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NUR 311: IPC > Week 13 - Topic 1: Skin Infections > Flashcards

Week 13 - Topic 1: Skin Infections Flashcards

1
Q

A patient comes in with a skin rash. What are some important “contagious” questions to ask?

A
  • Have you been exposed to anyone with a rash?

- Have you travelled to a community in an outbreak of contagious rashes?

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2
Q

A patient comes in with a skin rash. What are some “non-contagious” questions to ask?

A
  • Have you gone hiking or camping recently?
  • Do you have a history of skin illnesses
  • Do you have allergies to foods/medications/other?
  • Have you been using new soaps, laundry detergents, topical preparations, new clothes?
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3
Q

What are the 3 lines of attack on the skin?

A

1) Systemic infections via BBI or toxin-mediated
2) Direct extensions from fistulae or sinuses
3) Direct breaches (cuts, bruises, warts, ulcers, etc)

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4
Q

What diseases result to attacking the skin from systemic infections?

A
  • Measles
  • Scarlet fever
  • Toxic shock syndrome
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5
Q

What procedure can attack the skin from direct extensions?

A

Draining abscess

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6
Q

What are macules?

A

Flat red lesions

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7
Q

How do macules form?

A

Microbes/toxin arrive on the skin (ex: from the blood vessel) and inflammation/redness is triggered from responding macrophages and neutrophiles (leukocytes)

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8
Q

What is a papule?

A

Raised red lesion

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9
Q

How does a papule form?

A

Formation of a macule + invasion of neighbouring tissue triggering more inflammation

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10
Q

What are vesicles?

A

Papules filled with fluid

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11
Q

What two viruses can cause vesicls?

A

Herpes simplex and varicela zoster

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12
Q

How does an ulcer form?

A

When there is a rupture of the epithelium (or the vesicle)

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13
Q

What is a papilloma?

A

It is the growth and proliferation of a microbe (introduced directly) in the epithelium

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14
Q

What causes a papilloma?

A

Warts from HPV

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15
Q

What is a granuloma?

A

A build-up of macrophages

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16
Q

Where do you find Pseudomonas folliculitis?

A

In the water –> think spas

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17
Q

What does Pseudomonas folliculitis produce on the skin?

A

Macules, papules and vesicles on the back

Begin as pruritic red macules and end as itchy papules and pustules

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18
Q

What additional precautions should you use on Hot Tub Folliculitis?

A

Contact

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19
Q

What is folliculitis?

A

Build of of MO in the hair shaft + inflammation

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20
Q

What is a sty?

A

Inflammation of the sebaceous gland that opens into a follicle of an eyelash

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21
Q

What is a furuncle?

A

A folliculitis with pus

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22
Q

What is a carbuncle?

A

A cluster of furuncles that produce deep seated pus

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23
Q

What usually causes infectious such as folliculitis, sty, etc?

A

Staph aureus

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24
Q

What bacteria causes acne?

A

Propionibacterium acnes or spp

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25
Q

What bacteria causes gas gangrene?

A

Clostridium perfingens

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26
Q

Why shouldn’t diabetics walk barefoot?

A

C perfingens is found in soil and could cause gas gangrene in their feet

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27
Q

What bacteria causes abscesses?

A

Staph aureus

Strep pyogenes

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28
Q

What bacteria causes impetigo?

A

Staph aureus

Strep pyogenes

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29
Q

What precautions does acne require?

A

Routine

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30
Q

What precautions does gas gangrene require?

A

Routine

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31
Q

What precautions does draining an abscess require?

A

Additional (Contact)

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32
Q

What precautions does impetigo require?

A

Additional (contact)

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33
Q

What bacteria causes leprosy?

A

Mycobacterium leprae

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34
Q

What is the incubation period of leprosy?

A

2-10 years

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35
Q

What precautions does leprosy require?

A

Routine

Additional (contact) only when it has been untreated

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36
Q

What is another name for Leprosy?

A

Hansen’s disease

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37
Q

What type of lesions do you find in leprosy and where are they?

