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39 Cards in this Set

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Bacteria tend to be _______ (like fungus) not systemic, like viruses
localized
G+ cocci, catalase +, Coagulase (-)
Staph epidermidis
G+ cocci, catalase +, Coagulase +
S. Aureus
G+ cocci, catalase (-) beta hemolyitic, Group A, Bacitracin sensitive.
Strep Pyogenes
G+ cocci, catalase (-) beta hemolyitic, Group B, CAMP/Hippurate sensitive
Strep Agalactiae
G+ cocci, catalase (-) alpha hemolyitic, Optochin/Bile sensitivity
Step Pneumonia
G+ cocci, catalase (-), gamma hemolyitic, Bile Esculin (+) grows with 6.5% NaCl
Enterococcus
Pt with eczema presents with a superficial epidermal vesicopustule that began shortly after a mild trauma to the area. The lesion progresses to form an erythromatous tender papule to a honey colored crusted scab
Dx?
Organism?
Impetigo
Staphylococcus aureus and/or Group A Streptococcus (strep pyogenes)
Previous case is cultured and grows G+ cocci in clusters, catalase +, coagulase +
Staphylococcus aureus
G+ cocci in pairs & chains, catalase (-), Bacitracin sensitive with M protein
Group A Streptococcus (Strep Pyogenes)
A deeper form of impetigo that extends into the dermis caused by group A beta-hemalytic streptococci (GABHS).
Ecthyma
Women presents with a small erythematous papules topped by a central pustule under her arm after shaving.
Dx –
Most common organism:
Folliculitis - infection in the hair follicle
Staph aureus
Woman with folliculitis doesn’t get it treated. Infection envelops the whole hair follicle and also adjacent subcutaneous tissue. A deep inflammatory nodule develops
Dx:
Most common organism:
Furuncles (boils)
Staph aureus
Woman with furuncles doesn’t get checked out and several furnucles develop close together and join. The infection extends further into subcutaneous fat areas
Dx:
Most common Organism:
Carbuncles
Staph aureus
pt with previous open wound developes an acute, severe, rapidly spreading infection of the skin and subcutaneous tissues. The infection spreads to the blood and pt develops fever w/ chills and sweats may be present.
Dx:
Most common organisms:
Cellulitis
Streptococcus pyogenes or Staphylococcus aureus.
Pt presents with fever and superficial cellulitis w/lymphatic involvement of the face (or lower extremities)
Dx:
Most common organism:
Erysipelas
Streptococcus pyogenes.
Swine farmer presents with a purpulish red non vesiculated inflammation sharply defined by a distinct but irregular raised border on the hands. A cx is done and grows a Gram positive, non-motile nonsporulating microaerophilic rod
DX:
Organism:
Erysipiloid
Erysipelothrix rhusiopathiae.
15 y/o boy develops small cysts form in the hair follicles due to blockage of the orifices by retention of sebum and keratinous material. Some cysts are white, some cysts are black
DX:
Organism:
Acne vulgaris
Propionibacterium acnes (microaerophilica bacteria) or Malassezia furfur (Lipophilic yeast)
Baby d/c from newborn nursery develops blisters. Cx shows baby is colonized with S. Aureus that produces an exfoliative toxin (ET).
DX:
Bullous Impetigo
Pt presents with generalized blistering. Blood culture shows Staph aureus. Staph Aureus is typed and found to be part of a phage group II type 71 strain that produces exfoliative toxin (ET).
DX:
Staphyloccocal “Scalded Skin Syndrome” (SSSS)
Pt leaves her tampon in too long and develops a rash that looks like scarlet fever and results in desquamation.
Dx:
Superantigen:
Toxic Shock Syndrome
Staphylococcus aureus toxin (TSST-1)
Pt presents w/ a pharyngeal infection which procedes to a cutaneous red rash followed by desquamation. Cx shows Streptococcus pyogenes & presence of streptococcal pyrogenic exotoxins (super antigens that activate T cells non specifically)
DX:
Scarlet fever
Pt presents with rash and severe itching. You note the presents of mites (anthropods) that mate and lay eggs in the skin.

