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MIML 240 > SKIn and Soft Tissue- Part 1 > Flashcards

SKIn and Soft Tissue- Part 1 Flashcards

1
Q

Normal Flora of the Superficial Skin

A

Bacillus (except anthraces, cereus)
Lactobacillus
Micrococcus
CONS (except Lugdunensis)
Corynebacterium sap-diphtheroids
Proprionibacterium acnes
Viridans streptococcus group

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2
Q

single or small area of skin with abnormal growth or appearance

A

Lesions

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3
Q

flat discolouration of skin

A

Macule

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4
Q

elevated solid lesion with distinct border

A

Papule

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5
Q

a papule > 0.5 cm, may affect subcutaneous tissue

A

Nodule

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6
Q

raised lesion (varies in size) with fluid & pus

A

Pustule

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7
Q

blister with clear fluid

A

vesicle

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8
Q

type of vesicle- larger, fluid trapped sacs

A

Bullae

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9
Q

excess dead skin cells, causes thickening and crusting

A

Scales

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10
Q

crater-like sore on skin

A

Ulcers

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11
Q

a widespread eruption of lesions

A

rashes

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12
Q

a rash on skin surface (example: dermatitis)

A

Exanthem

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13
Q

rash on a mucus membrane inside the body (example: in the throat)

A

Enanthem

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14
Q

a painful collection of pus, bacteria and dead tissue in an enclosed tissue space

A

abscess

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15
Q

inflammation of the surface of skin with rash; can be caused by genetics, an overactive immune system, allergies, or irritating substances

A

Dermatitis

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16
Q

a type of dermatitis characterized by skin inflammation due to moisture (sweat) collecting in hot areas of folds of skin (armpit, groin under breasts) + friction;
- breakdown of skin can result in secondary infection by bacteria or fungus
-caused mostly by Candida spp, Dermatophytes, Malasezzia furfur, S aureus and coliforms

A

Intertrigo

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17
Q

an infection of the surface of the skin caused by NSF, Corynebacterium minutissimum
-results in red or brown patches in folds of skin
-can also be caused by Candida spp., Dermatophytes and Malassezia furfur
-Dermatophytes cause circular scaly patch of erythema with raised border- called Tinea
-Malasezzia causes white patches in those with darker skin and brown patches in those with pale skin

A

Erythrasma

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18
Q

group of inflammatory skin disorders that is characterized by the production of pus
-types:
Impetigo
Folliculitis
Furuncle (boil)
Carbuncle
Erysipelas
Cellulitis

A

Pyodermas

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19
Q

occurs mostly in children 2-5 years
-caused most commonly by S. aureus, followed by GAS
-or by GBS in newborns
-affects skin around the nose and mouth or arms and legs
-start as small vesicles that become rupturing pustules
-have a thick yellow discharge that form golden crusts
-contagious
-Bullous form caused by S aureus that produce an exfoliative toxin

A

Impetigo

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20
Q

papular or pustular inflammation of hair follicles
caused mostly by S aureus and MRSA

A

Folliculitis

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21
Q

painful, film or fluctuant abscess originating from a hair follicle
-also called a boil
-caused mostly by S aureus and MRSA

A

Furuncle

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22
Q

a network of furuncles connected by sinus tracts
-are more serious because go deeper into tissue and can lead to bacteremia
-often have to be surgically drained

A

Carbuncle

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23
Q

acute spreading inflammation of the superficial skin and subcutaneous fat tissues
-occurs mostly on legs and face
-Happens when S aureus, GAS, other BHS enter the skin from mild trauma or a wound, burn, or surgical incisions
-can become more serious if organism gets into the lymphatics and blood stream
-SKIN IS HOT, EVENLY SWOLLEN AND ORANGEY/ PINKY RED
-THE LINE OF DEMARKATION BETWEEN INVOLVED AND UNINVOLVED SKIN IS NOT DISTINCT

A

Cellulitis

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24
Q

a superficial type of cellulite that also affects mostly the legs and face
-it is also usually caused by S aureus and GAS
-the organism can spread into the lymphatic system
-SHINY, FIRM DEEPLY RED PLAQUES RAISED ABOVE THE SURROUNDING SKIN
-CLEAR DISTINCT MARGINS BETWEEN INVOLVED AND UNINVOLVED TISSUE

