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122 Cards in this Set
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- Back
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an infection of keratonized epithelium caused by dermatophyte fungi
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tinea
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infection of just the epidermis, usually caused by strep pyogenes
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impetigo
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an infection blocking the dermal lymphatics; appears red, raised, and well demarcated
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erysipelas
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infection of a hair follicle or pilosebaceous duct leading to an anatomically contained infection
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abscess
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most common cause of a skin abscess
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staph aureus
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different types of skin abscesses
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pustule - <10 mm
folliculitis - multiple pustules only in hair follicles furuncle - <2.5 cm abscess carbuncle - >2.5 cm abscess surrounded by cellulitis |
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skin infection that extends into fascial plains and invades muscle
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necrotizing fasciitis
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infection of deep skin from traumatic inoculation with clostridium species
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gangrene
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superficial skin infection caused by staph aureus that separates the dermis at the desmosomes causing large bullae
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scalded skin syndrome
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why does staph aureus separate the dermis in scalded skin syndrome
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Staph aureus exotoxins A and B are serine proteases
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skin infection involving the subcutaneous fat
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cellulitis
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differentiate cellulitis caused by staph vs. strep
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staph - cellulitis has central nidus such as a boil
strep - non-centralized and diffuse, often with blister and scabs |
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cause of cellulitis and foot ulcers in patients with DM or peripheral vascular disease
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anaerobes
mixed infections |
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hot tub folliculitis
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chlorine tolerant pseudomonas
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physical signs/symptoms of patient with necrotizing fasciitis
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pain out of proportion with physical appearance
evidence of organ damage and shock presence of myoglobin and CPK |
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hallmark of necrotizing fasciitis
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presence of myoglobin and CPK
*dark urine without presence of RBCs is myoglobinuria |
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causes of necrotizing fasciitis
gas vs. non-gas producing |
non-gas - strep pyogenes, MRSA
gas - mixed anaerobe with non-A strep |
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antibiotics used for necrotizing fasciitis
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clindamycin
vancomycin 3rd generation cephalosporin |
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virulence factors associated with streptococcus
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protease, hyaluronidase, DNase, streptokinase, streptolysin
superantigens |
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why do deep strep infections cause so much more tissue damage than superficial ones
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two-component regulatory system involving external environmental conditions triggering protein kinase to phosphorylate a response regulatory protein which activates or represses gene cassettes
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hallmark of gangrene infection
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gas and crepitus
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virulence factor of clostridium perfringens
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alpha toxin (lecithinase) that hydrolyzes lipids in cell membranes
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where does gangrene usually occur
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poorly vascularized skin such as peroneum or buttocks
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what allows P. acnes to cause inflammation of hair follicle
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keratin plug caused by a comedone allowing P. acnes to break down sebum to form fatty acids and proliferate
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infects skin histiocytes, endothelium cells, and Schwann cells
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M. leprae
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differentiate tuberculoid leprosy and lepromatous leprosy
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tuberculoid - strong cell mediated immunity, red blotchy areas of anesthesia
lepromatous - minimal cell mediated immunity, extensive skin lesions and leonin faces |
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necrotic center is usually present with a surrounding erythematous edge caused by pseudomonas
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ecthyma gangrenosum - pathognomic for this organism
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pharyngitis presenting with sandpaper-like rash that is worse in creases and the neck
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scarlet fever
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cause of rash in scarlet fever
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strep pyrogenic exotoxins A, B, and C cause the rash instead of toxic shock in strep throat
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what signs more likely point to viral pharyngitis than bacterial
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involve the uvula
tender lymphadenopathy |
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why is it important to treat a strep infection
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prevent rheumatic fever
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will treating a strep infection prevent post-strep glomerulonephritis
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No, only prevents rheumatic fever
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4 causes of shock presenting with rash
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toxic shock syndrome
rocky mountain spotted fever pneumococcal sepsis without a spleen meningococcal sepsis |
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differentiate the rash found in RMSF, Pneumococcal/meningococcal sepsis, and toxic shock syndrome
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toxic shock syndrome - blanching rash
RMSF, pneumo/meningococcal - non-blanching, petechial rash |
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toxin associated with classic toxic shock syndrome
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TSST-1 from staph aureus
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how do you get toxic shock syndrome
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you must be colonized with staph aureus with a superantigen gene containing a strain that you do not make antibodies to - 0.3% women able to get toxic shock
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when is TSST-1 gene expressed
