Skin Infections Flashcards
1
Q
HPV thickens the ____ layer
Causes ____ to be stimulated
A
Prickle cell layer
Keratin production stimulated
2
Q
virulence factor that allows organism to bind to host
A
adhesin
3
Q
virulence factor that allows organism to avoid host defences
A
impedin
4
Q
virulence factor that causes direct host damage
A
aggressin
5
Q
Skin microbiota = (8)
A
Staph coag -ve + aureus dipheroids Strep spp bacillus spp malassezia furfur occasionally mycobacteria
6
Q
staph infections of skin and mucous membranes caused by
A
staph epidermidis
7
Q
staph infections of anterior nares and perineum caused by
A
staph aureus
8
Q
examples of adhesins
A
fibrinogen binding (CIfA/B) collagen binding (CNA)
9
Q
impedin examples
A
Protein A superantigens alpha toxin and PVL capsule coagulase
10
Q
TSST-1 stands for ___ it is a ___
Causes +++ in 48hrs
A
Toxic shock syndrome Toxin - superantigen of Staph aureus
high fever, v+d, sore throat, myalgia
11
Q
Staph food poisoning is caused by a ___ and causes v+D within __
A
enterotoxin
1-5hrs
12
Q
Staph aureus infection that often affects neonates - face, groin and axilla
___ toxins target DG-1
A
Scalded skin syndrome
exfoliatin
13
Q
Superantigens bind directly to ___ causing a massive release of ___
A
MHCII
cytokines
14
Q
Characteristics of Toxic Shock
A
39* fever
diffuse macular rash and desquamation “sunburn”
hypotensive
>=3 organs involved
15
Q
Toxin that has a specific toxicity for leukocytes, found in 1-2% of clinical Staph strains
A
PVL (Panton Valentine Leukocidin)
16
Q
PVL is associated with severe skin infections such as ++_
the alpha toxin that is linked with CA-MRSA is responsible for +
A
sepsis, nec fasc, recurrent furunucleosis
necrotising pneumonia, contagious severe skin infections
17
Q
Necrotising pneumonia characteristics
A
flu like syndrome precedes haemorrhagic rapid progression ARD refractory hypoxaemia much reduced pulm function multiorgan failure despite antibiotics
18
Q
severe invasive M protein antigen subtypes of Strep pyogenes
A
3+18
19
Q
Superficial type of cellulitis usually in keratin layer that is usually on the face and highly contagious
A
impetigo
20
Q
erysipelas =
A
localised cellulitis that leads to fevers rigor and nausea
21
Q
TSLS stands for __
Caused by ___ from ___
__+__ most common toxin
A
Toxic shock like syndrome
exotoxin from strep pyogenes
SpeA+C
22
Q
TSLS is an ___ disease caused by __
TSS is a ___ caused by __
A
invasive = strep pyogenes
localised with no bacteraemia = Staph aureus
23
Q
investigation for fungal infections =
A
skin scraping
24
Q
suspect fungal infection if lesions are:
A
epidermal, asymmetrical, flaky, in warm and moist areas, red, scaly
25
blue tub swab is for
bacterial swabs
26
suspect bacterial cause of skin infection if:
red confluent pus, tight pain, itchy, hot, swollen, weepy
27
treatment for cellulitis =
flucloxacillin
| doxycycline if allergic
28
red tub swab is for
viral swabs
29
suspect viral cause of skin infection if:
electrical shock/Hypersensitivity pain, bluer red, blisters/vesicles/ulcers
30
management of mulluscum infection =
time - lesions disappear on their own
31
gram positive cocci in clusters, aerobic and facultatively anaerobic =
Staph spp.
32
staph that is coagulative +ve and golden culture
S. aureus
33
enzyme that makes S. aureus distinguishable
coagulase
34
staph species that causes infections of implanted artificial material =
epidermidis
35
S. saprophyticus cause __
UTI in women of child bearing age
36
gram +ve cocci in chains, aerobic and facultatively anaerobic
Strep spp.
37
```
Strep spp
complete haemolysis =
toxin that damages tissues =
Group A cause _+_
Group B cause __
```
beta
haemolysin
A = throat and skin infections
B = neonatal meningitis
38
Strep spp.
partial haemolysis =
2 egs
alpha
pneumoniae
viridans - commensal of throat, mouth and vagina - rarely cause infection
39
Strep spp.
