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Infection > Skin, Soft Tissue And Bone Infections > Flashcards

Skin, Soft Tissue And Bone Infections Flashcards

1
Q

Name the skin layers starting from the outer layer to the inner layer

A

Epidermis
Dermis
Subcutaneous

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2
Q

What features does the epidermis have

A

Waterproof

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3
Q

What features does the dermis have

A

Connective tissue
Sweat glands
Hair follicles

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4
Q

What features does the subcutaneous layer have

A

Fat

Connective tissue

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5
Q

Which bacteria can colonise onto the skin

A

Staphylococci: staph aureus
Streptococci: group a (s.pyogenes)
Corynebacteria

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6
Q

When does infection occur in the skin

A

When the immune system is overcome e.g the physical barrier

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7
Q

Which cells are involved in the innate defeneces of the skin

A

Macrophages
Langerhans
Lymphocytes
Antibodies

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8
Q

Name a infection that tends to occur in the face

A

Impetigo/folliculitis

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9
Q

What is impetigo

A

A golden crusting rash on the face

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10
Q

What is folliculitis

A

Infection of the hair follicles

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11
Q

Which organism tends to cause impetigo/folliculits

A

S.aures

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12
Q

What is cellulitis

A

Infection of the skin and the subcutaenous tissues i.e it is deeper infection

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13
Q

When can cellulitis occur

A

When the skin is breached

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14
Q

How does bacteria breach the skin

A
  1. Bacteria penetrate the skin
  2. Bacteria multiple in the skin
  3. Host fails to control the multiplication to cause cellulitis
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15
Q

What are the risk factors for cellulitis

A

Poor blood supply: arterial, venous or lymphatic
Diabetes
Immunosuppressed: chemotherapy, steroid use, malnutrition

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16
Q

Where does cellulitis commonly occur in the body

A

arms and legs i.e limbs

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17
Q

Give examples when the skin can be breahed

A 
Cut
Scratch
Ulcers
Athletes foor 
Burns 
Foreign bodies e.g drains 
Eczema
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18
Q

What are the local symptoms of cellultis

A

Redness
Warmth
Pain
Swelling

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19
Q

What are the systemic symptoms of cellulitis

A

Fever
Malasie
Chills

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20
Q

What investigations can we do for cellulitis

A

Bloods: FBC, CRP- Raised WBC
Superficial swab
Blister fluid
Blood culture- take if the patient is febrile and unwell

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21
Q

What is erysipelas

A

A subgroup of cellulitis that is limited to the dermis therefore does not include the subcutaenous tissue and is superficial

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22
Q

What is the feature of erysipelas

A

Demarcated and raised

23
Q

Which organism tends to cause erysipelas

A

streptococci

24
Q

What is the treatment of erysipelas

A

Penicillin

Clindamycin

25
Q

What is the management of cellulitis

A

Broad specturm antibiotics as we dont known the organism to direct the antibitoics towards

26
Q

What is the organism for cellulitis likely to be

A

Staph aueres

Streptococci

27
Q

In cellulitits if there is MRSA positive what is the treatment

A

Vancomycin

Co trimoxazole/clindaymycin

28
Q

In cellulitis if its MRSA negative what is the treatment

A

Beta lactams e.g flucloxacillin

Macrolide e.g clindamycin

29
Q

What are the other management of cellulitis

A

Analgesia
Elevation of limb to prevent swelling
Fluid
Treat predisposing factors e.g diabetes

30
Q

What can occur in severe cellulitis

A

Toxix shock

31
Q

Why can toxic shock occur in severe cellulitis

A

streptococci can produce superantigens which are proteins that cross link t cell receptors and antigen presenting cells to cause them a release of cytokines

32
Q

What is the treatment for severe cellulitis

A

Adjunctive therapy e.g IVIG

33
Q

How can we prevent cellulitis in the first place

A
  • Reduce skin bacteria colonisarion by skin hygiene, MRSA eradications, prophylatic antibodies
  • Prevent skin breaks, clean wounds, treat eczema and atheletes foot
  • Maxmise defences: treat vascular disease, reduce oedema, and good diabtes control
34
Q

What is necrotising Fasciitis

A

Severe infection of the deep fascial layers

35
Q

What are the featuers of necrotising fasciitis

A

Pain

Dusky bruised apperance

36
Q

What is the management of necrotising fasciitis

A

Surgical emergency for surgeons (cutting away the tissue) and clindamycin antibiotics

37
Q

What is pyomyositis

A

Acute bacterial infection of the skeletal muscle

38
Q

What are the features of pyomyositis

A

Muscle pain
Tenderness
Swelling

39
Q

Which organism is the most common cause of pyomyositis

A

Staph aureus

40
Q

What typical history does pyomyositis have i,e when does occur

A

After trauma or vigourous exercise

41
Q

What is the diagnosis of pyomyositis by

A

MRI scan: can show muscle odema

CT scan

42
Q

What is the management of pyomyositis

A

Drainage

Antibiotics

43
Q

What is septic arthritis

A

Infection of the joint space that becomes acutely swollen

44
Q

Which bacteria are involved in septic arthritis

A

Streptococci
Staphylococci
TB

45
Q

How does the ogranism enter the joint space

A

Directly to the blood stream

Haemtogenous deposition

46
Q

How is the diagnosis of septic arthritis made

A

By clinical picture
Imaging: US and MRI
Joint aspiration- sample then looked at with microscopy and PCR

47
Q

What is the management of septic arthritis

A

Surgical washing out

Antibiotics

48
Q

What is osteomyelitis

A

Bacterial infection of the bone

49
Q

How does bacteria spread into the bone

A

Haemtogenous deposition

Direct inoculation: trauma, surgery or spread from skin

50
Q

What is the management of osteomyelitis

A

Surgery

Antibiotics

51
Q

What is chronic osteomyelitis characterised by

A

Reactive bone
Sinus formation
Trapped necrotic bone formation
Biofilm

52
Q

What are the investigations for osteomyelitis

A

X-ray
MRI
Ct- to aid surgery
Ultrsound for biopsy

53
Q

Which organism is common to cause osteomyelitis

A

S.aureus

54
Q

What is the antibiotic management of osteomyelitis

A

Beta lactam: fluxloxacillin, cephalosporins
Lincosamide: clindamycin
Fluroquinolones: ciprofloxacin, moxifloxacin
Linezolid, fucidic acid, rifampicin, cotrimoxazole

Infection (17 decks)

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