Skin Infection

Question 1

Name 3 normal skin commensals.

Answer 1

Staph epidermidis
Propionibacterium
Corynebacterium

Question 2

Give 2 examples of coagulase +ve and 3 of -ve staph + which normally needs abx.

Answer 2

Epidermidis and saprophyticus

Aureus, MSSA and MRSA (abx)

Question 3

What is the abx for staph aureus and MSSA vs MRSA?

Answer 3

FLUCLOXACILLIN

Doxycyline, co-trimoxazole, clinda/vancomycin

Question 4

Name 3 infections of the hair follicle caused by staph aureus.

Answer 4

Folliculitis
Furuncles
Carbuncles

Question 5

What is the name of the staph aureus infection causing a golden crust with contagious discharge?

Answer 5

Impetigo

Question 6

Name 4 staph aureus toxins.

Answer 6

alpha-toxin (haemolysin)
TSST-1
PVL
SSST

Question 7

What is TSST-1 and what does it cause?

Answer 7

Superantigen

Mass cytokines release

Question 8

Which 2 antigens are associated with necrotising pneumonia?

Answer 8

PVL and alpha-toxin

Question 9

Which toxin causes widespread blisters and skin failure in a newborn?

Answer 9

SSST

Question 10

Which system and antigen are streptococci classified by + what are the groups?

Answer 10

Lancefield system and M antigen
Alpha, beta and gamma
Beta divided into A, B and C

Question 11

What is the bacteria species of group A beta-haemolytic streptococcus (GAS) + where is it found + treatment?

Answer 11

Strep. pyogenes
Pharynx
Penicillin or doxycycline

Question 12

Which streptococcus toxin causes necrotising fasciitis + treatment?

Answer 12

Streptolysin S (SLS)
Debridement + abx

Question 13

What is the cause of type 1 and type 2 necrotising fasciitis + x-ray sign?

Answer 13

Type 1 = anaerobes and coliforms after abdo surgery
Type 2 = GAS
Gas in soft tissue

Question 14

Name 2 abx that can cover anaerobes.

Answer 14

Clindamycin

Metronidazole

Question 15

What are the 3 fungi which can cause ringworm starting with the most common.

Answer 15

Tricophyton rubrum
Tricophyton mentagraphytes
Microsporum canis

Question 16

What area of the body is affected in tinea capitis, corporis, cruris, pedis and unguium?

Answer 16

Head
Body
Groin
Foot
Nail

Question 17

Name 2 tests + treatment for general, nail and scalp ringworm.

Answer 17

Wood's lamp
Scraping and culture
General = topical clotrimazole
Nails = amorolfine
Scalp = oral terbinafine + itraconazole

Question 18

Treatments for mild vs severe candida yeast infection.

Answer 18

Topical clotrimazole

Oral fluconazole

Question 19

Which parasite causes scabies + incubation period + key sign + 2 treatment (+ exception)?

Answer 19

Sarcoptes scabiei
6 weeks
Burrows/tracts
Malathion or benzoyl benzoate (not in kids)

Question 20

What is the other name for lice + treatment?

Answer 20

Pediculosis

Malathion

Question 21

Which virus causes chickenpox and shingles + where does it lie dormant?

Answer 21

Varicella zoster virus (VZV)

Dorsal root ganglia of spine

Question 22

Who is chickenpox seen in + what does it affect?

Answer 22

Children and immunosuppressed

Sensory nerve endings

Question 23

How does neonatal VZV occur + 2 treatments for mum?

Answer 23

Secondary to chickenpox in mum

VZV immune globulin or aciclovir

Question 24

Name 3 complications of chickenpox.

Answer 24

Secondary bacterial infection
Haemorrhagic rash
Encephalitis

Question 25

Who is shingles seen in + cause + presentation?

Answer 25

Older and immunosuppressed Reactivation of VZV Rash, vesicles and neuralgia affecting a dermatome

Question 26

What is the name for neuralgia persisting 4 weeks after shingles + which nerve does it commonly affect?

Answer 26

Post herpetic neuralgia | CN V

Question 27

What is Ramsay-Hunt syndrome?

Answer 27

VZV causing CN VII paralysis and irritation of CN VIII

Question 28

Who is the shingles vaccine offered to?

Answer 28

Over 70s

Question 29

Which virus causes erythema multiforme + name 3 other manifestations of it?

Answer 29

HSV Mucosal lesions Encephalitis Eczema herpeticum

Question 30

Which type of HSV is found in children and causes primary gingiostomatitis + treatment?

Answer 30

Type 1 | Aciclovir

Question 31

How does molloscum contagiosum present + alternative spread + treatment?

Answer 31

Small pearly nodules in kids or spread as STD | Liquid nitrogen

Question 32

Which types of HPV cause warts/veruccas + genital warts + cervical cancer?

Answer 32

Types 1-4 Types 6-11 Types 16-18

Question 33

Name a HPV injection + 2 treatments for warts/veruccas?

Answer 33

Gardasil | Liquid nitrogen or salicylic acid

Question 34

Name 2 types of enterovirus + where they are found.

Answer 34

Echovirus Coxsackie GI tract

Question 35

What is herpangina + cause?

Answer 35

Rash at the back of throat | Enterovirus

Question 36

What causes hand, foot and mouth disease?

Answer 36

Coxsackie virus

Question 37

How does Orf present + cause?

Answer 37

Fleshy nodule on farmer's hands | Sheep parapoxvirus

Question 38

What causes slapped cheek/erythema infectiosum + how does it present in kids + adults + test?

Answer 38

Parovirus B19 Facial rash fading to body rash Arthritis of the hands B19 IgM antibodies

Question 39

Name 2 complications of slapped cheek + why?

Answer 39

Miscarriage Anemia Virus spreads in bone marrow and affects RBCs

Question 40

What bacteria causes syphilis + how does primary/secondary/tertiary present + treatment?

Answer 40

``` Treponema pallidum Primary = painless chancre at site of entry Secondary = rash and snail trail ulcers Tertiary = affects CNS and other organs Penicillin injections ```

Question 41

What causes Lyme disease + how does early/late present + treatment?

Answer 41

Ticks carrying borrelia burgdorferi Early = erythema migrans (bullseye rash) Late = heart block and CNS effects Treatment = doxycycline or amoxicillin

Question 42

What spreads Zika virus + 3 complications?

Answer 42

Aedes aegypti mosquito Birth defects Microcephaly Guillain-Barre

Question 43

What is the most common entry of staph. aureus + name 2 virulence factors and what they are?

Answer 43

Nose Fibrinogen-binding protein (adhesin) PVL (toxin)

Question 44

Which M antigens are most common + which cause severe disease?

Answer 44

M1 and M3 | M3 and M18

Question 45

Name 2 virulence factors of GAS + what do they do.

Answer 45

M protein Hyaluronic acid capsule Inhibit phagocytosis