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120 Cards in this Set

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What is the epidermis composed of?

Keratin

What is the dermis composed of?

Connective tissue

The two most dominant normal flora on the skin?

Pseudomonas species


Janthinobacterium species

The two normal flora on the skin present in low concentrations (5% or less)?

Staphylococcus epidermidis


Propionibacterium acnes

The two normal flora of the kin that are yeasts?

Candid albicans


Pityrosporum

Types of acne?

Comedo: When the skin initially swells over the pore laeding out of a hair follicle (whitehad/blackhead)


Pustule: When the lesion erupts on the surface

Propionibacterium acnes gram reaction?

Gram positive anaerobic bacillus

Prevention for acne?

There is none

Treatment for acne?

Topical treatments to encourage skin sloughing


Topical or oral antibiotics (erythromycin, tetracycline)


Oral contraceptives


Isotretinoin (Accutane)

Definition of impetigo?

Spreads through the epidermis causing local inflammation, blistering, peelingand crusts.

How is impetigo caused? And spread?

Staphylococcus aureus, streptococcus pyogenes, or both


Spread through contact


Fomites


Mechanical vectors

Carbuncle?

Group of interconnecting furuncles deep in the skin

Furuncle?

Occurs when a hair follicle is infected and produces a tender abscess or pustule

Coagulase?

An enzyme that coagulates plasma and blood

You can cofirm stapylococcus aureus by testingfor the presence of?

Coagulase

Culturing for impetigo would include what two agars?

5% sheep blood again


Mannitol sal agar

What is the treatment for impetigo?

Topical mupirocin (Bactroban)

Prevention for impetgo?

The only preventon is good hygiene

The pyogenic cocci includes

Staphyloccoccus aureus


Streptococcus pyogenes

Gram rxn, morphology, amd arrangement of Staphylococci?

Gram positive, spherical, clusters

Where do we generally carry Staphylococcus?

Anterior nares

Symptoms of a local staph infection?

Abcess: inflamed, fibrous lesion with core of pus

Definiton of folliculitis?

Mild, superficial infection or inflammation os hair follicles.

Erysipelas?

A streptococcal infection where the bacteria enter the skin through a small cut or break in the skin and cause blisters or swollen lesions accompanied by fever, shaking, and chills.

Necrotizing Fasciitis

Flesh eating bacteria caused by Staphylococcus aureus and Streptococcus pyogenes.


Starts with a minor infection at follicle or break in skin Then toxins are spread and break down tissues, the tissues then die and the bacteria spreads through the bloodstream.

Symptoms of cellulitis?

Pain, tenderness, and swelling (often in lower legs)


Local fever

Definition of cellulitis?

Rapidly spreading infection due to the introduction of bacteria or fungi into the dermis and subcutaneous tissue

Cause of cellulitis in healthy individuals?

Staphylococcus aureus


Streptococcus pyogenes

Cause of cellulitis in immunocompromised individuals?

Any bacterial and some fungal pathogens

Cause of cellulitis in infants?

Group B streptococci

Treatment of cellulitis?

Oral antibiotics


IV antibiotics


Surgery

What is Staphylococcal Scalded Skin Syndrom (SSSS) caused by?

Staphylococcus aureus

What is the progression of SSSS?

1. Bullous lesions that begin as red areas


2. Large blisters formm


3. Top layers of the epidermis peel

What is toxic shock syndrome caused by?

Staphylococcus aureus


Tampons:absorbed large concentrations of magnesium

Symptoms of toxic shock syndrome?

Fever, vomiting, sunburn-like rash

What are some predisposing factors for gas gangrene?

Surgical incisions


Compound fractures


Diabetic ulcers


Septic abortions


Punctures and gunshot wounds


Dirty wounds


Crushing injuries

What is gas gangrene caused by?

Clostridium perfringens

Two forms of gas gangrene?

Anaerobic cellulitis


True myonecrosis

Anaerobic cellulitis?

The infection stays localized in damaged tissue and does not pread into healthy tissue.


Bacteria produces toxins and gas

True myonecrosis?

Toxins are produced in large muscle and spread to nearby healthy tissue.


Damaged tissues serve as a focus for continual clostridial growth, gas production and toxins.

Clostridium perfringens produces?

1. Exotoxin (alpha toxin): ruptures RBCs and causes tissue destruction


2. Collagenase


3. Hyaluronidase


4. DNase

Prevention of gas gangrene?

Proper wound care and prophylactic administration of antibiotics

Treatment of gas gangrene?

Aggressive surgical debridement and high dose penicillin therapy.


Hyperbaric oxygen chamers may be used as well.

What is the virus that causes chickenpox and shingles?

Varicella-Zoster Virus (VZV)

What percentage of the population develops shingles?

10-20%

Definition of herpes zoster?

A sporadic, incapacitationg disease of adults who had chickenpox. Characterized by a vesicular rash limited in distribution to skin innervated by a single sensory ganglion.

What is the contagious period like for chickenpox?

The contagious period is greatest 1 to 2 days before the rash and lasts 3-4 days into the rash.

How is chickenpox spread?

Through the repiratory route or through contact with skin vesicles

What is the incubation period for chickenpox?

2-3 weeks

What is the pattern for the skin eruption of chickenpox and smallpox?

1. Macule


2. Papule


3. Vesicle


4. Pustule


5. Scab

Reactivation of the VZV virus can be stimulated by?

X-ray treatments


Immnosuppressive or drug therapy


Surgery


Leukemia

Where does the VZV virus multiply in response to reactivation?

Neurons

What is the treatment for shingles?

Antiviral drugs acyclovir (Zovirax) or valcyclovir

Prevention of shingles in adults?

