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118 Cards in this Set
- Front
- Back
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acne is a disorder of what
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pilosebaceous unit
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what is the effect of androgens on pilosebacceous glands
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cause the gland to produce more sebum
promote follicular keritinization |
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what clogs pore in acne
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keratinocytes that have clumped together
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what are the pathogenic factors of acne
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sebum production
alteration in keratinization P acnes colonization rls of inflammatory mediators into skin |
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what is role of P acnes
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secretes a soluble factor that induces proinflammatory cytokine production
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what are the contributing factors of acne
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stress
mechanical or frictional |
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what kind of disease is acne
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a chronic disease
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what is first choice therapy for acne
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topical retinoids
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topical retinoids
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tretinoin
adapalene tazarotene |
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topical antibiotics
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clindamycin
erthromycin |
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what should antibiotic for acne always be used with
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benzoyl peroxidase
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a systemic retinoid
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isotretinoin=accutane
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what are side effects of accutane
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teratogen
depression controversy |
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what are some oral anitbiotics used with acne
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tetracycline
doxycycline minocycline |
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what is the only oral antibiotic that can be used during pregnancy
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erthromycin
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what things can be done to decreases resistance
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combine with BPO and topical retinoid
avoid topical and oral together reassess every 6-12 wks do not switch |
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staph and strep in epidermis
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impetigo
ecthyma |
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staph and strep in the dermis
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erysipelis
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staph and strep in subQ fat
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cellulitis
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staph and strep in follicle
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folliculitis
furnuncle/carbuncle |
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staph and strep in the fascia
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necrotizing fascitis
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toxin assoc staph and strep
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toxic shock syndrome
scarlet fever scaled skin syndrome |
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what are the two types of impetigo
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bullosa
contagiosa |
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what is cause of impetigo contagiosa
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group A beta hemolytic streptococcus
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what is used to treat systemic impetigo
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penicillinase resistance penicillin or 1st gen ceph
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ecthyma
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ulcerated form of nonbullos impetigo
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where do you see ecthyma
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on shins and dorsum of feet
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what is infectious organism of erysipelas
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group A beta hemolytic strep
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what is clinical presentation of erysipelas
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bright red, warm, indurated and well defined border
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what is treatment for erysipelas
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penicillin, macrolides and cold compress
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what is infectious agent in cellulitis
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staph aureus or streptococcus
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what levels of tissue are involved in cellulitis
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skin and subq
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treatment for cellulitis
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antibiotic that covers staph and strep
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when might other organisms be involved in cellulitis
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diabetics, burns and immunosuppressed
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what is differential for cellulitis
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venous insufficiency
drug reaction |
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bacterial folliculitis
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hair follicle infection
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where don't you get folliculitis
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palms and soles
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deeper folliculitis is called what
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furnuncle
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mutiple furnuncles is called what
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carbuncle
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what is infectious agent of folliculitis in long term antibiotic users
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gram - bugs
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what is infectious agent in hot tub folliculitis
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pseudomonas
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furnuncle
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boil
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folliculitis/furnucle treatment
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bleach bath
incise and drain topical antibiotics oral antibiotics if severe |
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what is mixture on bleach baths
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1/2 cup bleach to 1/2 full bath
1oz bleach per quart |
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necrotizing fascitis
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gangrene of SQ tissue
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what is infectious agent of necrotizing fasciitis
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mixed: anaerobes, strep, enterobacteriacae
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characteristics of necrotizing fasciitis
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cellulitis that becomes deep purple painful bullous and crepitus
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what is treatment for necrotizing fasciitis
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surgical debridement and IV antibiotics
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what is mortality with necrotizing fasciitis
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20%
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what causes scaled skin syndrome
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exofoliative toxin types A and B of staph
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what causes toxic shock syndrome
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TSST-1 from staph and similiar from strep
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what causes scarlet fever
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eyrthrogenic toxin form strep A
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what is prodrome of scaled skin
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very tender skin, fever, malaise
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who is affected by scaled skin
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<6 yr with renal problems
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what is presentation of scaled skin
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erythematous skin on head first and spreads down leaving moist skin
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what are the signs of toxic shock syndrome
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redness of pharynx, strawberry tongue, red conjunctiva, diarrhea, vomitting, hypotension and organ failure
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what does the skin have with toxic shock syndrome
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diffuse scarletiniform exanthem
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how is scaled skin diagnosed
