Bacterial Infections Of The Skin

Front 1

What are the ssx of a staph skin lesion?

Back 1

1. Honey-colored crust

2. Pustules, furuncles, erosions

3. Osler node

4. Janeway lesion

Front 2

Back 2

1. Osler node

Front 3

Back 3

Janeway lesion

Front 4

What are the risk factors for MRSA?

Back 4

1. Age >65

2. Exposure to MRSA

3. Recent abx use

4. Recent hospitalization

Front 5

How do you tx suspected MRSA?

Back 5

1. Clindamycin

2. Bactrim

3. Linezolid

4. Vancomycin

Front 6

What is the use of mupirocin in the tx of MRSA?

Back 6

1. Colonized patients of anterior nares with MRSA or localized impetigo

Front 7

What is the virulence factor of MRSA?

Back 7

1. PVL

Front 8

What are the ssx of impetigo contagiosa?

Back 8

1. 2mm erythematous papule develops into vesicles and bullae

2. Straw colored seropurulent discharge dries to form yellow crust

Front 9

What are the MCC of impetigo contagiosa?

Back 9

1. S. aureus

2. S. pyogenes

Front 10

How do you tx impetigo contagiosa?

Back 10

1. Dicloxacillin or 1st gen cephalosporin + mupirocin

2. 7-10d

Front 11

What are the ssx of bullous impetigo in kids (systemic)?

Back 11

1. Hypo/hyperthermia

2. Weakness

3. Diarrhea, pneumonia, meningitis, death

Front 12

What disease has bullous impetigo as an early manifestation?

Back 12

1. HIV

Front 13

What are the ssx of bullous impetigo?

Back 13

1. Large, fragile bullae

2. Rupture leave circinate weepy crusted lesion

Front 14

What are the ssx of Staph SSS?

Back 14

1. Febrile

2. Rapidly evolving desquamation of skin

3. Positive nikolsky

Front 15

What is the MCC of SSS?

Back 15

1. S. aureus at mucosal surface, NOT IN LESIONS

Front 16

What antibody is involved in SSS?

Back 16

1. Desmoglein 1

Front 17

What will a bx show in SSS?

Back 17

1. Subcorneal blister with rare inflammatory cells

Front 18

How do you tx SSS?

Back 18

1. Cloxacillin/oxacillin

2. Allergic^^: aminoglycosides

3. Supportive: fluid and 'lyte replacement

Front 19

How do you separate TEN from SSS?

Back 19

1. TEN: drug-induced, in adults, DE separation

2. SSS: toxin from S. aureus, infants and young kids, granular layer split, no mucous membrane involvement

Front 20

What are the ssx of TSS?

Back 20

1. Temp>38.9

2. Erythematous eruption with desquamation of palms and soles 1-2 weeks after onset

3. Hypotension

4. Involvement of 3+: GI, muscular, renal, CNS

Front 21

What are the MCC of TSS?

Back 21

1. S. aureus (TSST-1)

2. GAS (1 and 3)

Front 22

How do you tx TSS?

Back 22

1. Nafcillin

2. Fluid tx

3. Drainage of infected site

Front 23

What are the ssx of staph TSS?

Back 23

1. Perineal ertyehma

2. Desquamation

3. Strawberry tongue

4. Due to tampons

Front 24

What are the ssx of strep TSS?

Back 24

1. Preceded by soft tissue infection

Front 25

What is pyogenic paronychia?

Back 25

1. Inflammatory reaction involving folds of skin around fingernail

Front 26

What are the MCC of pyogenic paronychia?

Back 26

1. S. aureus

2. GAS

3. Pseudomonas

4. Proteus

Front 27

How do you tx pyogenic paronychia?

Back 27

1. Keep nails dry

2. Avoid trauma

3. Acute: 1st gen cephalosporin

4. Chronic: oral antifungal

Front 28

What are the ssx of erythrasma?

Back 28

1. Dry, brown, delineated scaling patches

2. Located in intertrignous areas

3. Generally asymptomatic, except in groin

Front 29

What is the MCC of erythrasma?

Back 29

1. Corynebacterium Minutissimum

Dx with Wood's lamp

Front 30

How do you tx erythrasma?

Back 30

1. Topical clindamycin/erythromycin

Front 31

What are the ssx of pitted keratolysis?

Back 31

1. Thick weight-bearing portions of soles gradually covered by asymptomatic round pits

Front 32

What is the MCC of pitted keratolysis?

Back 32

1. Microccus sedentarius + coryneacteria (??)

Front 33

How do you tx pitted keratolysis?

Back 33

1. Topical erythromycin, clindamycin

2. Aluminum chloride solution

Front 34

What are the ssx of trichomycosis axillaris?

Back 34

1. Superficial bacterial infection of axillary or pubic hair

2. Adherent yellow, red, or black nodules

Front 35

How do you tx trichomycosis maxillaries?

Back 35

1. Antibacterial soap/topical abx

Front 36

What is the MCC of folliculitis?

Back 36

1. S. aureus

2. Pseudomonas (swimming pool)

Front 37

How do you tx folliculitis?

Back 37

1. Antibacterial soap

2. Drain deep abscess

3. Topical clindamycin and mupirocin

Front 38

What are the ssx of sycosis vulgaris?

Back 38

1. Chronic pustular staph infection of bearded region

2. Appear after shaving

Front 39

What is an abscess?

Back 39

1. Localized collection of pus that can occur at any site of the body

Front 40

What is a furuncle?

Back 40

1. Acute inflammatory abscess of hair follicles and surrounding tissue

Front 41

What is carbuncle?