A

Macules, patches, papules and nodules

Symmetrically distributed all over the body

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38
Q

True or False: People with leprosy lose their eyebrows and eyelashes.

A

True

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39
Q

Leprosy is easily treatable. If left untreated, what happens to the person?

A

Disfigurement and nerve damage

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40
Q

What animal is also a host for leprosy?

A

Armadillo

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41
Q

What bacteria causes Scarlet Fever?

A

Group A strep

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42
Q

What bacteria causes Necrotizing fasciitis?

A

Group A strep

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43
Q

What bacteria causes Erypsipela (St Antony’s fire)?

A

Group A strep

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44
Q

What precautions does Scarlet Fever require?

A

Routine

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45
Q

What precautions does necrotizing fasciitis require?

A

Additional (droplet + contact)

46
Q

What bacteria causes Scalded skin syndrome?

A

Staph aureus (strain that produces TSST-1 and exfoliative toxin)

47
Q

What bacteria causes impetigo of newborn (impetigo neonatorum)?

A

Staph aureus (strain that produces TSST-1 and exfoliative toxin)

48
Q

What precautions does Scalded Skin Syndrome require?

A

Additional (contact)

49
Q

What precautions does newborn impetigo require?

A

Additional (contact)

50
Q

What type of gram and shape is Staph aureus?

A

Gram + cocci

51
Q

True or False: Staph aureus is an opportunistic pathogen.

A

True

52
Q

True or False: Streptococcus pyogenes is the common cause of nosocomial infections.

A

False, it is Staph aureus

53
Q

What are the 3 virulence factors of Staph aureus?

A

1) Exotoxins
2) Exoenzymes
3) Structural defenses against phagocytosis (slime, protein A preventing opsonization)

54
Q

What are the 2 categories of the exotoxins of Staph aureus?

A

1) Cytotoxins, exfoliative toxin –> toxic shock syndrome toxin-1 (TSST-1)
2) Enterotoxin and leukocidin –> food poisoning

55
Q

What virus causes chickenpox?

A

Varicella zoster virus

56
Q

What virus causes shingles?

A

Varicella zoster virus?

57
Q

What precautions does chickenpox require?

A

Additional (airborne)

58
Q

What precautions does shingles require?

A

Routine

59
Q

What virus causes german measles?

A

Rubella virus

60
Q

What precautions does German Measles require?

A

Droplet (for 7 days after onset of rash)

61
Q

What virus causes Measles?

A

Rubeola virus

62
Q

What precautions does measles require?

A

Airborne (for 4 days after start of rash)

63
Q

What lesions are found in chicken pox?

A

Macules, papules and vesciles

64
Q

How long is chicken pox contagious for?

A

2 days before onset of rash up until lesions dry up

65
Q

What lesions are found in german measles?

A

Macules and papules

66
Q

What lesions are found in measles?

A

Macules and papules

67
Q

How long is a person with measles contagious for?

A

4 days before onset of rash up until 4 days after onset

68
Q

What is the difference between german measles and measles in terms of symptoms?

A

German measles:
They do not look sick –> mild fever + palpable lymph nodes

Measles:
They look sick –> fever + cough + conjunctivitis + coryza + Koplic spots

69
Q

What are koplic spots?

A

Small, red irregular shaped spots with blue-white centers on the mucosal layer of the oral cavity = Measles

70
Q

What virus causes smallpox?

A

Variola virus

71
Q

What precautions does smallpox require?

A

Airborne + contact (until all lesions have separated and crusted, 3-4 weeks)

72
Q

What virus causes warts?

A

70 different types of HPV

73
Q

What are the 3 types of warts?

A

1) Common warts
2) Venereal warts
3) Planter warts

74
Q

True or False: All warts require additional precautions?

A

False, only planter warts requires contact precautions

75
Q

What type of lesions are found in warts?

A

Papillomas

76
Q

What type of fungus causes tinea (ringworm)?

A

Dermatophytes

77
Q

What type of fungus causes diaper rash?

A

Candida

78
Q

What precautions does tinea require?

A

According to Rpap: routine

According to Ramona: additional

79
Q

What precautions does candida require?

