Clinical Micro - Skin And Wound

Front 1

Why is there an increase in Pseudomonas Aeruginosa infections (as in folliculitis)

Back 1

Use of whirlpools and hot tubs

Front 2

A _ is a Folliculitis lesions that develop into deeper inflammatory nodules in the hair follicle, sebaseous or sweat glands

Back 2

Furuncle

An infection at the base of the eyelash is called a stye and is a type of furuncle

Front 3

A _ Results from spread of infection (furuncle) to adjacent subcutaneous tissues

Back 3

Carbuncle
It is a cluster of boils

Front 4

Chronic furunculosis is episodes of _, and is a/w

Back 4

boils
Associated with depressed host immunity (defective PMN function)

Front 5

Most common etiologic agent for folliculitis, furuncles, & carbuncles?

Back 5

Staphylococcus Aureus

Front 6

What attributes to the virulence of Staph aureus infections?

Back 6

Protein A.
It prevents antibody from attaching to phagocytes (preventing opsonization), inhibits complement cascade.

It also produces coagulase and beta lactamase

Front 7

Impetigo is due to what bacteria?

Back 7

Streptococcus Pyogenes

This is characterized by yellowish crusts and is highly contagious!

Front 8

Acute glomerulonephritis is a complication of _infections

Back 8

Streptococcus pyogenes

Front 9

Most cases of cellulitis and erysipelas are caused by what organism? Predisposing factors include _

Back 9

Group A Streptococci

Lymphatic Obstruction, diabetes mellitis, venous stasis, alcohol abuse

Front 10

_ is characterized by a painful, erythematous area with a sharply demarcated border, What organism is usually responsible for this?

Back 10

Facial Erysipelas

Streptococcus Pyogenes (group A strep)

Front 11

Staphylococcus aureus release Toxins called _, particularly in a condition called _

Back 11

exfoliatins

Staphylococcal Scalded Skin Syndrome

Front 12

In _, there are large blisters containing clear fluid and the epidermis peels off in sheets.
It primarily affects infants and children less than _ years

Back 12

SSSS (Staphylococcus Scaled Skin Syndrome)

5 years old

Front 13

Rickettsia rickettsii is a _ bacteria because they lack _.

You can get this infection from _

Back 13

obligate intracellular bacteria, lack their own ATP source.


the bite from a tick

Front 14

Rickettsia rickettsii preferentially infects _

Back 14

epithelial cells lining blood vessels by the parasite -induced phargocytosis.

Front 15

_ is characterized by faint pink spots that appear on palms, wrists, ankles and soles which then spread to the rest of the body. The patient also has a headache, muscle and joint pain, and a fever

Back 15

Rocky Mountain Spotted Fever

caused by rickettsia rickettsii

Front 16

In rickettsia _, humans are the primary reservoir

Back 16

prowazekii. This causes epidemic typhus

Front 17

Epidemic typhus is caused by what organism?

What characterizes the rash?

Back 17

Rickettsia prowazekii

Contrast to RMSF, rash usually begins at the trunk and spreads to the extremities. It is maculopapular and Can be petechial or hemorrhagic

Front 18

Lyme Disease is caused by _. What are the main symptoms?

Back 18

Borrelia borgdorferi (introduced via an infected deer tick)

Influenza like, Target shaped lesions!

Front 19

Lyme Disease has 3 stages. What characterizes each one of them?

Back 19

skin rash called erythema migrans,

2nd - heart and nervous system

3rd - arthritis

Front 20

Cat Scratch disease is caused by _. .

What is notable about this organism?

Back 20

Bartoniella hensalae
It triggers angiogenesis!


associated with aids pts

Front 21

Anthrax is caused by _.

What is the colony morphology of this organism?

Back 21

bacillus anthracis (spore former, gram + rod, facultatitive anaerobe)

Ground glass appearance on solid medium, Medussa head texture

Front 22

Anthrax is primarily a disease of _. It can be acquired by _, _, or _

Back 22

herbivores. (humans are infected through accidental exposure)


Inoculation, Ingestion, Inhalation

Front 23

How would you describe the skin rash seen in Scarlet fever?

Back 23

A bad sunburn with small bumps that may itch. Sand paper feel

First appears on neck and face then spreads

Front 24

What is the causative agent of Chicken pox?

Back 24

Herpes virus. Enveloped DS DNA

Front 25

What is the causative agent of measles?

This viral envelope has 2 biologically active projections...what are they?

Back 25

rubeola virus (ss RNA), belongs to paramyxovirus family.

H (for viral attachement to Host cells)
M (for fusion of the viral outerMembrane with the host cell)

Front 26

What are the symptoms of Measles?

Back 26

High FEVER
KOPLIKS spots (appear on mucous membrane of mouth)
Maculopapular lesions that appear on head and spread over body, they fuse and form RED PATCHES

Front 27

Smallpox is a _ virus, belonging to the _ family.

What is necessary for infection?

Back 27

Double-stranded DNA virus belonging to the Poxviridae family

Close contact. However, crusts can remain infective for up to 2 years.

Front 28

The characteristic skin lesions of smallpox appear _ days after exposure

When was the last case of smallpox?

Back 28

12 days.


1949 in US, 1977 worldwide

Front 29

What is the difference between small pox rash and chicken pox rash?

Back 29

with small pox, An individual is contagious from the onset of the rash until the last scab falls off (unlike chicken pox, which is only until it starts scabbing)

Front 30

(T/F) there is treatment for small pox

Back 30

False.

A vaccine is available though, even though we don't take it anymore because it's been eradicated.