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micro-environmental changes such as increased O2 content or decreased Magnesium ion concentration
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activates T cells in a non-specific manner
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superantigen
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which form of toxic shock is more likely to have a rash
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classic toxic shock with staph aureus
*rash is less common with streptococcal toxic shock |
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which form of toxic shock is associated with bacteremia
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strep toxic shock, because it has a serious infection
*bacteremia is rarely seen in classic TSS because do not have a serious infection |
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treatment of superantigen exotoxins
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clindamycin and erythromycin because they block ribosome protein production
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when is a "D" test needed
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whenever MRSA is erythromycin resistant and clindamycin sensitive - the erythromycin resistance is caused by methylation of the ribosome and causes clindamycin binding site to be affected as well
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virus notoriously for myalgias
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influenza
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cause of myocarditis and pericarditis
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coxsackie virus B
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most common organism to cause bone infection associated with hematogenous spread
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staph aureus
*think TB if spine is involved |
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cause of bone infection associated with punctured running shoe
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pseudomonas
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cause of bone infection associated with jaw trauma
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actinomyces israelii
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cause of septic arthritis in children
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secondary to osteomyelitis - kingella kingae, staph aureus, haemophilus, salmonella (sickle cell)
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most common cause of septic arthritis
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staph aureus
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normal skin flora
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staph aureus
staph saprophyticus staph epidermidis yeast |
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most common cause of skin infections
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staph aureus
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most common cause of cellulitis
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strep pyogenes
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organism that causes erysipelas
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strep pyogenes
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common location of erysipelas
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well-defined erythematous plaque of the face
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presentation of necrotizing fasciitis
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skin initially appears shiny and tense, then turns red/purple
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most severe form of infectious gangrene
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gas gangrene
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what causes increased sebum and keratinization leading to the blockage of pilosebaceous units
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androgenic hormones
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mycobacterial skin infection associated with water and marine organisms, usually follos a minor trauma
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M. marinum
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myobacterial skin infection that infects the skin and subcutaneous tissue causing chronic, painless ulcers
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M. ulcerans
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painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face
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lupus vulgaris
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firm, deep-seated subcutaneous nodule from underlying tuberculous lymphadenitis
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scrofuloderma
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caused by the yeast malassezia furfur causing hypo or hyperpigmented patches
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tinea versicolor
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direct microscopy of malassezia furfur
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thick-walled yeast and fungal hyphae with "spaghetti and meatball" appearance
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3 dermatophyte genera of fungi
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microsporum
trichophyton epidermophyton |
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most common organism to cause tinea capitis
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T. tonsurans
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associated with tinea concentricum
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tinea imbricata
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most likely cause of tinea corporis
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tinea rubrum
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most likely cause of tinea cruris
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tinea rubrum
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cause of tinea manuum
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tinea rubrum
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cause of tinea pedis
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tinea rubrum
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predisposing factor for mucocutaneous candidasis
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DM
immunosuppression corticosteroids broad-spectrum antibiotics |
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cause of common, plantar warts on body or soles of feet
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HPV 1,2, 4
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endophytic papules that are painful with walking
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plantar warts
*body warts are exophytic, dome-shaped papules |
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associated with flat warts
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HPV 3 and 10
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cause of condyloma accuminata
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HPV 6 and 11
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Cause of eroded and bleeding warts that are unresponsive to treatment in the genital region
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HPV 16, 18, 31, 33
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caused by poxvirus with small, firm, dome-shaped umbilicated papule
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molluscum contagiosum
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maculopapular rash that are vesicles with red halo that are in all stages of development
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varicella zoster virus (chickenpox)
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associated with pain, pruritis, and burning sensation in a distribution of a sensory dermatome
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reactivation of VZV
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HHV-4
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EBV
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HHV-5
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CMV