A

Routine

80
Q

What technique must you use when taking a wound sample?

A

Aseptic no touch clean technique

81
Q

What are the steps in taking a wound sample?

A

1) Remove non-viable tissue (necrotic or eschar)
2) Irrigate to remove exudate and topical agents
3) Scrap the base or break the pustule
4) Moisten swab with NS
5) Rotate over 1-2 cm area w/pressure to express fluid or scrap deep within the wound
6) Place swab in transport media, biohazard bag, label and date
7) Do not refrigerate

82
Q

True or False: For abcesses, you send in a swab.

A

False, you send pus or fluid

83
Q

Where do you aspirate the pus/fluid from an abcess?

A

Into a sterile container, such as a syringe (send without needle)

84
Q

Can you refrigerate abcess samples?

A

No

85
Q

What are ectoparasites?

A

Parasites that live on their host (outer layer of skin) and depend on them for nourishment

86
Q

What parasite causes Leishmaniasis?

A

Leishmania (a flagellated protozoan infecting via sand flies)

87
Q

What characterizes Leishmaniasis?

A

Boils on the face

88
Q

What parasite causes scabies?

A

Sacroptes sabiei (mites)

89
Q

What characterizes scabies?

A

They dig tunnels onto the skin (red) and lay eggs there

90
Q

What do scabies mites feed on?

A

Human blood

91
Q

How is scabies transmitted?

A
  • Closed person-to-person contact of long duration
  • Shared clothing and bedding
  • Sex
92
Q

What is Norwegian scabies?

A

A severe form of scabies

Millions in crusted scabies that look like psoriasis

93
Q

Which is the only parasite that can transmit infections?

A

Body lice

94
Q

What parasite causes pubic lice?

A

Phthirus pubis (crab louse)

95
Q

True or False: Humans are the only reservoir for pubic lice.

A

True

96
Q

What is the difference between pubic lice and head lice?

A

Pubic:

  • Phthirus pubis
  • Shorter life span off host (1-2 days)
  • Morphological differences

Head:

  • Pediculosis capitis
  • Longer life span off host (several days)
97
Q

What parasite causes body lice?

A

Pediculus humanus corporis

98
Q

What diseases can body lice transfer?

A

Epidemic typhus
Trench fever
Epidemic relapsing fever

99
Q

Where does body lice lay eggs?

A

On clothing and move onto skin to feed

100
Q

True or False: Body lice is only found on the body.

A

False, it is also found on mattresses, sheets and clothing

101
Q

What parasite causes bed bugs?

A

Cimex lectularius/hemipterus

102
Q

What do bed bugs feed on?

A

Blood of animals (humans) while they sleep

103
Q

True or False: Adult bed bugs can live several days without blood.

A

False, several months

104
Q

Where do bed bugs live?

A

Within 8 feet of where people sleep

105
Q

What is dangerous about bed bugs?

A

Can cause excessive scratching from itching with can lead to secondary skin infection

106
Q

How do you spot bed bugs?

A

Rusty coloured blood spots (from poop)

Pepper-like exoskeletons while molting

107
Q

What education can you provide to your patient regarding the treatment and prevention of bed bugs?

A
  • Avoid scratching the area
  • Apply antiseptic creams or lotions
  • Take an antihistamine for itching
  • Spray the infested area with insecticide
108
Q

How so you find head lice?

A

By looking for adults or eggs (nits)

109
Q

How do you treat prophylactically a family for head/pubic lice?

A
  • Use permethrin for skin (brand name: Nix or Kwellada)
  • Follow product manufacturer instructions + remove nits with vinegar
  • Re-treat after 1 week if no clinical improvement
110
Q

What do you do with clothing/bedding infested with ectoparasites?

A

1) If worn in the last 3 days, wash in hot water 50° or dry cleaned OR
2) Place in plastic bags for 1 week

111
Q

What do you do with mattresses, chair or car seats that have been infested with ectoparasites or come in contact with infected person?

A

Vacuum them

NUR 311: IPC (17 decks)

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