Zostavax vaccine

Macule?

Flat lesion, characterized mainly by color change

Papule?

Small, elevate, solid bump

Vesicle?

Elevated lesion with clear fluid

Pustule?

Small, elevated lesion filled with pus

Through what route was smallpox usually spread?

Respiratory route

Signs and symptoms of smallpox?

Fever


Malaise


Pustular rash

How did smallpox differ from chicken pox?

All of the vesicles and pustules develped simultaneously

Progression of symptoms in smallpox?

1. High fever and malaise


2. Rash starts in the mouth, ever abdominal and back pain


3. Rash appears on the skin and spreads to the entire surface

What is unique about the pustules in smallpox?

Indented in the center

Symptoms of measles (Rubeola)?

Maculopapular rash, fever, cough, conjunctivitis, respiratory symptoms

Gray whitespots surrounded by red that are measles?

Koplick's spot

Progression of measles?

Incubation period: 7-18 days


1-2 days after that, Koplick's spots start to form


24 hours after Koplick's spots appear, the typical meales rash begins, first on the head, then on the trunk and extremities.


Communicable from 3-5 days before the rash to 4 days after.

How are measles antigens identified?

They are identified in urinary sediment or pharyngeal cells by flourescent antibody methods.

Treatment for measles?

No treatment except support

Preferred age for immunization of measles?

13-15 monthes

Incubation period for German measles (Rubella)?

14-21 days

Symptoms of German Measles (Rubella)?

Low grade fever


Upper respiratory symptoms


Macular rash that lasts for 1-3 days

The most common defects of congenital rubella are?

Congenital heart disease


Total or partial blindness or deafness


Mental retardation

When is the incidence of rubella the highest?

Winter and spring

How long is rubella contagious?

7 days before the rash and 7 days afer the rash

Treatment for Rubella?

No treatment

Symptoms of Fifth Disease (Erythema infectiosum)?

Slapped face


Fever


Malaise


Rash

What is fifth disease caused by?

Parvovirus B19

Ho is fifth disease spread?

Respiratory droplets or direct contact

What causes Roseola (6th disease)?

Human herpesvirus (HHV-6 or HHV-7)

Symptoms of Roseola?

High fever (105F) that may last for 3 days


Rash on chest and trunk and lightly on limbs

How does a rash from scarlet fever develop?

Results from respiratory infections caused by Streptococcus pyogenes producing erythrogenic toxin

Characteristics of warts (papilloma)?

Painless


Elevated


Rough

Warts that usually occur on fingers?

Seed or common wart

Wart that occurs on soles of feet?

Plantar wart

Wart that is prevalent on genitals?

Genital wart

How many different types of HPV are there?

At least 58

Transmission of warts?

Direct contact


Fomites

Incubation period for warts?

3-4 months

Treatment of warts?

Surgical cryotherapy (freezing them)


Electrocautery (burning with electricity)


Chemically

What kind of virus is molluscum contagiosum?

Poxvirus

Symptoms of molluscum contagiosum?

Smooth waxy skin nodules with an indented center

Transmission ofmolluscum contagiosum?

Direct contact and fomites

Treatment of molluscum contagiosu?

Surgical removal


Chemical treatment

How is Leishmaniasis transferred?

Zoonotic


Female sand fly

What is cutaneous leishmaniasis caused by?

L. Tropica, L. Major, L. Mexicana

Leishmania braziliensis (espundia)?

Affects both the skin and mucous membranes

Symptoms of cutaneous leishmaniasis?

Firm papules forms at the site of the bite (may look like a pimple without white center)


Bite enlarges


Abscesses develop

What kind of lesion does L. Major cause? Incubation period?

Moist, ulcerative lesions


2 week incubation period

What kind of lesion does L tropica cause? Incubation period?

Chronic dry lesion


Incubation period of several months to 3 years

Treatment for cutaneous leishmaniasis?

Heals spontaneously

Where is Cutaneous Anthràx found?

Soil and on vegetation

Treatment of cutaneous anthrax?

Ciprofloxacin

Worm of the scalp?

Tinea capitis

Worm of the beard?

Tinea barbae

Worm of the body?

Tinea corporis

Worm of the groin?

Tinea cruris

Worm of the foot?

Tinea pedis

Worm of the hand?

Tineae manuum

What are the three species that can cause tinea?

Trichophyton


Microsporum


Epidermophyton

Superficial mycoses? (Tinea versicolor)

Patchy discolored skin

What are the exposed surfaces of the eye?

Conjuctiva


Cornea

Primary defenses of the eye?

Tears


Lactoferrin


Lysozyme

Cause of conjuctivitis?

Pathogens that may be on contact lenses and or hands

Signs and symptoms of conjunctivitis?

Milky discharge (bacterial pathoen)


Clear discharge (viral pathogen)


Gritty feeling in the eyes


Redness


Eyelid swelling

What bacterial pathogens cause neonatal conjunctivitis?

Neisseria gonorrhoea


Chlamydia trachomatis

Bacterial Pathogens that cause conjunctivitis in adults?

Staphylococcus epidermidis


Streptococcus pyogenes


Streptococcus pneumoniae


Haemophhlus influenzae


Moraxella species

Viral pathogens that cause conjunctivitis?

Adenoviruses

What is put in the eyes of newoborns who have acquired neonatal conjunctivitis?

Erythromycin


Tetracycline

How is trachoma transferred?

Hands, fomites, flies

Symptoms of trachoma?

Mild inflammation of conjunctiva with exudate


Pebbled appearance of inner eyelid


Eyelids turn inward abradin and ulcerating the cornea


Pseudomembrane forms over the cornea


The cornea is usually scarred with reduced vision