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Dermatology > Skin infections > Flashcards

Skin infections Flashcards

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Dermatology Board Prep flashcards
1
Q

What defences does the skin have against infection?

A 
Physical barrier
Dryness desiccates micro-organisms
Sebum inhibits microbial growth
Commencal bacteria competes with pathogenic bacteria
Innate immunity such as Langerhan cells.
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2
Q

What is the most common commensal bacteria?

A

Staph epidermidis

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3
Q

How do you tell the difference between a bacterial and viral infection?

A

Bacteria is localised and pus filled

Viral is widespread and full of clear fluid

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4
Q

What tests do you do to identify an organism?

A

Culture -> Gram test -> Form -> Coagulase test (for Staph) or hemolysis test (for Strep).

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5
Q

Describe Staph epidermidis

A

Gram +ive, coagulase -ive, clumps, skin commensal.

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6
Q

Describe Staph aureus

A

Gram +ive, coagulase +ive, clumps, gives golden crust.

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7
Q

What conditions can S. Aureus cause?

A

Boils/carbuncles, wound and skin infections such as cellulitis, infected eczema and impetigo.

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8
Q

How do you treat S. Aureus?

A

Flucloxicillin

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9
Q

How do you treat MRSA?

A

Vancomycin, doxycycline, Co-trimoxazole, Clindamycin

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10
Q

Describe Strep Pyogenes

A

Gram +ive, beta haemolysis, chains.

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11
Q

What conditions can S. Pyogenes cause?

A

Infected eczema, impetigo, cellulitis, necrotizing fasciitis

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12
Q

How do you treat S. Pyogenes?

A

Penicillin or flucloxacillin

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13
Q

Describe Necrotizing fasciitis.

A

Extreme pain
Crepitations when pressed
Air on XR

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14
Q

How do you treat necrotizing fasciitis?

A

Antibiotics and debridement

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15
Q

What is Tinea?

A

A fungal infection commonly called Ringworm

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16
Q

Where is T. Capitis found?

A

Head

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17
Q

What is tinea on the head called?

A

T. capitis

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18
Q

Where is T. Barbac found?

A

Beard

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19
Q

What is tinea on the beard called?

A

T. Barbac

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20
Q

Where is T. Corpus found?

A

Body

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21
Q

What is tinea on the body called?

A

T. Corpus

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22
Q

Where is T. mannum found?

A

Hand

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23
Q

What is tinea on the hand called?

A

T. Manuum

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24
Q

Where is T. Unguium found?

A

Nails

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25
Q

What is tinea on the nails called?

A

T. Unguium

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26
Q

Where is T. Cruris found?

A

Groin

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27
Q

What is tinea in the groin called?

A

T. Cruris

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28
Q

Where is T. Pedis found?

A

Foot

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29
Q

What is tinea on the foot called?

A

T. Pedia (commonly athletes foot).

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30
Q

What fungi cause tinea?

A

Dermatophytes such as: Trichophyton rubrum or trichophyton mentagraphytes

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31
Q

Where do dermatophytes attack?

A

Keratinised tissue and enter through broken or soggy skin.

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32
Q

What does tinea look like?

A

Outwards growing ring like lesion of scale.

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33
Q

What are some sources of dermatophytes?

A

Humans, soil, cats, dogs, cattle.

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34
Q

How do you treat tinea?

A

Small areas: Topical clotrimazole or amorolfine

Large areas: Oral Terbinafine or itraconazole.

35
Q

What is candida?

A

A yeast infection

36
Q

Where does candida present?

A

Warm, moist skin folds.

37
Q

How do you treat candida?

A

Clotrimazole cream and oral fluconazol.

38
Q

How do lice present?

A

With an intense itch

39
Q

What is another name for lice?

A

Pediculus.

40
Q

How do you treat lice?

A

Malathion.

41
Q

How do scabies present?

A

Intense itchy rash on fingers, wrist and genitalia.

42
Q

What do you look for in a scabies infestation?

A

Burrows in skin.

43
Q

How do you treat scabies?

A 
Malathion overnight 
Benzyl benzoate (avoid in children).
44
Q

What two conditions does the Varicella Zoster virus cause?