A

Erysipelas

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25
Q

Common pathogens from a dog or cat bite

A

Pasteurella, Staph, strep + other oral flora including anaerobes

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25
Q

Common pathogens from a dog or cat bite

A

Pasteurella, Staph, strep + other oral flora including anaerobes

26
Q

Common pathogens from human bites

A

Streptococcus anginosi
S aureus
Eikenella
Fusobacterium
Prevotella

27
Q

common in diabetics because of their compromised vascular circulation
-infections seen as cellulitis, or acute/chronic ulceration that may progress to osteomyelitis and gangrene
-infections often due to a mixture of bacteria like Staph, strep, enterobacterales, pseudomonas, and anaerobes
-most infections require debridement if becomes severe enough to need amputation

A

diabetic foot infections

28
Q

injury to skin due to long period of constant pressure
-decreased blood flow leads to tissue damage and tissue death
-common in infirm people who can’t move- elderly
-starts as a pressure sore then becomes a decubitus ulcer (bed sore)

A

pressure sore/decubitus ulcer (bed sore)

29
Q
  1. Painful, hot, unbroken discoloured skin
  2. Blister or shallow ulcer leaking fluid or pus
A

Pressure sore

30
Q
  1. Deep ulcer affecting fat layer
  2. Very deep ulcer where you see muscle or bone
A

Decubitus ulcer

31
Q

infections that cause tissue necrosis
-initially affects skin, fascia and subcutaneous fat- and progresses to muscle tissue
-rapid, life threatening- often requires surgical debridement or amputation

A

Necrotizing skin and soft tissue infections

32
Q

due to a polymicrobial infection- may include GAS, S aureus, Enterobacterales and anaerobes

A

Type I

33
Q

due most commonly to GAS alone or 2nd mosts commonly by S aureus alone or very rarely, by both together

A

Type II

34
Q

due to a marine bacteria V vulnificans

A

Type III

35
Q

due to Clostridium spp

A

Gas gangrene

36
Q

skin infection due to a SA that produces exfoliative or epidermolytic toxin
-causes blistering and peeling of skin can be localized or spread to 90% of body
-affects children < 6 yrs old (primarily in newborns)
-can happen in immunocompromised adults

A

S aureus Scalded Skin syndrome

37
Q

a rare, potentially fatal multisystem disease
-begins with fever, sun burn like rash, peeling skin progresses quickly to hypotension, organ failure, shock and death
-one cause is production of TSST-1 exotoxin

A

Toxic Shock Syndrome

38
Q

a type of TSS associated with high absorbency tampon use in women who have this organism as normal flora in their vagina or on hands

A

Menstruating associated

39
Q

type of TSS associated with any Staph infection especially post surgical ones

A

Non menstruating associated

40
Q

__ % of CA MRSA infections are localize to skin and soft tissue
OFTEN BEGINS AS A PAINFUL SKIN BOIL (LOOKS LIKE A ______ ________)

A

75
SPIDER BITE

41
Q

very rare type of S aureus skin and soft tissue infection
-when it happens it is mostly in those who are immunocompromised
-increasingly due to community acquired MRSA
-rapid and serious infection that affects skin, fascia, subcutaneous and muscle tissue
-a number of exotoxins cause decreased coagulation and fluid leakage in tissue results in swelling and bull formation

A

S aureus Type II Necrotizing infection

42
Q

caused by an infection with a GAS that produces a pyrogenic exotoxin
-toxin damages plasma membranes of capillaries
-is seen as a diffuse red rash on the upper chest that spreads to the trunk and extremities- followed by desquamation of skin
-may also have fever, sore throat and a strawberry tongue

A

Scarlet fever

43
Q

rare, potentially fatal multisystem disease caused by a GAS that elaborates a pyrogenic exotoxin- SpeA, B, or C that act as super antigens
-children with chicken pox and elderly at risk
-toxin causes the initiation of massive proinflammatory response
-causes same symptoms as Staph where rapid multi organ failure leads to shock and death

A

GAS TSS

44
Q

____ is most common cause of Necrotizing Infection II
-contains a number of ___ ___ and elaborates ______ ______ _______.
-begins with slight redness and swelling at site of infection