Dx:
Bug:
Scabies-
Sarcoptes scabiei
13 y/o boy in Virginia presents with extremely pruritic erythematous papule. He has history of playing in grasses and shrubs.
Dx:
Chigger mites (Trombiculidae)
13 y/o girl reports itchy scalp. PE shows eggs (nits) cemented to hair. You also note presence of a hematophagous arthropod insect.

DX:
Pediculous. humanus var. capitis is the (head louse)
Pt reports intense itching in pubic region. PE shows eggs cemented to hair. You also note presence of a hematophagous arthropod insect with an appearance similar to a crab.

DX-
Phthirus pubis- pubic or crab louse
Pt reports waking up with bites. Labs show low hgb. You also note presence of a hematophagous arthropod insect.

•Dx-
bed bugs,Cimex lectularius (temperate regions) & C. hemipterus (tropics)
Pt presents with rash and severe itching. You note the presents of mites (anthropods) that mate and lay eggs in the skin.

Dx:
Bug:
Scabies-
Sarcoptes scabiei
13 y/o boy in Virginia presents with extremely pruritic erythematous papule. He has history of playing in grasses and shrubs.
Dx:
Chigger mites (Trombiculidae)
13 y/o girl reports itchy scalp. PE shows eggs (nits) cemented to hair. You also note presence of a hematophagous arthropod insect.

DX:
Pediculous. humanus var. capitis is the (head louse)
Pt reports intense itching in pubic region. PE shows eggs cemented to hair. You also note presence of a hematophagous arthropod insect with an appearance similar to a crab.

DX-
Phthirus pubis- pubic or crab louse
Pt reports waking up with bites. Labs show low hgb. You also note presence of a hematophagous arthropod insect.

•Dx-
bed bugs
Cimex lectularius (temperate regions) & C. hemipterus (tropics)
Bullous Impetigo is a dz that causes the skin to slough off, it is caused by this organism.
Staph. aureus
What is the sloughing off of the skin in Bullous Impetigo due to. Infectious organism? Inflammation?
NO. It is due to an EXFOLIATIVE TOXIN that is produced by S. aureus
The E.T. of S. aureus acts as a serine protease that can cleave human _______, an adhesion molecule in the skin. This causes a blister to be formed and allows bacteria to spread under the skin. Blisters occur at the site of infection of S. aureus. Between 10-30% of people in the population are colonized with S. aureus on their skin. These people have a propensity to get this type of disease
desmoglein 1
Strains of S. aureus can be typed based on their susceptibility to different bacteriophages. The S. aureus phage type that causes Bullous Impetigo is often group II phage type ____. So, if you plate S. aureus and it is susceptible to this phage type , you know that this bacterium has a propensity to cause this disease.
71
_________ involves the same type of exfoliative toxin and the same phage type of Staph aureus as bullous impetigo. However, this dzs toxin is not elaborated only at the site of infection; it also enters the systemic circulation. In bullous impetigo, on the other hand, the toxin’s effects are only at the site of infection.
Scalded skin syndrome
The mechanism that causes toxic shock syndrome is quite different from the mechanism that causes scalded skin syndrome. TST is caused by ____________ which is a super antigen that can over activate T-cell receptors. Over activation of T-cells leads to overproduction of a homing chemical that targets these activated T-cells to the skin. This results in inflammation and desquamation of the skin. This is the dermal manifestation of this disease. S.S.S., on the other hand, is caused by an ________ that has nothing to do with the super activation of T-cells.
Staphylococcal toxic shock syndrome toxin (TSST-1)
exfoliative toxin
Toxic shock syndrome is mostly caused by ____ and less commonly by Strep. It is mediated by super antigens. Scarlet fever is mostly caused by ____ and less commonly by Staph. It is also mediated by super antigens.
Staph
Strep