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Derm Pharm > Skin Infections > Flashcards

Skin Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

Primary bacterial infections involve what areas of skin and caused by how many pathogens?

A

Involve previous healthy skin and caused by a single pathogen

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2
Q

Secondary bacterial infections involve what areas of skin and caused by how many pathogens?

A

Involve areas of previously damaged skin and are polymicrobial

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3
Q

Examples of primary skin infections

A

erysipelas, impetigo, lymphangitis, cellulitis, necrotizing fasciitis

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4
Q

Examples of secondary infections

A

diabetic foot infections, pressure sores, bite wounds, burns

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5
Q

Bacterial cause of Erysipelas

A

Group A Streptococci pyogenes

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6
Q

Bacterial cause of Impetigo

A

Staph aureus, group A strep pyogenes

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7
Q

Bacterial cause of Lymphangitis

A

Group A strep

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8
Q

Bacterial cause of Cellulitis

A

Group A strep, Staph aureus (may include MRSA)

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9
Q

Bacterial cause of Necrotizing fasciitis type I

A

anaerobes (bacteroides, Peptostreptococcus), and faculatives (streptococci, Enterobacteriaceae)

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10
Q

Bacterial cause of Necrotizing Fasciitis type II

A

Group A streptococci

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11
Q

Bacterial cause of diabetic foot infections/pressure sores

A

S. aureus, Streptococci, Enterobacteriaceae, Bacteroides, Peptostreptococcus, Pseudomonas

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12
Q

Most common bacterial cause of animal bite wounds

A

Pasteurella

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13
Q

What is the primary initial Tx for a diabetic foot ulcer?

A

Debridement of affected area + Abx

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14
Q

Class I skin infection presentation

A

patients are afebrile and healthy

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15
Q

Tx of Class I skin infections

A

Topical/Oral antimicrobials

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16
Q

Class II skin infection presentation

A

patients are febrile/ill and without unstable comorbidities

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17
Q

Tx of Class II skin infections

A

IV antibiotics (OP or short term IP), some may be able to have PO antibiotics

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18
Q

Class III skin infection presentation

A

patients are toxic, with an unstable comorbidity or limb threatening infxn

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19
Q

Class IV skin infection presentation

A

patients are septic or with a life threatening infxn (necrotizing fasciitis)

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20
Q

Tx of Class III and Class IV skin infections

A

Hospitalize with IV abx

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21
Q

DOC and dosing for erysipelas

A

Pencillin G (IM) or Pen VK (PO) for 7-10 days

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22
Q

DOC for Impetigo

A

Cephalexin, Pencillin

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23
Q

DOC for mild cellulitis

A

Dicloxacillin, Amoxicillin, Cephalexin

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24
Q

DOC for severe cellulitis

A

Nafcillin, Cefazolin, IV Vanco

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25
Q

DOC for severe cellulitis with PCN allergy

A

Vancomycin, Clindamycin

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26
Q

Tx for necrotizing fasciitis

A

early/aggressive surgical debridement, Clindamycin+PCN

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27
Q

DOC for animal bites

A

Augmentin

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28
Q

Abx options for Tx of community acquired MRSA

A

Clindamycin, Bactrim, Doxycycline

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29
Q

Abx options for Tx of hospital acquired MRSA

A

Vancomycin, Daptomycin, Linezolid

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30
Q

What is the gene associated with high resistance in both community and nosocomial acquired MRSA strains?

A

mecA gene

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31
Q

What are the three pathogens that most commonly cause SSTIs?

A

S. aureus, S. pyogenes, MRSA

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32
Q

Local Tx for folliculitis

A

warm compresses, topical Abx therapy

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33
Q

What are the options/dosing for topical Abx for folliculitis

A

Clindamycin, Erythromycin, Mupirocin, Benzoyl peroxide applied 2-4xqd for 7 days

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34
Q

Tx for PCN allergic pts with Erysipelas

A

Clindamycin, Erythromycin

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35
Q

Tx for severe Erysipelas infxn

A

Hospitalize, IV Pen G 2-8million units qd

36
Q

Tx for S.pyogenes caused Impetigo

A

PO Pen VK

37
Q

Tx for PCN allergic pts with Impetigo with dosage

A

Clindamycin for 7-10 days

38
Q

Tx and dosage for pts with mild cases of Impetigo

A

Mupirocin/Retapamulin ointment applied BID/TID for 7 days

39
Q

MOA for Mupirocin (Bactroban)

A

Inhibits bacterial protein synthesis by binding to bacterial isoleycyl transfer RNA synthetase

40
Q

What pathogens is Bactroban effective against

A

G+, MRSA

41
Q

MOA for Retapamulin (Altabax)

A

inhibits bacterial protein synthesis at 50S ribosome subunit site

42
Q

What pathogens is Altabax effective against

A

Staph aureus (methicillin susceptible), Strep pyogenes

43
Q

What will the presentation of cellulitis look like if caused by S. aureus

A

furuncles, carbuncles, abscesses on the skin

44
Q

What will the presentation of cellulitis look like if caused by streptococcus

A

diffuse skin infection and without a defined portal

45
Q

In what cases will cellulitis be caused by mixed aerobes and anaerobes pathogens

A

diabetics, following traumatic injuries, at sites of abdomen/perineum surgical incisions, vascular insufficiency

46
Q

DOC for PCN allergic pts with mild cellulitis

A

Clindamycin, Macrolide

47
Q

What two diagnostic interventions are not helpful with cellulitis?