Back 41

1. Collection of furuncles that extend deep into subQ tissue

2. May have sinus tracts and ulcerations

Front 42

What are the ssx of furunculosis?

Back 42

1. Perifollicular, round, tender abscess that ends in central suppuration

Front 43

What is the MCC of furunculosis?

Back 43

1. S. aureus

Front 44

What are the risk factors for furunculosis?

Back 44

1. Alcoholism

2. Malnutrition

3. Blood dyscrasias

4. Neutrophilic dysfunciton

Front 45

How do you tx furunculosis?

Back 45

1. Warm compress

2. 1st gen. cephalosporin

Front 46

What is the MCC of chronic furunculosis? How do you tx?

Back 46

1. Autoinoculation

2. Tx: chlorhexidine, daily laundering of bedding, hand washing, bactroban BID to nares

Front 47

How do you eradicate the carrier state in chronic furunculosis?

Back 47

1. Rifampin + dicloxacillin

2. Bactrim

3. Clindamycin for 3 mos.

Front 48

What is the danger triangle for furunculosis?

Back 48

1. Upper lip and nose

Front 49

What are the ssx of ecthyma?

Back 49

1. Ulcerative lesion on shins or dorsal feet

2. Saucer-shaped ulcer when crust is removed

Front 50

What is the MCC of ecthyma?

Back 50

1. Staph

2. Strep

Front 51

How do you tx ecthyma?

Back 51

1. Mupirocin BID + dicloxacillin

Front 52

What are the ssx of scarlet fever?

Back 52

1. Diffuse erythemtous exanthem

2. Erytematous papular eruption--- sandpaper

3. Pharyngitis

4. Stawberry tongue

5. Pastia lines

6. Circumoral pallor

Front 53

What is the Schultz-Carlton phenomenon?

Back 53

1. Blanching 2o to exotoxin from GAS

Front 54

What are the ssx of erysipelas?

Back 54

1. Acute infection of dermis an superficial dermal lymphatics

2. Leukocytos >20K

3. Sharp, raised border

Front 55

What is the MCC of erysipelas?

Back 55

1. GAS

2. GBS in newborns

Front 56

How do you tx erysipelas?

Back 56

1. PCN

2. Erythromycin

Front 57

What are the MCC of necrotizing fasciitis?

Back 57

1. Beta hemolytic strep

2. Pseudomonas

3. Bacterioides

Front 58

What are the predisposing factors for necrotizing fasciitis?

Back 58

1. Psoriasis

2. Childhood varicella

Front 59

How do you tx necrotizing fasciitis?

Back 59

1. Early surgical debridement

2. Broad spectrum abx

Front 60

What are the different types of necrotizing fasciitis?

Back 60

1. Type I-- polymicrobia

2. Type II-- GAS

3. Type III- gas gangrene or clostridial myonecrosis

Front 61

What is Fournier's syndrome?

Back 61

1. Localized variant of type I NF involving scrotum and penis

Front 62

What are the ssx of blistering distal dactylitis?

Back 62

1. Tense superficial blisters on solar fat pad phalanx of digit

Front 63

What are the MCC of blistering distal dactylitis?

Back 63

1. GAS

2. S. aureus

Front 64

How do you tx blistering distal dactylitis?

Back 64

1. PCN

Front 65

What are the ssx of perianal dermatitis?

Back 65

1. Well-demarcated perianal rim of erythema

2. May lead to fecal retention

Front 66

What are the MCC of perianal dermatitis?

Back 66

1. GAS

2. S. aureus

Front 67

How do you tx perianal dermatitis?

Back 67

1. PCN

2. Erythromycin

Front 68

What are the ssx of streptococcal intertrigo?

Back 68

1. Fiery-red erythema in neck, groin, and axillae

2. In young children and infants

3. Malodorous

Front 69

What are the MCC of streptotcoccal intertrigo? How do you tx?

Back 69

1. MCC: GAS

2. Tx: PCN with low-potency corticosteroid

Front 70

What are the cutaneous signs of rheumatic fever?

Back 70

1. Erythema marginatum early

2. Subcutaneous nodules late

Front 71

What are the ssx of erysipeloid of Rosenbach?

Back 71

1. Purplish swelling of hands

2. Polygonal patches of bluish erythema

3. Migratory

Front 72

What are the MCC of cellulitis?

Back 72

1. S. aureus

2. S. pyogenes

Front 73

What are the ssx of cellulitis?

Back 73

1. Suppurative inflammation involving subq tissue

2. MC due to T. pedis on leg

Front 74

How do you tx cellulitis?

Back 74

1. 1st generation ceph

Front 75

What is the MCC and tx of an infected cyst?

Back 75

1. MCC: S. aureus

2. Tx: incision and drainage, abx

Front 76

What is the MCC of tropical ulcer?

Back 76

1. B. vincentii

2. Bacteroides

Front 77

What are the MCC of desert sore?

Back 77

1. C. diphtheriae

2. Staph

3. Strep

Front 78

What are the toxins associated with B. anthracis?

Back 78

1. Edema toxin: transport protein

2. Lethal toxin: lethal factor+ protective antigen

Front 79

What are the forms of anthrax?

Back 79

1. Cutaneous-- eschar, suppurative adenitis

2. Inhalation-- hemorrhagi mediastinal infection

3. GI

Front 80

How do you dx anthrax?

Back 80

1. Gamma bacteriophage

2. Mice serum titer

3. Electrophoretic immunoblots

Front 81

How do you tx anthrax?

Back 81

1. PCN IV followed by oral