Brainscape's Knowledge GenomeTM

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


See full index

Year 3 > Skin and Soft Tissue Infections > Flashcards

Skin and Soft Tissue Infections Flashcards

1
Q

name the layers of the skin

A 
stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the infection site in the epidermis?

A

impetigo

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

what is the infection site in the dermis and upper subcut fat?

A

folliculitis

erysipelas

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

what is the infection site in the lower dermis and upper sub cut fat?

A

cellulitis

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

what is the infection site in the lower subcut fat and muscle fascia

A

necrotising fascitis

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

organisms causing impetigo

A

s. aureus

strep pyogenes

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

organisms causing folliculitis

A

s. aureus

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

organisms causing erysipelas

A

strep pyogenes

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

organisms causing cellultitis

A

strep pyogenes (common)

s. aureus (uncommon)
h. influenzae (rare)

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

organisms causing necrotising fascitis?

A

strep pyogenes

mixed bowel flora

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

what is impetigo?

A

superficial skin infection

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

what does impetigo look like?

A

multiple vesicular lesions on an arythematous base

golden crust

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

causes of impetigo

A

most common s. aureus

less common strep pyogenes

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

what age is most affected by impetigo ?

A

2-5 yrs

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

how infectious is impetigo ?

A

highly

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

where does impetigo occur?

A

exposed parts of the body including face, extremities, scalp

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

predisposing factors for impetigo

A 
skin abrasions
minor trauma
burns
poor hygiene
insect bites
chickenpox
eczema
atopic dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

treatment of impetigo

A

small area - topical antibiotics

large area - topical and oral antibiotics - flucloxacillin

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

what is erysipelas?

A

infection of the upper dermis

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

features of erysipelas?

A

painful, read area (no central clearning)
associated fever
regional lymphadenopathy and lymphangitis
typically has distinct elevated borders

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

most common cause of erysipelas

A

strep pyogenes

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

where does erysipelas occur?

A

70-80% - lower limbs
5-20% - face
areas of pre-existing lymphoedema, venous stasis, obesity, paraparesis, DM

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

what is the recurrence rate for erysipelas?

A

30% within 3 years

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

what is cellulitis?

A

diffuse skin infection involving deep dermis and subcutaneous fat

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

how does cellulitis present?

A

spreading erythematous area with no distinct borders

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

most common causes of cellulitis

A

strep pyogenes

staph aureus

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

features of cellulitis

A

fever

regional lymphadenopathy and lymphangitis

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

predisoposing factors for cellulitis

A

DM
tinea pedis
lymphoedema

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

treatment of erysipelas and cellulitis

A

combination of anti-staphylococcal and anti-streptococcal antibiotics
in extensive disease, admission for IV antibiotics

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

name the hair-associated infections

A

folliculitis
furunculosis
carbuncles

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

features of folliculitis

A

circumscribed, pustular infection of a hair follicle
up to 5mm in diameter
small red papules
central area of purulence that may rupture and drain

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

where is folliculitis typically found?

A

head
back
buttocks
extremities

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

most common cause of folliculitis

A

staph aureus

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

features of furunculosis

A

furuncles commonly referred tto as boils
single hair follicle associated inflammatory nodule
extending into dermis and SC tissue
may spontaneously drain purulent material

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

where does furunculosis commonly affect?

A

moist, hairy, friction prone areas of the body - face, axilla, neck, buttocks

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

most common organism causing furunculosis

A

staph aureus

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

systemic symptoms of furunculosis

A

uncommon

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

risk factors for furunculosis

A 
obesity
DM
atopic dermatitis
chronic kidney disease
corticosteroid use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

when does a carbuncle occur?

A

when infection extends to involve multiple furuncles

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

where are carbuncles often found?

A

back of neck

posterior trunk or thigh

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

features of carbuncle

A

multiseptated abscesses

purulent material may be expressed from multiple sites

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

systemic symptoms of carbuncle

A

common

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

treatment of folliculitis

A

no treatment or topical antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

treatment of furunculosis

A

no treatment or topical antibiotics

if not improving oral antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

treatment of carbuncle

A

often require admission to hospital, surgery and IV antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

where can necrotising fasciitis occur?

A

anywhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

predisposing conditions for necrotising fasciitis

A 
DM
surgery
trauma
peripheral vascular disease
skin popping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is type 1 necrotising fasciitis?

