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34 Cards in this Set
- Front
- Back
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What can cause breaches to the skin?
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Trauma, burns, tattoos, cuts, lacerations
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What are some examples of skin infections caused by direct entry of the infective pathogen(s) into the skin via skin breaches?
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Cellulitis, folliculitis, carbuncles, impetigo
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Looking at the major causative pathogens for cellulitis & erysipelas, which antibiotics would be the likely ones used for treatment?
Likely pathogens: Streptococcus pyogenes, Streptococcus aureus |
Di/flucloxacillin
If Strep.pyogenes confirmed or suspected then use phenoxymethylpenicillin or procaine penicillin If hypersensitive to penicillin (excl. immediate hypersensitivity), use cephalexin. If immediate hypersensitivity to penicillin, use clindamycin |
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What preventative measures can be taken to reduce the risk of recurrent cellulitis?
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Moisturising
Losing weight Wearing gardening gloves Protective clothing |
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In a severe post operative wound infection that you suspected a gram positive & gram negative organism was involved in, what anti-infective would you recommend if you wanted to use a single IV anti-infective agent?
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Timentin (ticarcillin +clavulanic acid)
Tazocin (piperacillin + tazobactam) |
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If there is a high incidence of MRSA on the post operative ward or MRSA is suspected, what IV antibiotic would you recommend?
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Vancomycin
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In a clean post-traumatic wound, which antibiotic would you use if the patient is allergic to penicillin?
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Non-immediate sensitivity = replace di/flucloxacillin with cephalexin, + usual metronidazole
Immediate hypersensitivity = ciprofloxacin PLUS clindamycin |
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What IV drug combination would you use in contaminated wound if the patient had a history of anaphylaxis?
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Gentamicin PLUS either clindamycin OR lincomycin
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Which IV antibiotic preparation(s) which has two components could be used in an established infection post bite, instead of using the metronidazole & cephalosporin?
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Timentin (ticarcillin + clavulanic acid)
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What is an example of tinea that causes cracking of the skin?
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Tinea pedis
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What can tinea mannum often be misdiagnosed as?
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Atopic dermatitis
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What are the pre-disposing factors for tinea pedis?
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Moist feet
Public showers Occlusive footwear Humidity/hot weather Diabetes Poor hygiene Being male Immunocompromised patients Poor circulation Sweating excessively Skin which produces less fatty acid |
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How can we minimize the spread or reoccurance of tinea pedis?
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Wearing thongs in showers
Open footwear Allowing feet to airdry Wearing cotton socks & changing them regularly. |
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What would you use to treat tinea of body, limbs, face and interdigital space?
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- Terbinafine 1% topically once daily for 1 week
- Bifonazole 1% topically once daily for 2-3 weeks - Clotrimazole 1% bd for 2-4 weeks, continue for 2 weeks after symptoms resolve - Econazole 1% topically bd, continue for 1 week after symptoms resolve - Ketoconazole 2% topically once daily, continue for several days after symptoms resolve - Miconazole 2% topically, bd for 4 weeks |
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When is oral antifungal therapy indicated in the management of tinea?
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- Tinea capitis
- Nails affected - Involving more than one body region - Tinea corporis where lesions are extensive - Tinea pedis when there is extensive involvement of sole, heel or dorsum - Sufficiently annoying & recurrent despite topical therapy |
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What are the predisposing factors for developing a candidal infection?
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- Infancy/old age
- Warm climate - Occlusion - Immune deficiencies - Broad spectrum antibiotics - Contraceptive pill/injection - Pregnancy - Diabetes, Cushings syndrome, other endocrine disorders - Iron deficiency - General debility (e.g. from cancer) - Underlying skin disease - Obesity & immobility - Chemotherapy & immunosuppressive medications |
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What treatment would you recommend for post herpetic neuralgia?
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- Analgesics/anti-inflammatories
- Heat/cold packs - TCAs, gabapentin, carbamazepine |
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What symptomatic treatment would you recommend for chickenpox?
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- Antihistamines & calamine lotion for pruritus
- Analgesia/antipyretics e.g. paracetamol |
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What organisms are likely to cause a super infection of the varicella lesion?
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Streptococcus pyogenes & Staphylococcus aureus
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What antibiotic would you recommend if urine MCS grew pseudomonas?
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Norfloxacin (or another quinolone e.g. ciprofloxacin
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What are the reasons for treatment failure in UTIs?
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- Resistance
- Treating the wrong bacteria - Non-compliance - Re-infection |
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What symptomatic treatment could you offer patients with UTIs?
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- Analgesics
- Alkalinisation of the urine (e.g. Ural) to prevent the burning sensation on passing urine due to its acidity in infection |
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What would you use for UTIs in pregnant women?
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- Cephalexin 500mg orally bd for 10 days
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What organisms are likely to cause a super infection of the varicella lesion?
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Streptococcus pyogenes & Staphylococcus aureus
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What antibiotic would you recommend if urine MCS grew pseudomonas?
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Norfloxacin (or another quinolone e.g. ciprofloxacin
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What are the reasons for treatment failure in UTIs?
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- Resistance
- Treating the wrong bacteria - Non-compliance - Re-infection |
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What symptomatic treatment could you offer patients with UTIs?
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- Analgesics
- Alkalinisation of the urine (e.g. Ural) to prevent the burning sensation on passing urine due to its acidity in infection |
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What would you use for UTIs in pregnant women?
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- Cephalexin 500mg orally bd for 10 days
OR - Nitrofurantoin 50mg orally qid for 10 days OR - Amoxycillin & clavulanic acid 500+125mg orally bd for 10 days |
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What could you use if a patient could not have an aminoglycoside?`
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Ceftriaxone IV
(could also use low dose of a quinolone in renal impairment) |
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What factors can predispose someone to an overgrowth of candida?
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- Immunosuppression
- Diabetes - Antibiotics - Corticosteroids - Hormonal changes (e.g. pregnancy, menopause) - Oral contraceptive pills |
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What treatment would you recommend for vaginal thrush?
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- Vaginal imidazole (e.g. clotrimazole 10% vaginal cream applicatorful intravaginally) as a single dose at night
OR - Nystatin cream, 1 applicatorful intravaginally, bd for 7 days If intolerant of topical Tx or prefers oral Tx and is not pregnant then use: Fluconazole 150mg orally as a single dose |
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How do you reduce the risk of getting traveller's diarrhoea?
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- Brush teeth with bottled water
- Wash hands before handling food - Eating freshly cooked foods served steaming hot - Eat fruits that can be peeled - Bottled/canned beverages - Avoid raw/undercooked food - Avoid fresh salads, peeled fruit, unpasteurised milk, unboiled water or ice - Avoid foods sold by street vendors |
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What type of therapy can be offered to patients with the common cold?
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Symptomatic Tx:
- Simple analgesics - Oral/topical decongestant - Steam inhalation - Nasal saline irrigation |
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When these host defences are compromised then there is an increased risk of pathogens infecting the LRT & causing pneumonia.
Examples include... |
Alteration in level of consciousness (e.g. stroke, drug/alcohol intoxication, anaesthesia)
Impaired mucociliary activity (e.g. smoking, old age) Impaired cell mediated and/or humoral immunity (e.g. HIV, immunosuppressive Tx) Mechanical obstruction (e.g. tumour) |