A

Chickenpox (Vericella)

Shingles (Zoster)

45
Q

Describe Varicella/Chicken Pox

A

Primary infection.
Macules > Papules > Vesicles > Scabs > Recovery
General centripetal rash
Fever

46
Q

Name some complication of CP

A

Secondary infection, scarring, pneumonitis

47
Q

What is neonatal VZV?

A

A VZV in newborns acquired if mother has it within 5 days of delivery.

48
Q

How do you protect against neonatal VZV?

A

Give VZ immunoglobulin to susceptible groups.

49
Q

Describe Shingles.

A

Dermatomal reactivation of VZV in the elderly or immunosuppressed.
Pain increases with age but progresses similar to CP.

50
Q

What is Ramsay-Hunt Syndrome?

A

Complication of shingles when in infects 7th and 8th CN

51
Q

List some effects of Ramsay-Hunt Syndrome.

A

Vesicles and pain in auditory canal and throat.
Facial palsy- 7th CN
Deafness, vertigo, tinnitus- 8th CN

52
Q

Who gets vaccinated against CP in the UK?

A

Vulnerable health care workers.

53
Q

Who gets vaccinated against shingles?

A

Everyone when they reach 70.

54
Q

What does Herpes Simplex Virus cause?

A

Extensive ulceration in and around the mouth which can be recurrent.

55
Q

What happens when HSV infects eczema?

A

You get potentially life threatening Eczema Herpericum .

56
Q

What is eczema herpeticum?

A

The result of HSV infecting eczema.

57
Q

Where does Type 1 HSV infect?

A

Oral and genitalia.

58
Q

Where does Type 2 HSV infect?

A

Genitalia only.

59
Q

What medication can be given for VZV and HSV?

A

Aciclovir

60
Q

What skin conditions can Human Papilloma Virus cause?

A

Warts, verrucas, genital warts.

61
Q

What strains of HPV cause warts?

A

1-4

62
Q

What strains of HPV cause genital warts?

A

6 and 11

63
Q

What conditions can enteroviruses cause?

A

Herpangina and Hand, foot and mouth disease.

64
Q

How does herpangina present?

A

Blistering in the back of mouth.

Self-limiting.

65
Q

How does hand, foot and mouth present?

A

Often in children

Fever, sore throat, not wanting to eat, mouth ulcers, rash, blisters.

66
Q

What is the common name for erythema infectiosum?

A

Slapped cheek disease.

67
Q

What virus causes erythema infectiosum?

A

Parvovirus B19

68
Q

What are the symptoms of parvovirus B19?

A

Arthritis (especially in wrists), rash on cheeks that mimics slapping, sudden drop in Hb, spontaneous abortion.

69
Q

Why does Hb drop in parvovirus B19 infection?

A

It grows in RBC progenitors.

70
Q

How do you detect Parvovirus B19?

A

Antibody test. Parvovirus B19 IgM.

71
Q

How does Orf present?

A

Firm fleshy nodules on farmers hands.

72
Q

Describe Orf.

A

Acquired from sheep and self-limiting. Clinical diagnosis only.

73
Q

What causes syphilis?

A

Treponema pallidum

74
Q

How does syphilis first present?

A

Painless ulcer at sight of entry

75
Q

How does syphilis progress?

A

Red rash all over body but most intense on sole of feet and palms of hand.
Snail track ulcers on mucous membranes.

76
Q

What are some complications of syphilis?

A

CNS and CV disturbances such as aortic aneurysms.

77
Q

How do you detect syphilis?

A

PCR or antibody tests.

78
Q

How do you treat syphilis?

A

Penicillin

79
Q

What causes Lyme disease?

A

Borrelia burgdofri

80
Q

How does Lyme disease first present?

A

Red ring rash called erythema migrans.

81
Q

How does Lyme disease progress?

A

Heart block, nerve palsy and arthritis.

82
Q

How do you treat Lyme disease?

A

Doxycycline or amoxicillin.

83
Q

How do you diagnose Lyme disease?

A

Erythema migrans rash in early stages or antibodies in later.

Dermatology (10 decks)

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