Skin/Soft Tissue (Exam #3)

Question 1

What is a common pathogen associated with animal bites? What other two pathogens might be suspected?

Answer 1

Pasteurella

• Staph
• Strep

Question 2

If you measure a human bite, what classifies it as “adult”?

Answer 2

Maxillary inter-canine is 2.5+ cm

Question 3

What three pathogens should be suspected with a human bite?

Answer 3

• Eikenella Corrodens
• GAS
• Staph

Question 4

For a wound, under what two conditions are prophylactic abx NOT recommended?

Answer 4

WITHOUT SUTURES

• Small
• Uncomplicated

Question 5

For a wound, under what two conditions are prophylactic abx recommended?

Answer 5

• Puncture wound

- Lac requires sutures

Question 6

What is the most common cause of a plantar puncture wound?

Answer 6

Ya stepped on a nail

Question 7

Under what five conditions would prophylactic abx be considered for a human bite?

Answer 7

• Deep
• Moderate/severe bite
• Underlying venous/lymph damage
• Needs suture closure
• IC

Question 8

What four things should always be performed for a needle stick?

Answer 8

• IMMEDIATE cleanse
• Report
• Document
• Check HIV status

Question 9

Under what four conditions is laceration closure CI?

Answer 9

• Contaminated
• 12+ hours old
• FB present
• Involvement of tendons/nerves/arteries

Question 10

WHAT ARE THE THREE ABSORBABLE SUTURES?

Answer 10

• Vicryl
• PDS
• Chromic gut

Question 11

What are the skin tension lines called?

Answer 11

Langer lines

Question 12

What is the general rule for suture removal?

Answer 12

Sutures remain in place longer the more distal the wound

- Ex. face = 5 days, fingertips/toes = 10-14 days

Question 13

What is the recommended recheck for suture placement?

Answer 13

24-48 hours

Question 14

What are the two most common pathogens associated with Cellulitis? What is the most common pathogen if IC?

Answer 14

• GAS
• Staph aureus

If IC = Pseudonomas

Question 15

What are the four cardinal signs of Cellulitis?

Answer 15

• Erythema
• Warmth
• Pain
• Swelling

Question 16

What is the mainstay tx for Cellulitis? What other three classes of abx may be considered?

Answer 16

B-Lactams (Amoxicillin for 10-14 days)

• Cephalosporins
• Macrolides
• Fluoroquinolones

Question 17

For Cellulitis, what two conditions should be met to consider OP tx?

Answer 17

• Mild/local sxs

- NO systemic sxs

Question 18

For Cellulitis, what three conditions warrant IP tx?

Answer 18

• Facial/periorbital
• IC
• Comorbidities

Question 19

What three things increase your risk for Abscess?

Answer 19

• IC
• Break in skin
• Staph aureus carrier

Question 20

What pathogen should be considered if recurrent Abscess?

Answer 20

MRSA

Question 21

What is the most common pathogen associated with Infected Burns?

Answer 21

Staph aureus

Question 22

With an Infected Burn and sepsis/shock present, what two abx should be considered?

Answer 22

Systemic abx

• Piperacillin
• Carbapenem

Question 23

With an Infected Burn and cellulitis present, what two abx should be considered?

Answer 23

• IV Cefazolin

- IV Clindamycin

Question 24

What is affected and what is spared with Necrotizing Fasciitis?

Answer 24

Spreads along fascia

- Muscle SPARED

Question 25

What condition involves severe pain in abdominal wall that migrates to the gluteus, scrotum and penis?

Answer 25

Fournier’s Gangrene

Question 26

What is the recommended tx for Fournier’s Gangrene (2)?

Answer 26

• Surgical debridement

- Broad-spectrum abx