no haemolysis =
eg. and infection it can cause
gamma
enterococcus spp
bowel commensals that may cause UTI
40
Signs of Staph aureus skin infections
```
furuncle/boil
carbuncle
infected cuts
cellulitis
infected eczema
impetigo
SSSS
```
41
Strep pyogenes skin infections
```
infected eczema
impetigo
cellulitis
erysipelas ( acute = large red raised patches on skin)
nec fas
```
42
bacterial infection spreading across fascial planes that causes rapid tissue destruction. Isn't much to look at but extremely painful
necrotising fasciitis
43
type 1 necrotising fasciitis is caused by
mixed anaerobes and coliforms - usually post op abdomen
44
type 2 necrotising fasciitis is caused by
Strep pyogenes
45
tinea =
ringworm - fungal infection
46
fungal infections infect the ___ only
cause increased ___
inflammatory responses in the dermis cause _+_ to be invaded
lesions grow ___ and heal in __ =
keratinised tissue
epidermal turnover
hair follicles and shafts
grow outward heal in middle = ring
47
most fungal infections are spread __
anthropophilically
48
organisms that cause skin fungal infections (3)
```
trichophyton rubum (human human, 70% of lab isolates)
trichophyton mentagraphytes (human human, >20% )
microsporum canis (dog cat human)
```
49
investigations for fungal skin infections
woods lamp
appearance on examination
scrapping/clipping/hair - 2wk to get back
50
small fungal infection treatments =
clotrimazole (canestan) cream or amordfine (topical nail paint)
51
extensive fungal skin infection/scalp/nail treatment
PO terbinafine (hepatotoxic and stay on 6m-12m), itraconazole
52
treatment for candida
clotrimazole cream, PO fluconazole
53
infection of the skin folds =
intertrigo
54
organism that causes scabies =
sign and sympt =
treatments =
sarcoptes scabiei
very itchy rash on finger webs, wrists and genitals
malathion lotion overnight and benzyl benzoate (not in kids)
55
pediculosis =
lice
56
treatment for lice -
malathion lotion
57
3 infectious diseases that need isolated
MRSA
strep. pyogenes
scabies
58
chickenpox is caused by ___ virus
progression of lesions =
centripedal and inflamed skin fever and itch
varicella zoster
| macule>papule>vesicle>scab
59
type of vaccine that the chickenpox vaccine is
live attenuated
60
maternal chickenpox can cause
neonatal VZV
61
progression of shingles presentation on the skin:
tingling/pain>erythema>vesicles>crust
| neuralgic pain
62
if shingles pain lasts for more than 4 wk ( in elderly/trigeminal distribution) =
post herpetic neuralgia
63
shingles affecting eye region and forehead on one side nerve =
ophthalmic V (CN V1)
64
if shingles affects below eye and cheek on one side of face nerve=
maxillary CNV2
65
shingles affects beard region on one side of face nerve =
CNV3 mandibulary
66
adults shingles tends to be in nerves ___+___+ maybe __
| in kids it is more likely to be in __+___
adults: lower thoracic, upper lumbar, maybe CNV
| kids = sacral or cervical nerve dermatomes
67
Ramsay Hunt syndrome =
| characteristics =
genculate/otic herpes zoster
vesicles and pain in auditory canal and throat
facial palsy
irritation of CNVIII => deafness and vertigo tinnitus
68
Primary gingivostomatitis is caused by ___
age =
characteristics =
lasts =
herpes simplex
pre-schoolers
extensive ulceration in and around mouth
1 wk ish
69
recurrence of herpes simplex (gingivostomatitis) characteristics -
blistering rash at vermillion border
| possibly herpetic whitlow or eczema herpeticum
70
abscess of finger caused by herpes simplex =
herpetic whitlow
71
HSV type 1/2 is the main cause or oral lesions and causes half of genital herpes, may lead to encephalitis
1
72
HSV type 1/2 rarely causes oral lesions, half of genital herpes, may cause encephalitis or disseminated infection
2
73
HSV and VZV treatment =
| It does/doesn's eliminate the latent virus
aciclovir
| doesnt
74
erythema multiforme lesions =
| 3 potential triggers =
target lesions with erythema
| drugs, HSV, mycoplasma pneumoniae
75
type of lesion seen with molluscum contagiosum
fleshy, firm, umbilicated pearlescent nodules - 1-2mm diameter
76
HPV types most common in warts and verrucae
1 to 4
77
HPV types most associated with genital warts
6 and 11
78
HPV types associated with cervical cancer
16 and 18
79
herpangina characteristic appearance =
caused by:
treatment =
blistering rash on back of mouth
enteroviruses eg coxsachie or echovirus
self-limiting
80
Hand foot and mouth is caused by ____
enteroviruses especially coxsackie
81
erythema infectiosum/slapped cheek disease is caused by :
erythrovirus/parvovirus B19
82
Complications of parvovirus B19 infection
```
spontaneous abortion (foetal hydrops precursor)
aplastic crisis (esp if thalassaemia, sickle cell, hereditary spherocytosis)
chronic anaemia in IS
```
83
progression of appearance of parvovirus B19 infection
slapped cheek rash > facial rash fades and lacy macular body rash appears + acute arthritis esp in wrists
84
Diagnosis of Parvovirus B19 infection =
IgM parvovirus B19 test
85
tests to diagnose rubella =
IgM and IgG tests
86
signs and symptoms of rubella =
fever, sore throat, arthralgia, blanching rash on face neck trunk and arms, posterior cervical lymphadenopathy
87
after fever and pain of rubella ____ develops and disappears spontaneously in __
oral pain with petechial haemorrhages of soft palate
| 2 days
88
Orf is a ___ infection from ___ aka __
characteristic appearance =
treatment=
```
viral
sheep
scabby mouth
firm fleshy nodule on farmer's hands
self-limiting
```
89
chancre =
primary syphilis
| painless ulcer at site of entry
90
2ndry syphilis =
red body rash, prominent on soles and palms, mucous membrane snail track ulcers
91
tertiary syphilis =
CNS CVS, granuloma
92
treponema pallidum is a bacteria that causes ___
syphilis
93
treatment for syphilis =
penicillin injections
94
borrelia burgdoferi bacterium causes:
lyme disease
95
early presentation sign of lyme disease
erythema migrans (bull's eye)
96
treatment for lyme disease
`doxycycline/ amoxicillin
97
some signs of measles
fever, cough and rhinorrhea after travel
widespread exanthem - head neck shoulders w cephalocaudal spread
small white papules bilaterally buccal mucosa
conjunctivitis
98
2 complications of Zika
Guillain Barre
| microcephaly
99
symptoms of zika
mild fever
maculopapular rash
headaches arthralgia
non-purulent conjunctivitis
100
can athletes foot enter the bloodstream?
no - specialised to skin
101
2 common orgs that cause impetigo
staph aureus
| strep pyogenes
102
most common org to infect eczema
staph aureus
103
virus that can infect eczema
herpes simplex
104
why do kids get lots of warts?
immature T cells
105
HPV types that cause warts
1-4
106
treatment for shingles
aciclovir 800mg - dont wait for swab result just start if facial distribution
