Sbl - Micro - Bacterial Skin Infections

Front 1

Three major bacteria in skin infections:

Difference between Strep/Staph:

clear hemolysis on blood agar, can lyse RBC's:

toxin involved in fasciitis:

Spreading factor for S. pyogenes:

Back 1

S. pyogenes, S. aureus, C. perfringens

Strep - catalase -, Staph - catalase +

S. pyogenes

M-protein

hyaluronidase

Front 2

Catalase +, Coagulase +, B-hemolysis;

Novobiacin sensitive:

Novobiacin resistant:

S. aureus toxin that binds to Fc region of IGG to prevent binding:

Back 2

S. aureus

S. epidermidis

S.saprophyticus

Protein A

Front 3

How is S. aureus resistant to PCN?

Role of PBP in bacteria?

Two major types of MRSA?

Which strains tend to be more virulent? Why?

Back 3

B-lctamase, PBP2a mutation - MRSA

Peptidoglycan synthesis

Healthcare-Associated MRSA, Community-Acquired MRSA

CA-MRSA - people affected tend to be healthier than hospital pts

Front 4

Gene/toxin implicated in CA-MRSA:

Associated with what symptoms?

Proposed mechanisms of cell death?

Pore-forming toxin in CA-MRSA:

involved in neutrophil recruitment, activaiton and lysis:

Back 4

PVL - Panton-Valentine leukocidin

skin infections, pneumonia

lyse macrophages, release cytokines, directly infect epithelial cells

A-hemolysin

PSM (phenol-solube modulins)

Front 5

Most common strain of CA-MRSA:

CA-MRSA is the #1 cause of what?

Who is most at risk?

G+ bacillus, anaerobic, non-motile, spore forming:

Back 5

USA300

CA-skin infections

close contact - sports teams, military, prisoners, day cares, schools

C. perfringens

Front 6

How to treat MRSA abscesses?

Why are maggots effective in treating fasciitis?

Why are infections in midline structures significant?

Midline infections of the face should make you consider what?

Back 6

Heal with steel - puncture, drain, clean, Abx

only eat dead tissue, leave live tissue alone

uniquely vascular, shared blood supply

cavernous sinus syndrome

Front 7

A patient with pain siginificantly higher than expected from their clinical presentation should make you consider:

Why is the color gray bad on the body?

Main treatment for Fournier's gangrene?

Back 7

necrotizing fasciitis

usually means dead tissue

Surgery

Front 8

Most important test for treating gangrene?

What are symptoms of toxic shock syndrome?

Two causes of wet gangrene?

Back 8

Vascular studies

3 or more organ systems affected, fever, hypotension

accidents (trauma), frostbite

Front 9

DOC:
1. MSSA

2. CA-MRSA

3. HA-MRSA

4. S. pyogenes

5. C, perfringens

Back 9

1. PARP, Ceph, Amox/Clav

2. Clinda, Doxy, TMP/SMX (Bactrim)

3. Vanc, Gent, Rif

4. PCN, macrolide, Cephalexin

5. PCN, Clinda

Front 10

Nafcillin, Cloxacillin:

ADR?

ADR's with PCN?

Back 10

PARP

hypersensitivity

allergic response, K+ salt, so watch for K+ toxicity

Front 11

Oral 1st gen cephalosporin, often given prophylactically for trauma:

1st gen cephalosporin given pre-surg:

3rd gen cephalosporin, broad spectrum:

3rd gen, effective against Pseudomonas:

Back 11

cephalexin (Keflex)

cefazolin (Ancef)

ceftriaxone (Rocephin)

ceftazidime

Front 12

Amoxicillin/Clavulanate:

MOA, AFE, ADR:

Attaches to 50S ribosomal subunit, given PO/IV, ADR of pseudomembranous colitis:

30S ribosomal subunit, given PO/IV, ADR of photosensitivity and teeth/bone yellowing:

Back 12

MOA: cell wall synthesis

AFE: PO only

ADR: allergic rxn; Clav - N/V/D

Clindamycin

Doxycycline

Front 13

Folic acid inhibitor, given PO/IV, used for PCP, ADR of SJS:

Multiple MOA's, usually given IV, given PO for tx of C. diff, ADR's are nephro, ototoxicity and red neck syndrome:

30S subunit, given IV, topically, nephro/ototoxicity:

Back 13

Bactrim (TMP/SMX)

Vancomycin

Gentamicin

Front 14

Used primarily for TB, meningitis, DNA-dependent-RNA pol, usually given PO:

Macrolides - 3 major ones, AFE, ADR:

inhibits RNA synthesis, can be used topically against MRSA:

Back 14

Rifampin

Erythro, Clarithro, Azi
Ery, Azi - PO/IV, Clarithro - PO only
ADR - Azi - GI upset; DI with ketoconazole (CYP 3A4)

Mupirocin (Bactroban)