Skin, Bone, Healthcare Infections Flashcards

1
Q

most skin and soft tissue infections are caused by?

A

staph aureus

strep pyogenes

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2
Q

cellulitis is?

A

acute inflammatory process involving skin and soft tissues causing erythema, tenderness, warmth, swelling, lymphangitis
mostly lower limb

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3
Q

lymphangitis vs lymphadenitis

A

lymphangitis is inflammation of lymph tracks, red lines running up the legs
lymphadenitis is painful swollen nodes

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4
Q

risk factors for cellulitis

A

peripheral edema
lymph stasis
ulcers/wounds/trauma
dermatophytic infections (tinea)

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5
Q

mycobacterium marinum causes

A

fish tank granuloma

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6
Q

management of cellulitis

A

flucloxacillin

or cephalexin or cephazolin if allergic to penicillins

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7
Q

what is chronic venous insufficiency

A

disruption of the valves in veins which overwhelms the lymphatics.
get blood in the interstitial space that isnt cleared, breaks down leaving hemosiderin stains.
get swelling of legs
not as painful as cellulitis

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8
Q

how to differentiate acute contact dermatitis with cellulitis

A

usually have an exposure to irritant

and isnt as tender as cellulitis

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9
Q

differentials for cellulitis

A
septic arthritis
septic bursitis
contact dermatitis
chronic lymphodema
necrotising fasciitis 
pyomyositis 
DVT
gout
thrombophlebitis
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10
Q

markers for deeper infection (necrotising fasciitis/gas gangrene)

A
severe pain
systemic toxicity (high HR, low BP)
gas
clinical deterioiration despite antibiotics
skin necrosis
bullae
elevated CK (due to muscle destruction)
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11
Q

typical pathogen post-burn

A

pseudamonus aerigonosa

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12
Q

treatment for cellulitis (suspected staph or strep)

A

flucloxacillin or cephalexin if allergic

if strep pyogenes likely can use penicillin

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13
Q

treatment of severe cellulitis

A

IV fluclox 2g/6 hourly

or IV cephazolin if allergic

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14
Q

what is gout? what joint is most common? treat with?

A

urate crystal deposition in joints, usually metatarsophalyngeal
diagnosed by urate aspirate
treat with NSAIDS

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15
Q

what is thrombophlebitis

A

inflammation and thrombus within a vein

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16
Q

septic arthritis mostly occurs via

A

blood borne infection

but oculd be direct innoculation

17
Q

what is a fomite

A

contaminated object

18
Q

what is MRSA, what is it resistant to?

treat with?

A

methicillin resistant staph aureus
resistant to all penicillins, most cephalosporins
treat with vancomycin

19
Q

does culture of klebsiella in sputum mean a patient has pneumonia?
what about staph aureus in blood?

A

for pneumonia look at the patient and assess them for actual symptoms of pneumonia.
staph aureus in blood is ALWAYS significant

20
Q

what is VRE

A

vancomycin resistant enterococcus

21
Q

what is CPE

A

carbapenemase producing enterobacteriaceae

22
Q

difference between gram positive and gram negative

A

gram positive = 1 membrane and surrounding peptidoglycan wall
gram negative = inner and outer membrane (LPS) with a thin peptidoglycan wall in between

23
Q

examples of beta lactam drugs and how they work

A

penicillins
cephalosporins
carbapenems

they inhibit cell wall synthesis by blocking transpeptidase so only work on dividing bacteria

24
Q

antibiotics that inhibit protein synthesis by blocking ribosomal subunits

A

aminogycosides (gentmicin)
tetracyclines (doxycycline)
macrolides (azithromycin)
lincosamides (clindamycin)

25
Q

antibiotics that inhibit nucleic acid synthesis

A

trimethoprim
sulphonamides
fluoroquinolones (ciprofloxacin)
metranidazole

26
Q

normal white cell count range

A

4-11

27
Q

normal CRP levels

A

below 5

28
Q

gram positive diplococci present on sputum culture would indicate?

A

pneumococcal infection

29
Q

treatment for pneumoccal pneumonia

A

typically penicillins
penicillin G (IV)
and penicillin V (oral)

30
Q

a broad specturm penicillin with activity against pseudamonus aeriginosa

A

piperacillin

commonly prescrribed with beta-lactamase inhibitor tazobactam

31
Q

if patient with pneumococcal pneumonia developed rash from penicillin what would you give?

A

cephtriaxone (a cephalosporin)

cephtriaxone doesnt work well for staph aureus

32
Q

the kind of organisms that cause atypical pneumonia?

treatment?

A

intracellular
legionalla
chlamydia
coxiella

treatment: doxycycline (a tetracycline)
or azithromycin (a macrolide)
with intracellular activity
33
Q

what causes rigors?

A

other than influenza it is mostly bacterial infections

34
Q

when should you treat asymptomatic bacteriuria

A

only in pregnancy or before urology procedures

35
Q

causes of postoperative fever?

A
usually a result of the procedure itself
wind (pneumonia)
water (UTI)
wound
walking (PE)