A

Skin aspiration, Blood Cx

48
Q

Abx Tx for nonsevere diabetic foot infections

A

Augmentin 875 mg q 12 hrs

49
Q

Abx Tx for severe diabetic foot inxns

A

Vancomycin

50
Q

Why is Zosyn not a good option for Tx of severe diabetic foot inxns?

A

Covers G+, G- and anaerobes but doesn’t cover MRSA

51
Q

Abx Tx for PCN allergic for diabetic foot inxns

A

Meropenem

52
Q

Examples and MOA of topical azoles

A

Ketoonazole, Miconazole, Itraconazole, Flucanozole; Inhibits synthesis of ergosterol

53
Q

Examples and MOA of allylamine

A

Naftin, Lamisil; Inhibits squalene epoxide enzyme in ergosterol synthesis

54
Q

Examples and MOA of polyene

A

Amphotericin B, nystatin; binds to fungal sterol

55
Q

Examples and MOA of Echinocandins

A

Caspofungin, Micafungin; inhibits 1,3 beta D glucan

56
Q

Major pathogen responsible for candidiasis

A

Candida Albicans

57
Q

In what kind of patients can complicated VVC occur

A

immunocompromised, uncontrolled diabetes mellitus

58
Q

Tx for complicated VVC

A

more aggressive, lengthen therapy to 10-14 days

59
Q

Tx for resistant cases of VVC

A

Boric Acids, 5-Flucytosine

60
Q

OTC Topical Tx for VVC

A

Butoconazole, Clotrimazole, Micaonazole, Ticonazole

61
Q

Rx topical Tx for VVC

A

Nystatin, Terconazole

62
Q

Rx PO Tx for VVC

A

Fluconazole

63
Q

Which Tx is more effective for Onychomycosis, oral or topical?

A

Oral, topical will only work if nails are removed first

64
Q

DOC for Onychomycosis

A

Terbinafine, Itraconazole

65
Q

What properties are found in both Terbinafine and Itraconazole to make them effective for Tx of onychomycosis

A

lipophilic and keratinophilic properties

66
Q

Is Terbinafine fungicidal or fungistatic

A

fungicidal

67
Q

Is Itraconazole fungicidal or fungistatic

A

fungistatic

68
Q

What fungi is Terbinafine active against?

A

dermatophytes, non-dermatophyte molds

69
Q

What fungi is Itraconazole active against?

A

dermatophytes, nondermatophytes, Candida

70
Q

SE for Terbinafine/Itraconazole

A

GI (diarrhea, dyspepsia, nausea, abd pain), dermatologic (rash, urticaria, pruritis), headache

71
Q

DI for Itraconazole

A

Lovastatin, Simvastatin; Itraconazole inhibits CYP3A4 enzymes and reduces drug levels

72
Q

DOC for HSV

A

Acyclovir, Famiciclovir, Valacyclovir

73
Q

What dosing adjustment must you consider with all antiviral therapy?

A

Renal dosing adjustment

74
Q

MOA for Acyclovir

A

acyclic guanosine analog, binds viral DNA polymerase, chain terminator to end replication

75
Q

MOA for Valacyclovir

A

I valine ester prodrug of acyclovir, 5x greater bioavailability than acyclovir

76
Q

MOA of Famciclovir

A

purine analog similar to acyclovir with high bioavailability

77
Q

What virus causes warts

A

HPV

78
Q

Tx options for Warts

A

Diethyl ether+propane (freeze), Nitrogen, Salicyclic Acid

79
Q

What is the pathogen that commonly causes gas gangrene?

A

Clostridial perfringens (G+ bacilli)

80
Q

What conditions are seen associated with gas gangrene?

A

Neutropenia, GI malignancy

81
Q

What is the primary Tx for gas gangrene?

A

Debridement, TTX+Clindamycin+PCN+Chloramphenicol

82
Q

When should Amphotericin B be prescribed for fungal infections?

A

When all other antifungal Tx fail, only available IV

83
Q

Preferred Tx for oral candidasis

A

Clotrimazole, Nystatin suspension

84
Q

SE of Clotrimazole

A

Altered taste, Nausea, Vomiting

85
Q

SE of Nystatin

A

Nausea, Vomiting, Diarrhea

Derm Pharm (2 decks)

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