A

mixed aerobic and anaerobic (diabetic foot infection, Fournier’s gangene)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

type 1 necrotising fasciitis causative agents

A 
streptococci
staphylococci
enterococci
gram negative bacilli
clostridium
50
Q

what is type 2 necrotising fasciitis?

A

monomicrobial

51
Q

type 2 necrotising fasciitis causative agents

A

strep pyogenes

52
Q

features of necrotising fasciitis

A

rapid onset
sequential development of erythema, extensive oedema, and severe unremitting pain
haemorrhagic bullae, skin necrosis and crepitus
fever, hypotension, tachycardia, delirium and multiorgan failure

53
Q

what feature is highly suggestive of necrotising fasciitis?

A

anaesthesia at site of infection

54
Q

treatment of necrotising fasciitis

A

surgery

broad spectrum antibiotics - flucloxacillin, gentamicin, clindamycin

55
Q

mortality from necrotising fasciitis

A

17-40%

56
Q

what is pyomyositis?

A

purulent infection deep within striated muscle, often manifesting as an abscess

57
Q

what is pyomyositis often secondary to?

A

seeding into damafed muscle

58
Q

multipe sites of pyomyositis are involved in what %?

A

15%

59
Q

common sites of pyomyositis

A 
thigh
calf
arms
gluteal region
chest wall
psoas muscle
60
Q

features of pyomyositis

A

fever, pain, woody induration of affected muscle

61
Q

if pyomyositis is untreatmed it can lead to?

A

septic shock and death

62
Q

predisposing factors of pyomyositis

A 
DM
HIV
immunicompromised
IVDU
rheumatological diseases
malignancy
liver cirrhosis
63
Q

commonest cause of pyomyositis

A

staph aureus

64
Q

other organisms causing pyomyositis

A

gram +ve/-ve
TB
fungi

65
Q

investigation of pyomyositis

A

CT

MRI

66
Q

treatment of pyomyositis

A

drainage with antbiotics

67
Q

what are bursae?

A

small sac-like cavities that contain fluid and are lined by synovial membrane

68
Q

where are bursae found?

A

subcutaneously between bony prominences or tendons

69
Q

what do bursae do?

A

facilitated movement with reduced friction

70
Q

most common sites of septic bursitis

A

patellar

olecranon

71
Q

septic bursitis is infection often originating where?

A

adjacent skin

72
Q

predisposing factors for septic bursitis

A 
RA
alcoholism
DM
IVDU
immunospuression
renal insufficiency
73
Q

features of septic bursitis

A

peribursal cellullitis, swelling and warth

fever and pain on movement

74
Q

diagnosis of septic bursitis

A

aspiration of the fluid

75
Q

most common cause of septic bursitis

A

staph aureus

76
Q

other causes of septic bursitis

A

gram -ve
mycobacteria
vrucella

77
Q

what is infectious tenosynovitis?

A

infection of the synovial sheaths that surround tendons

78
Q

where is infectious tenosynovitis most common?

A

flexor muscle associated tendons

tendons of hands

79
Q

what is the most common initiating event of infectious tenosynovitis?

A

penetrating trauma

80
Q

most common cause of infectious tenosynovitis

A

staph aureus

streptococci

81
Q

what causes chronic infectious tenosynovitis?

A

mycobacterium

fungi

82
Q

what may infectious tenosynovitis cause?

A

disseminated gonococcal infection

83
Q

presentation of infectious tenosynovitis

A

erythematous fusiform swelling of finger
held in a semiflexed position
tenderness over the length of the tendon sheath and pain with extension

84
Q

treatment of infectious tenosynovitis

A

empiric antibiotics

hand surgeon review

85
Q

toxin mediated syndromes are often due to?

A

superantigens

86
Q

mechanism of toxin mediated syndromes

A

• Group of pyrogenic exotoxins
• Do not activate immune system via normal
contact between APC and T cells
• Superantigens bypass this and attach directly to
the T cell receptors activating up to 20% of the
total pool of T cells instead of the normal
1/10,000
• Massive burst in cytokine release
• Leads to endothelial leakage, haemodynamic
shock, multi-organ failure and ?death

87
Q

causes of toxin mediated syndromes

A

staph aureus - TSST1, ETA and ETB

strep pyogenes - TSST1

88
Q

what can cause toxic shock syndrome?

A

tampons

small skin infections due to staph aureus

89
Q

diagnostic criteria for staphlococcal TSS

A

• Fever
• Hypotension
• Diffuse macular rash
• Three of the following organs involved
• Liver, blood, renal, gatrointestinal, CNS, muscular
• Isolation of Staph aureus from mucosal or
normally sterile sites
• Production of TSST1 by isolate
• Development of antibody to toxin during
convalescence

90
Q

streptococcal TSS is almost always associated with?

A

streptococci in deep seated infections such as erysipelas or necrotising fasciitis

91
Q

mortality rate of strep and staph TSS

A

5% staph

50% strep

92
Q

treatment of strep TSS

A

urgent surgical debridement

93
Q

treatment of TSS

A 
remove offending agent e.g. tampon
IV fluids
ionotropes
antibiotics
IV immunoglobulins
94
Q

what is staphylococcal scalded skin syndrome?

A

infection due to a particular strain of staph aureus producing the exfoliative toxin A or B

95
Q

what is staphylococcal scalded skin syndrome characterised by?

A

widespread bullae and skin exfoliation

96
Q

who gets staphylococcal scalded skin syndrome?

A

children but rarely adults

97
Q

treatment of staphylococcal scalded skin syndrome

A

IV fluids and antimicrobials

98
Q

mortality rate of staphylococcal scalded skin syndrome

A

3% in children

higher in adults who are often immunosuppressed

99
Q

what is panton-valentine leucocidin toxin?

A

gamma haemolysin

100
Q

panton-valentine leucocidin toxin can be transferred from?

A

one strain of staph aureus to another including MRSA

101
Q

what can panton-valentine leucocidin toxin cause?

A

SSTI

haemorrhagic pneumonia

102
Q

who gets panton-valentine leucocidin toxin?

A

children and young adults

103
Q

presentation of panton-valentine leucocidin toxin

A

recurrent boils which are difficult to treat

104
Q

treatment of panton-valentine leucocidin toxin

A

antibiotics that reduce toxin production

105
Q

IV catheter associated infections are what kind of infections?

A

nosocomial

106
Q

what do IV catheter associated infections normally start as and progress to

A

start as locall SST inflammation progressing to cellulitis and even tissue necrosis

107
Q

risk factors for IV catheter associated infections

A

continuous infusion > 24 hrs
cannula in situ > 72 hrs
cannula in LL
patients with neurological/neurosurgical problems

108
Q

most common organism IV catheter associated infections

A

Staph aureus

109
Q

what does staph aureus in IV catheter associated infections form?

A

biofilm which spills into blood stream

110
Q

where can IV catheter associated infections end up?

A

endcocarditis

osteomyelitis

111
Q

diagnosis of IV catheter associated infections

A

clinically or by positive blood cultures

112
Q

treatment of IV catheter associated infections

A

remove cannula
express pus from the thrombophlebitis
antibiotics for 14 days
echocardiogram

113
Q

prevention of IV catheter associated infections

A

– Do not leave unused cannula
– Do not insert cannulae unless you are using them
– Change cannulae every 72 hours
– Monitor for thrombophlebitis
– Use aseptic technique when inserting cannulae

114
Q

describe the classification of surgical wounds: class 1

A

clean wound

resp, alimentary, genital or infected urinary systems not entered

115
Q

describe the classification of surgical wounds: class 2

A

clean-contaminated wound

resp, alimentary, genital or infected urinary systems entered but no unusual contamination

116
Q

describe the classification of surgical wounds: class 3

A

contaminated wound

open, fresh accidental wounds or gross spillage from the GIT

117
Q

describe the classification of surgical wounds: class 4

A

infected wound

existing clinical infection, infection present before the operation

118
Q

causes of SSI

A
  • Staph aureus (incl MSSA and MRSA)
  • Coagulase negative Staphylococci
  • Enterococcus
  • Escherichia coli
  • Pseudomonas aeruginosa
  • Enterobacter
  • Streptococci
  • Fungi
  • Anaerobes
119
Q

risk factors for SSI: patient associated

A 
– Diabetes
– Smoking
– Obesity
– Malnutrition
– Concurrent steroid use
– Colonisation with Staph aureus
120
Q

risk factors for SSI: procedural factors

A 
– Shaving of site the night prior to procedure
– Improper preoperative skin preparation
– Improper antimicrobial prophylaxis
– Break in sterile technique
– Inadequate theatre ventilation
– Perioperative hypoxia

Year 3 (164 decks)

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