A

GAS
M proteins; pyrogenic exotoxin A

45
Q

a pseudomonas infection due to direct inoculation of bacteria in skin;
can cause mild skin infection, like folliculitis
-often infects burns, and wound due to injuries or surgery as well as bed sores

A

Primary skin Manifestations

46
Q

due to pseudomonas bacteremia;

A

secondary skin manifestation

47
Q

a secondary skin manifestation which is a result of bacterial invasion of dermal veins leading to hemorrhage of necrosis of skin
-sore has a purple-black centre and is surrounded by a band of red

A

Ecthyma gangrenosum

48
Q

S lugdunensis
in Superficial wounds- full ID with AST only if _____ or ______
in deep wounds or sterile site- full ID with AST regardless of the amount growing in culture

A

pure; predominating

49
Q

S lugdunensis
Cat:
Staphaurex:
Tube Coagulase
PYR
Ornithine

Use Vitekl OX MIC result or cefoxitin (30 ug) as a surrogate to report ______ -DO NOT DO _____ SCREEN
CLSI uses same breakpoints as _____ ______

A

pos
neg
neg
pos
pos
Oxacillin
OX
S aureus

50
Q

causes Type III necrosis infection
-infections from exposure of open wound to seawater with the bacteria
-patients can develop widespread skin lesions with formation of hemorrhagic bull that progresses to necrosis

A

Vibrio vulnificus

51
Q

causes Type III necrosis infection
-found natural in brackish or fresh water- enter the skin through an open wound
-also, if leeches used therapeutically

A

Aeromonas

52
Q

Vibrio
gram:
MAC:
Oxidase
Nitrates to _______
salt____

A

Curved GNB/ comma, facultative anaerobe
LF
Pos
nitrites
loving

53
Q

Aeromonas
gram:
Oxidase
MAC

A

small gram negative coccobacilli, facultative anaerobe
Pos
LF

54
Q

a gnb or gncb that can cause skin and soft tissue infections after animal bite- mostly dogs and cats
-has 5 serotypes but mostly A and D causes disease in humans
-virulence due to formation of capsule and toxin
-skin infection starts with redness and swelling then cellulitis with purulent discharge
-does not grow on MAC, oxidase pos, spot indole pos

A

Pasteurella multocida

55
Q

severe skin and soft tissue infection due to anaerobic organism Clostridium;
-can happen spontaneously in those with abdominal diseases- usually due to Clostridium septic

A

Clostridium Gas Gangrene

56
Q

produces multiple toxins- alpha toxin the most virulent;
-organism produces DNAse, hyaluronidase, and a hemolysin which al breakdown tissue- accompanied with a foul smelling gas- gas gangrene

A

Clostridium Perfringens

57
Q

a rare direct cause of cellulitis and indirect skin manifestations

A

Neisseria meningitidis

58
Q

causes dermal micro vessel thrombosis that rapidly leads to hemorrhagic skin necrosis, peripheral gangrene & shock

A

Purpura fulminans

59
Q

Specimen collection:
this type of specimen is not optimal;
-should only be collected when tissue or aspirate can’t be obtained
-only for wounds that show obvious signs of infection or chronic wounds that are not healing
-must cleanse the wound first to remove superficial debris by irrigating with ______ ______
-collect the specimen by gently rolling the swab over the surface of the wound approximately ____ times, focusing on ____ or inflamed tissue
-Place swab in transport media like ____ or _____
-SUPERFICIAL SWAB SPECIMEN NOT APPROPRIATE FOR ________ CULTURE

A

Superficial swabs
sterile saline
five
pus
Amies; Stuarts
ANO2

60
Q

Best specimens for skin and soft tissues

A

Aspirates or Biopsies

61
Q

For infected bite wounds:
-aspirate pus from the infected wound
Don’t culture fresh bite wounds- will have normal rest flora introduced from the bite but cultures can’t predict if these will cause infection

A
62
Q

useful for the detection of an IV catheter-associated bloodstream; a short section of the catheter that had been under the skin is aseptically;
cultured by rolling tip across the agar surface using sterile forceps

A

Intravascular Tips

MIML 240 (11 decks)

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