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leading cause of congenital deafness and mental retardation, also causes mononucleosis-like syndrome
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CMV
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causes rapid onset of high fever followed by a maculopapular rash as the fever subsides
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HHV-6 (roseola)
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HHV-8
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Kaposi's sarcoma, cutaneous vascular endothelial malignancy
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red/purple skin discoloration that do not blanch caused by bleeding beneath the skin
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petechiae and purpura
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term used to describe serious bacterial infection that causes sepsis, purpura, and skin necrosis
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purpura fulminans
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four primary features of purpura fulminans
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purpuric skin lesions
fever hypotension DIC |
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most common infection associated with acute purpura fulminans
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meningococcemia
*staph aureus, strep pneumo, GBS, haemophilus, Gram (-) |
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when does staphylococcal purpura fulminans (toxic shock syndrome) usually present
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after a viral respiratory infection - the virus damages the respiratory tract and allows endogenous S. aureus to infected damaged areas
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most common form of systemic vasculitis seen in children
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henoch-schonlein purpura
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classic tetrad of henoch-schonlein purpura
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palpable purpura
arthritis abdominal pain glomerulonephritis |
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when does Henoch-schonlein purpura usually present
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following a respiratory illness
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caused by deposition of IgA-containing immune complexes into smaller blood vessels and affected organs
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Henoch-Schonlein purpura
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skin rash with vesicles that firm, round, well-circumscribed and of uniform size and stage
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smallpox
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causes gingivostomatitis (fever with painful oral vesicles), keratoconjunctivitis, and encephalitis
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HSV-1
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causes painful, ulcerative groin lesions with lymphadenopathy
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HSV-2
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hand, foot, and mouth disease
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coxsackie A virus
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acute hives in children under 5 years is commonly associated with what
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viral illness
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virus associated with cataracts, mental retardation, and deafness
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Rubella
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virus associated with rash and arthritis caused by formation of immune complexes
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parvovirus B19
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most characteristic finding of secondary syphilis
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diffuse macular or papular eruption involving the entire trunk and extremities (condyloma lata)
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this rash beings on the ankles and wrists and spreads both centrally and to the palms and soles
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RMSF
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rare, autosomal recessive genetic skin disorder with hundreds of flat macules and papules primarily on the hands and feet (sun-exposed areas)
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HPV 5 and 8
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cause of stevens-johnson syndrome
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M. pneumoniae
drug interactions |
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Source and transmission of infection for Hepatitis A-E
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A,E - feces
B,C,D - body fluids/blood |
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Which hepatitis viruses are associated with chronic infection
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B,C,D
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Circular ds DNA virus
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Hepatitis B
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which two hepatitis viruses have vaccines available
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Hep A and B
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symptoms associated with viral hepatitis
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fever
RUQ abdominal pain grey-colored stools dark urine joint pain jaundice |
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symptoms associated with hepatocellular carcinoma
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enlarged abdomen
ascites hepatomegaly portal HTN hypoalbunemia |
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hepatitis virus associated with an RNA intermediate
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Hep B
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which two hepatitis viruses are treated with supportive care
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Hep A and E
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the hosts RNA polymerase transcribes viral ssRNA using cccDNA as template for which hepatitis virus
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Hep B
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this antigen indicates extremely infectious hepatitis B infection
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HBeAg
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MDR strains of S. typhi
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resistant to ampicillin, chloramphinicol, and TMP-SMX
*give ceftriaxone or ciprofloxacin |
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typhoid vaccine for 6 years of age and older
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oral Ty21a vaccine
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typhoid vaccine for 2 years of age and older
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Vi capsular polysaccharide vaccine, IM dose
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all patients with infection with this bacteria develop respiratory symptoms, bronchopneumonia
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salmonella typhi
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associated with fever, hepatomegaly, and abdominal rose spots
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Salmonella typhi
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associated with bacterial invasion and multiplication in mononuclear phagocytic cells of liver, spleen, lymph nodes, and Peyer's patches
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Salmonella typhi
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most sensitive sign on physical exam for appendicitis
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tenderness in RLQ
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epigastric and periumbilical pain that shifts to the RLQ
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appendicitis
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