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clinically
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who else needs to be treated with scaled skin
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other carriers
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where do most TSS infections come from now
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wounds catheters
contraceptive diaphrams nasal packing |
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treatment for toxic shock
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penicillinase resistant abx that suppress toxin production ie clinda, rifampin, flouroquinolones
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clinical signs of scarlet fever
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diffuse blanching erythematous fine sandpaper papules
pastias lines in skin folds strawberry tongue |
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treatment for scarlet fever
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oral antibiotics
synthetic penicillins and cephalosporins |
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what are the delayed sequale of strep
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post strep glomerulonephritis
rheumatic fever |
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signs of rheumatic fever
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erythema marginatum
subcutanteous nodules |
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what causes erythrasma
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corynebacterium
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signs of erythrasma
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red brown patches of groin and web spaces
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treatment for erythrasma
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topical erythromycin
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what causes pitted keratolysis
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corynbacterium or micrococcus sedentaris
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what is pathology of pitted keratolysis
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proteolytic enzyme that degrades stratum corneum
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what is differential diagnosis of pitted keratolysis
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plantar warts
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treatment for pitted keratolysis
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topical erythromycin or clindamycin
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skin lesions of neisseria meningitidis
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petechia with dusky gun metal gray centers
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untreated neisseria meningitidis is what
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fatal
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what is treatment for neisseria meningitidis
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immediate IV penicillin
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what must happen to all contacts of neisseria meningitidis
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all must be treated prophylactically with oral rifampin for 2 days
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what often follows a mild upper respiratory infection
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meningitis and meningococcemia
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blue psuedomonas
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pyocyanin
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green psuedomonas
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pyoverdin
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yellow green pseudomonas
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fluorescein
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black pseudomonas
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pyomelanin
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who gets psuedomonas hot foot syndrome
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children swimming in pool
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signs of pseudomonas hot foot syndrome
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painful red-purple 1-2cm nodules
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treatment of hot foot syndrome
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self limiting
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what patients are predisposed to green nail syndrome
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those with wet work or trauma
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treatment for green nail syndrome
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topical fluoroquinolone, tobramycin, 1% acetic acid soaks for 1-4mo
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ecthyma gangerosum is seeded by what
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pseudomonas
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who does ecthyma gangerosum happen to
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immunosuppressed patients
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treatment for ecthyma gangerosum
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IV aminoglycoside combined with ceftazidime or cefepime
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how is syphillis divide
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early and late
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what are the stages in early syphillis
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primary, secondary and latent
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what are the stages in late syphillis
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late latent and tertiary syphillis
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primary syphillis
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cancre
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secondary syphillis
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rash
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what occurs on genitals in secondary syphillis
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condyloma lata
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what occurs in oral cavity in secondary syphillis
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mucous patches
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latent
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positive test but no symptoms
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late latent
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2 yrs beyond initial infection
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tertiary syphillis
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gumma develops into punched out ulcer with gummy base
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signs of tertiary syphillis
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ulcerative nodules
aortic aneurism, cns sings, dementia |
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what are serologic tests for syphillis
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RPR and VDRL
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what is specific for syphillis
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FTA-ABS
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syphillis treatment
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IM penicillin either once or as a series of three
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what does latent or teritary syphillis require
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CSF evaluation and IV penicillin
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what can men develop from gohorrhea
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epididymitis
vesiculitis prostatitis |
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what can women develop from gonorrhea
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vaginal bleeding, PID,
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treatment of gonnorhea
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ceftriaxone and doxycycline
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men with chlamydia
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clear urethral discharge, burning, ascending infections
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women with chlamydia
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cervicitis
endometritis PID |
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treatment for chlamydia
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doxycycline
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what is canchroid caused by
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haemophilus ducreyi
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treatment for canchroid
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erythromycin and ceftriaxone
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lymphogranuloma venereum is caused by what
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chlamydia L1, L2, L3
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groove sign
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lymphogranuloma venereum
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treatment for lymphogranuloma venereum
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doxycycline
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granuloma inguinale caused by what
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dlebsiella granulomatis
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pseudobubos
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granulom ingiunale
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treatment for granuloma inguinale
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ampicillin or quinolone
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