Front 31

Routine immunizations against smallpox was eliminated in

Back 31

1972

Front 32

Tinea versicolor is caused by _. What skin changes do you see in this infection?

Back 32

malassezia furfur


Increased pigmentation in fair-skinned individuals (dark patches) or
Decreased pigmentation in dark-skinned individuals (light patches)

Front 33

What are the 3 major types of dermatophytes?

Back 33

Epidermophyton, Microsporum, Trichophyton

EMT

Front 34

How do dermatophyte fungi cause pathogenesis?

Back 34

Use keratinase to dissolve keratin, which they are able to use as a nutrient

Front 35

Chromoblastomycosis is caused by _ fungi

Phaeohyphomycosis is caused by _ fungi

Back 35

Dematiaceous fungi

Dematiaceous (dark) fungi

Front 36

Rose gardener's disease aka _ is caused by _

Back 36

Sporotrichosis Caused by the dimorphic fungus, Sporothrix schenckii

Front 37

What are symptoms of Sporottrichosis?

In the environment it is in _ form. In the body, it is in _

Back 37

chronic ulcer forms at wound site, rash follows lymph channels. lymph nodes enlarge

mold form, yeast form.

Front 38

Psoriasis is caused by an underlying fungal infection (T/F)

Back 38

FALSE. It is an inflammatory response.

Front 39

What is notable about staphylococcal wound infections?

Back 39

Staph is Pyogenic (pus producing).

Front 40

What is a unique feature regarding staphylococcus aureus?

What is the virulent factor of Staphylococcus aureus?

Back 40

It produces coagulase, - causes blood to clot.

Protein A (which binds IgG by the Fc portion)

Front 41

Staphylococcus epidermis adhere to a _ and produce

Back 41

plastic surface

produce a biofilm

Front 42

How do you treat MRSA?

Back 42

Vancomycin

Front 43

What causes necrotizing fasciitis?

Back 43

Group A streptococcus, Strep Pyogenes (produces pyogenic exotoxin A)

S. pyogenes colonization is followed by destruction of fatty tissue and fibrous tissues. Only method of treatment is surgery to remove diseased tissue

Front 44

Pseudomonas Aeruginosa is a _ pathogen, it forms _ in the lungs of CF patients

Back 44

opportunistic pathogen

biofilms

may be found in swimming pools and hot tubs

Front 45

What is the key to a pseudomonas infection?

Back 45

Pigmentation! (green)

Sweet odor

Front 46

Lockjaw or _, is often caused by _

Back 46

Tetanus (characterized by sustained painful, uncontrollable muscle spasms)

CLOSTRIDIUM TETANI
- ANaerbobic spore former! Usually transmitted via puncture wounds

Front 47

How does Clostridium tetani produce virulence?

Back 47

releases an exotoxin called tetanospasmin, which blocks the action of the inhibitory neurons. Therefore the muscles contract continuously.

Front 48

How do you treat lockjaw?

Back 48

with tetanus antitoxin

(caused by clostridium tetani which releases toxin called tetanospasmin)

Front 49

Gas gangrene is typical of _ , and is caused by what organism?

Back 49

wartime wounds, (this is aka clostridial myonecrosis)

clostridium perfringens

Front 50

What are the symptoms of gas gangrene?

Back 50

swelling of wound with thin bloody, or brownish fluid leaking.

Fluid appears FROTHY (due to gas formation)

Front 51

The pathogenicity of Clostridium perfringens is due to _. It grows easily in _

Back 51

due to product of an alpha-toxin, that destroys host cell membranes

Clostridium perfringens grows easily in dead, necrotic tissue (delay in treatment - wartime wound)

Front 52

What are the most clinically important exotoxins produced by clostridium perfringes (gas gangrene)

Back 52

ALPHA TOXIN - LETHAL* LECITHINASE, NECROTIZING, A HEMOLYTIC, CARDIOTOXIC
Beta toxin - necrotizing*
Epsilon toxin - permease*
Iota toxin - necrotizing*
Delta toxin - hemolysin*
Theta Toxin - Causes beta hemolysis

Front 53

On blood agar, what will be unique about Clostridium perfringens, and why?

Back 53

Double zone of hemolysis.

Alpha toxin produces incomplete alpha hemolysis
Theta toxin causes complete beta hemolysis

Front 54

Cutaneous Leishmaniasis is a _ infection caused by _ in skin lesions

How is this spread?

Back 54

parasitic infection

leishmania mexicana AMASTIGOTES

Through the bite of a sandfly

Front 55

_ is defined as inflammation of the nailfolds

Back 55

Paronychia

Front 56

Acute Paronychia is most commonly caused by _

Back 56

Staphylococcus aureus or beta-hemolytic streptococci (ie. Group A Strep)

Front 57

What is the cause of chronic paronychia?

Back 57

Significant contact irritant exposure is a major cause. (People who wash hands a lot)

Most commonly by Staphylococcus aureus

Front 58

How do you tell the difference between a subungual hematoma and a psuedomonas infection under the nail?

Back 58

There will be pain with a hematoma, but not with Pseudomonas

Pseudomonas will have a green color!

Front 59

Dermatophytes _ and _ are responsible for most fingernail and toenail infections. They primarily invade what part of the nail?

Back 59

Tricophyton rubrum and Tricophyton mentagrophytes
Nail Plate

(Candida also infects the nail plate)

Front 60

Channeling of the nail is a characteristic feature of _ infections

Back 60

fungal infections

Front 61

_ is the most common cause of Transverse white bands

It is commonly seen in _

Back 61

Tricophyton rubrum

AIDS!

Front 62

Trichophyton rubrum is associated with _

Back 62

AIDS