

When is referral of impetigo required ?

A

If part of an outbreak

If diagnostic uncertainty

Resistant to maximal treatment

Complications

49
Q

SSSS

A

Staphylococcal Scalded Skin Syndrome

50
Q

What is SSSS ?

A

RARE bacterial infection

Staph aureus
- exotoxin release

51
Q

Diagnosis of SSSS

A

SSSS requires prompt recognition and treatment

52
Q

Treatment of SSSS

A

Parenteral antibiotics to cover staph aureus

53
Q

Outcomes of SSSS

A

Children generally recover well

SSSS is an infection control issue, may be a carrier in care home / nursery

54
Q

Erysipelas

A

Bacterial skin infection (upper dermis)

Caused by:
- strep pyogenes
- other bacteria can cause it too

55
Q

Characteristics of erysipelas

A

Clear boundary with normal skin
Fever, rise in WBC count

Treatment is as for cellulitis

56
Q

Cellulitis

A

Common bacterial skin infection of lower dermis and subcutaneous tissue

Typically caused by s. pyogenes (2/3) and s. aureus (1/3)

57
Q

Characteristics of cellulitis

A

Diffuse inflammation

Starts in a small area of redness, tenderness/ swelling.

Progresses to fever or chills

May lead to life threatening conditions (e.g. sepsis)

58
Q

Classes of cellulitis

A

Class 1-4

59
Q

Class 1 cellulitis

A

NO signs of systemic toxicity

Person has no uncontrolled comorbidities

60
Q

Class 2 cellulitis

A

Person is either systemically unwell / well but with a co-morbidity

61
Q

Class 3 cellulitis

A

Person has significant systemic upset or unstable co-morbidities that may interfere with a response to treatment.

62
Q

Class 4 cellulitis

A

Person has sepsis or severe life-threatening infection, such as necrotising fasciitis.

63
Q

Management of Class 1 cellulitis

A

Draw a line around lesion

Prescribe high dose oral antibiotics

Pain relief and elevation

Review in 48 hours

64
Q

Necrotising fasciitis

A

Very serious bacterial infection of the soft tissue and fascia

65
Q

Causes of necrotising fasciitis

A

Polymicrobial

S. pyogenes / S. aureus

Gas gangrene

Marine organisms / fungal infections

66
Q

Gas gangrene

A

Clostridium spp.

67
Q

How does necrotising fasciitis develop ?

A

Infection starts in the superficial fascia and spreads vertically up into the skin and down into deeper structures.

68
Q

Fungal infections of the skin

A

Ringworm - aka Tinea

Yeasts

69
Q

What causes ringworm ?

A

Trichophyton

Microsporum

Edpidermopythyton

70
Q

Yeasts

A

Candida albicans

Malassezia furfur

71
Q

Ringworm of the body

A

Tinea corporis

72
Q

Ringworm of the foot - athletes foot

A

Tinea pedis

73
Q

Ringworm of the groin

A

Tinea cruris

74
Q

Viral infections of the skin

A

Herpes simplex virus

Human papilloma virus

Chickenpox - Varicella-Zoster virus

75
Q

Warts / Gential warts

A

HPV

76
Q

Cold Sores

A

Herpes simplex virus 1

77
Q

Genital Herpes

A

Herpes Simplex virus 2

78
Q

Chicken pox, Shingles

A

Varicella Zoster Virus (VZV)

79
Q

Hand, Foot and Mouth Disease

A

Coxsackie A virus

80
Q

HPV

A

Affects the skin and moist membranes lining the body - cervix, anus, mouth and throat

Changes to cells within the cervix can lead to cervical cancer

81
Q

Parasites of the skin

A

Sarcoptes scabei (mites)

82
Q

Sarcoptes scabei (mites)

A

Causes scabies

Mite buries into the skin
Female lays eggs

Infection is asymptomatic
Hypersensitivity may occur

May lead to superinfection

83
Q

Most common types of bites

A

Dogs (80-90%)
Cats
Human children
Adults

84
Q

How common are bites ?

A

250,000 cases in A&E UK/ year

3% of visits

85
Q

Cat bite : features

A

Small deep wound (2-5 cm)

Usually periphery - hand/foot

Pasteurella spp.

Cellulitis

86
Q

Sites of animal bites

A

Children - facial / cervical (neck)

Adults - extremities

87
Q

Host factors

A

Immune status
Site of injury
Wound management

88
Q

Infection risks

A

Species
Host factors

89
Q

Dog bites : features

A

Large wound; tearing, crushing

Usually periphery but can occur anywhere

Secondary infections: large area damaged, higher chance of contamination

Crush damage comes with its own complications

Management: surgery - extensive superficial damage

90
Q

Species - bite causing

A

Cat (80%)
Dog (36%)
Humans (18%)

91
Q

Pasteurella multocida

A

Bacterial organism that causes infection - from cat bites

Gram negative coccus

Penicillin sensitive

92
Q

Human bite : features

A

Wide shallow wound

Anywhere…

Highly polymicrobial
Deep infection is common, viral infection

Drastically different - Assess

93
Q

Animal Bite ‘Mantra’

A

The Solution to Pollution is Dilution

  • get rid of the infecting material
  • clean the wound
94
Q

Microbiology of bites

A

Polymicrobial

95
Q

Human - microbiology of bites

A

Average 5 microorganisms will infect

60% anaerobes

Eikenella corrodes 1/4 hand bites

Group A strep

96
Q

Viral aetiology of human bites

A

Rabies
Simian herpes virus
Hep B, HIV, Hep C

97
Q

Management of bites

A

Full History

Radiology

Wound Exploration

Antibiotic therapy

98
Q

Full history - bites

A

Immunodeficiency
Country of exposure

99
Q

Radiology - bites

A

Clenched fist
Scalp bites children

100
Q

Wound exploration

A

Irrigate / Debride = Source of control

Delayed closure

101
Q

Antibiotic therapy - bites

A

Prophylaxis

Treatment

102
Q

Duration of antibiotics for Tenosynovitis

Inflammation and swelling of a tendon

A

21 days

103
Q

State some common antibiotics used mild-moderate bites

A

Co-amoxyclav
Doxycycline + Metronidazole

104
Q

Duration of antibiotics for Cellulitis

A

7-10 days

105
Q

Duration of antibiotics for Septic Arthritis

A

28 days

106
Q

Duration of antibiotics for Osteomyelitis

A

42 days

107
Q

Why do you need to adapt the duration of antibiotics ?

A

So that the agent can reach the bacterium and actually kill it.

As depending on where the infection lies, the bacteria can metabolise and will have access to antimicrobials differently, so won’t reach it as effectively.

Different metabolic states

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions