Brainscape's Knowledge GenomeTM

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


See full index

3rd Year Infection > Skin and Soft Tissue Infections > Flashcards

Skin and Soft Tissue Infections Flashcards

1
Q

What must you consider in skin/soft tissue infections?

A

Site

Organism

Host

Environment

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

What host factors can affect skin infections?

A

DM

Immunosuppression

Renal failure

Milroy’s disease

Predisposing skin conditions

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

What is Milroy’s disease?

A

Congenital lymphoedema of the legs

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

What are the layers of skin?

A

Epidermis

Dermis

Hair Follicle

Subcutaneous fat

Fascia

Muscle

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

Which infections affect the epidermis?

A

Impetigo

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

Which infections affect the dermis?

A

Folliculitis

Eryspipelas

Cellulitis

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

Which infections affect the Subcutaneous fat?

A

Cellulitis

Erysipelas

Necrotising Fasciitis

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

How does impetigo present?

A

Superficial skin infection

Multiple vesicular lesions on a red base

Golden crust

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

What are the most common pathogens in impetigo?

A

Staph aureus

Strep pyogenes

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

What is this?

A

Impetigo

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

What is the epidemiology of Impetigo?

A

Children 2-5y/o

Highly infectious

Exposed parts of the body

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

How is impetigo treated?

A

Small areas = Topical antibiotics

Large areas = oral flucloxacillin

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

What is Erysipelas?

A

Painful infection of upper dermis

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

How does Erysipelas present?

A

Painful red area with no central clearing

Fever

Regional lymphadenopathy

Lymphangitis

Distinct, elevated borders

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

What is the most common causative pathogen of Erysipelas?

A

strep pyogenes

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

What is this?

A

Erysipelas

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

Erysipelas typically affects which parts of the body?

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
18
Q

What is the recurrence rate of Erysipelas?

A

30% in 3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
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
20
Q

How does Cellulitis present?

A

Spreading erythematous area with no distinct borders

Fever

Regional lymphadenopathy/lymphangitis

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

What are the most common causative pathogens in Cellulitis?

A

Strep pyogenes

Staph aureus

Gram -ves (diabetics, febrile neutropaenics)

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

Cellulitis can cause what?

A

Bacteraemia

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

What is this?

A

Cellulitis

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

How is Cellulitis investigated?

A

Investigate for predisposing factors:

  • DM
  • Tinea pedis
  • Lymphoedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How is cellulitis and erysipelas managed?

A

Anti-staphylococcal and anti-streptococcal antibiotics

Potentially admission and IV antiB for severe disease

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

What are the most common hair-associated infections?

A
  • Folliculitis
  • Furunculosis
  • Carbuncles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is folliculitis?

A

Circumscribed, pustular infection of a hair follicle

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

How does Folliculitis present?

A
  • Up to 5mm in diameter
  • Present as small red papules
  • Central area of purulence that may rupture and drain

Typically on Head, back, buttocks and extremities

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

What is the most common causative pathogen of Folliculitis?

A

Staph aureus

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

What is Furunculosis?

A

Boils - single hair follicle associated inflammatory nodule

Extension into dermis and subcutaneous tissue

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

Furunculosis typically affects which parts of the body?

A

Moist, hairy, friction prone areas

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

What is this?

A

Furunculosis

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

What is the most common causative pathogen of Furunculosis?

A

Staph aureus

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

What are the risk factors for Furunculosis?

A

–Obesity

–Diabetes mellitus

–Atopic dermatitis

–Chronic kidney disease

–Corticosteroid use

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

What is a Carbuncle?

A

Infection spreading to involve multiple furuncles

Multi-septated abscesses

Purulent material expressed from multiple sites

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

How does a Carbuncle present?

A

Back of neck, posterior trunk, thigh

Constitutional symptoms

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

What is this?

A

Carbuncle

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

How is furunculosis treated?

A

Oral antibiotics if not improving by itself

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

How are Carbuncles treated?

A

Surgery

Intravenous antibiotics

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

What are the predisposing conditions of Necrotising fasciitis?

A

–Diabetes mellitus

–Surgery

–Trauma

–Peripheral vascular disease

–Skin popping

– IVDA

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

What are the main types of Necrotising fasciitis?

A

Type 1 - mixed aerobic/anaerobic

Type 2 - monomicrobial

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

What organisms are involved with type 1 Necrotising fasciitis?

A

–Streptococci

–Staphylococci

–Enterococci

–Gram negative bacilli

–Clostridium

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

What organisms are involved with type 2 Necrotising fasciitis?

A

Strep pyogenes

44
Q

What is this?

A

Type 2 necrotising fasciitis

45
Q

How does type 2 necrotising fasciitis present?

A

Cellulitis with extreme pain - opiates

Haemorrhagic bullae

46
Q

What is implied by a haemorrhagic bullae?

A

Necrotising fasciitis

or

Cellulitis with ANTICOAGULANTS

47
Q

How does Necrotising fasciitis present?

A

Rapid onset

Sequential erythema, oedema, severe pain

Haemorrhagic bullae

Skin necrosis

Fever, hypotension, tachycardia, multiorgan failure

48
Q

How is Necrotising fasciitis assessed?

A

Surgical review - see if NF has penetrated the fascia

49
Q

How is Necrotising fasciitis treated?

A

Broad spec. antibiotics

–Flucloxacillin

–Gentamicin

–Clindamycin

50
Q

What mortality is associated with Necrotising fasciitis?

A

17-40%

51
Q

What is pyomyositis?

A

Purulent deep infection in striated muscle - abscess

Multiple sites

52
Q

What sites are commonly effected by Pyomyositis?

A

–Thigh

–Calf

–Arms

–Gluteal region

–Chest wall

–Psoas muscle

53
Q

How does Pyomyositis present?

A

Fever, pain, induration of affected muscle

54
Q

What complications are associated with untreated Pyomyositis?

A

Septic shock

Death

55
Q

What predisposing factors are associated with Pyomyositis?

A

–Diabetes mellitus

–HIV/immunocompromised

–Intravenous drug use

–Rheumatological diseases

–Malignancy

–Liver cirrhosis

56
Q

What is the most common pathogen in Pyomyositis?

A

Staph aureus

Gram+ve/-ves

TB

Fungi

57
Q

How is Pyomyositis investigated?

A

CT/MRI

58
Q

How is Pyomyositis managed?

A

Drainage

Antibiotics (depending on stain)

59
Q

What are Bursae?

A

Small sac-like cavities that contain fluid in synovial membrane

Reduce friction in joints

60
Q

What are the most common sites of septic bursitis?

A

Patellar

Olecranon

61
Q

What is the cause of Septic bursitis?

A

Infection from adjacent skin site

62
Q

What are the predisposing factors for Septic bursitis?

A

–Rheumatoid arthritis

–Alcoholism

–Diabetes mellitus

–Intravenous drug abuse

–Immunosuppression

–Renal insufficiency

63
Q

How does Septic bursitis present?

A

Peribursal cellulitis

Swelling

Warmth

Fever

Pain on movement

64
Q

How is Septic bursitis diagnosed?

A

Aspiration of fluid

65
Q

What are the most common organisms in Septic bursitis?

A

Staph aureus

Gram -ves

Myocbacterium

Brucella

66
Q

What is Infectious tenosynovitis?

A

Infection of synovial sheaths surrounding tendons

67
Q

Which tendons are most commonly associated with Infectious tenosynovitis?

A

Flexor muscle associated tendons

Tendon sheaths around hand

68
Q

What is the most common cause of Infectious tenosynovitis?

A

Penetrating trauma

69
Q

Which pathogens are most commonly responsible for Infectious tenosynovitis?

A

Staph aureus

Streptcocci

70
Q

What are the most common causes of chronic Infectious tenosynovitis?

A

Mycobacteria

Fungi

Disseminated gonoccal infection

71
Q

How does Infectious tenosynovitis present?

A

Erythematous fusiform swelling of finger

Semiflexed position

Tenderness overlength of tendon sheath

Pain with extension

72
Q

How is Infectious tenosynovitis treated?

A

Antibiotics

Hand surgeon review

73
Q

What are the most common causes of toxin-mediated syndromes?

A

Superantigens (pyrogenic exotoxins)

74
Q

How do superantigens work?

A

Bypass APC and attach directly to T-cell receptors

Massive burst in cytokine release

Endothelial leakage, haemodynamic shock, multiorgan failure

75
Q

Which strains of Staphyloccus aureus are responsible for Toxin-mediated syndromes?

A

TSST1

ETA
ETB

76
Q

Which strains of Streptococcus pyogenes are responsible for Toxin-mediated syndromes?

A

TSST1

77
Q

What is the diagnostic criteria for Staphylococcal toxic shock syndrome?

A

Fever

Hypotension

  • 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
78
Q

What is streptococcal toxic shock syndrome associated with?

A

Deep seated infections:

Erysipelas

Necrotising fasciitis

79
Q

What is the rate of mortality for Streptococcal TSS compared to Staphylococcal TSS?

A

Strep: 50%

Staph: 5%

80
Q

How are toxic shock syndromes treated?

A

Surgical debridement of infected tissues

IV fluids

Inotropes

Antibiotics

IV immunoglobulins

81
Q

What is Staphylococcal scalded skin syndrome?

A

Infection due to Staph aureus strains producing exfoliative toxin A or B

82
Q

How does Staphylococcal scalded skin syndrome present?

A

Widespread bullae

Skin exfoliation

Children

83
Q

How is Staphylococcal scalded skin syndrome managed?

A

IV fluids

Antimicrobials

84
Q

What mortality is associated with Staphylococcal scalded skin syndrome?

A

3% children

Higher in adults

85
Q

What is Panton-Valentine leucocidin toxin?

A

Gamma haemolysin

Transfers from one strain of Staph aureus to another

86
Q

Panton-Valentine leucocidin toxin can cause what?

A

SSTI

Haemorrhagic pneumonia

87
Q

Panton-Valentine leucocidin toxin affects which patients?

A

Children/young adults

88
Q

How does Panton-Valentine leucocidin toxin present?

A

Recurrent, difficult to treat boils

89
Q

How is Panton-Valentine leucocidin toxin treated?

A

Antibiotics that reduce toxin production

90
Q

How do Intravenous-catheter associated infections present?

A

Starts with SST inflammation, progresses to cellulitis then tissue necrosis

Associated bacteraemia

91
Q

What are the risk factors for Intravenous-catheter associated infections?

A

–Continuous infusion >24 hours

–Cannula in situ >72 hours

–Cannula in lower limb

–Patients with neurological/neurosurgical problems

92
Q

What organisms are associated with Intravenous-catheter associated infections?

A

Staph aureus (MSSA/MRSA)

93
Q

How does the pathogen act in Intravenous-catheter associated infections?

A

Staph aureus forms a biofilm - spills into blood stream

Can seed to other places

94
Q

How is Intravenous-catheter associated infections diagnosed?

A

Blood cultures

95
Q

How are Intravenous-catheter associated infections treated?

A

Remove cannula

Express andy pus

14 days antibiotics

Echocardiogram

(Prevention)

96
Q

How are Intravenous-catheter associated infections prevented?

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

97
Q

What are the classes of surgical wounds?

A

Class 1-4

  1. Clean wound
  2. Clean-contaminated wound
  3. Contaminated wound
  4. Infected wound
98
Q

What is a class 1 surgical wound?

A

Clean wound - resp/alimentary/genital/urinary system not entered

99
Q

What is a class 2 surgical wound?

A

Clean-contaminated wound: respiratory, alimentary, genital or infected urinary systems entered but not contaminated

100
Q

What is a class 3 surgical wound?

A

Contaminated wound - Open, fresh accidental wound or gross spillage from GIT

101
Q

What is a class 4 surgical wound?

A

Infected wound - infection present before operation

102
Q

Name 3 bacterial causes of surgical site infections?

A
  • Staph aureus
  • Coagulase negative Staphylococci
  • Enterococcus
  • Escherichia coli
  • Pseudomonas aeruginosa
  • Enterobacter
  • Streptococci
  • Fungi
  • Anaerobes
103
Q

What are the patient associated risk factors for surgical site infections?

A

–Diabetes

–Smoking

–Obesity

–Malnutrition

–Concurrent steroid use

–Colonisation with Staph aureus

104
Q

What are the procedural factor associated risk factors for surgical site infections?

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

105
Q

How are surgical site infections diagnosed?

A

Send pus/infected tissue for culture - esp. when wound clean

Avoid superficial swabs (go deep fam)

Consider unlikely pathogen if sterile site

Antibiotics

3rd Year Infection (16 decks)

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