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15 Cards in this Set
- Front
- Back
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A rapidly progressing necrotising fasciitis that involves soft tissues of the perineal, perianal, or genital areas.
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Fournier Gangrene
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Risk factors for Fournier gangrene
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Diabetes mellitus, alcoholism, extremes of age, malignancy, chronic steroid use, malnutrition, HIV infection
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Pathophysiology of Fournier gangrene
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Steps
1. Impaired immunity + infection (+ trauma) 2. synergistic polymicrobial infection 3. thrombosis of subcutaneous blood vessels => gangrene 4. spread of gangrene via perineal-abdominal fascia communication |
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Microbes involved in Fournier gangrene
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Staph
Strep Entero Anaerobes Fungi |
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Example of synergistic action of microbes in fournier gangrene
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One bacterium produces an enzyme that stops blood flow, anaerobic bacteria can then grow which produce enzymes that degrade fascial barriers to promote spread
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Most common gender, and age for Fournier gangreene
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Males 10:1
30 - 60 years old |
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Symptoms of Fournier gangrene
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pain and tenderness in genitalia
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When would pain not be present in Fournier gangrene?
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When nerves die of ischemia
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Clinical course of Fournier gangrene
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1. Prodromal fever + lethargy
2. +edema 3. +erythema 4. +dusky skin + crepitations due to gas produced by bacteria 5. +obvious gangrene + purulent drainage of wound 6. septic shock may occur |
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Investigations in Fournier gangrene
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Blood + urine cultures
Imaging - initially x-ray, then CT, maybe Ultrasound |
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Tx for Fournier gangrene
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Begin broad spectrum abx
If ?systemic toxicity => IV access + fluid replacement + airway management Urgent surgical debridement to remove all necrotic tissue Reconstruction |
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List 3 catecholamines
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epinephrine (adrenaline),
norepinephrine (noradrenaline) and dopamine |
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2 signs in severe acute pancreatitis
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Grey Turner's sign (haemorrhagic discoloration of the flanks) and
Cullen's sign (haemorrhagic discoloration of umbilicus) can also occur in severe cases. |
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causes of acute pancreatitis
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I GET SMASHED
idiopathic gallstones ethanol trauma steroids mumps auto immune scorpion sting hyperlipidemia ERCP Drugs |
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3 different types drugs for prostate conditions with examples
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BPH
1. finasteride - anti-androgen 2. terazozin - alpha-1-antagonist PROSTATE CANCER 3. LHRH antagonist |
