124 Skin Infection

Question 1

43M with cellulitis  of the right leg, presents with  with decreased sensorium. PE BP 90/60 mmHg, HR 124, RR 24/min. He is allergic to beta lactam antibiotics,. What antibiotic regimen will you give?
A. Amikacin+ clindamycin
B. Aztreonam + ciprofloxacin
C. Levofloxacin + vancomycin
D. Linezolid + clindamycin

Answer 1

D. Linezolid + clindamycin

Question 2

Zoster common affects what types of person

Answer 2

Elderly

Immunosuppressed

Question 3

Herpes in head and neck of young wrestlers

Answer 3

Herpes gladiatorum

Question 4

Herpes in digits of health care workers

Answer 4

Herpetic whitlow

Question 5

DNA virus that infects fingers of workers around goats and sheep

Answer 5

Orf

Question 6

Papule with central vesicle that evolves to form 1 to 2.5 cm painless crusted black eschar with an erythematous halo and proximal adenopathy after a mite bite

Answer 6

Rickettsialpox of Rickettsia akari

Question 7

Differentiates SSSS from Ten on punch biopsy

Answer 7

Cleavage plane
SSSS: stratum corneum
TEN: stratum germinativum

Question 8

Most common cause of localized folliculitis

Answer 8

Staph Aureus

Question 9

Causative agent of raised erythematous nodules in patient who under went tattooing

Answer 9

Mycobacterium chelonei

Question 10

Causative agent of raised erythematous nodule in patient who underwent cosmetic laser surgery

Answer 10

Mycobacterium abscessus

Question 11

Raised serpiginous or linear eruptions caused by burrowing larvae of dog or cat hookworms; acquired through contact with soil contaminated by dog or cat feces

Answer 11

Ancylostoma braziliense

Question 12

Nodules measuring 1-10 cm occurring in persons bitten by Simulium files in Africa. Migration of microfilariae into the eyes can cause blindness

Answer 12

Onchocerca volvulus

Question 13

Condition can take a form of single gigantic lesions or multiple small lesions transmitted to humans by sandfly Phlebotomus

Answer 13

Bartonella bacilliformis

Question 14

Begins as pruritic papuks that develops within days into an ulcer with surrounding vesicle and edema and then into an enlarging ulcer with black eschar

Answer 14

Cutaneous anthrax

Question 15

Due to tissue hypoxemia secondary to pressured induced vascular insufficiency and may become secondarily infected with components of the skin and gastrointestinal flora

Answer 15

Decubitus ulcer

Question 16

Characterized by abrupt onset of fiery red swelling of the face or extremities; well defined indjrsted margins, particularly along the nasolabial folds, rapid progression and intense pain. What is the causative agent

Answer 16

Erysipelas. S. Pyogenes

Question 17

Acute inflammatory condition of the skin that is characterized by localized pain, Erythema, Swelling and heat

Answer 17

Cellulitis

Question 18

Pathogen of cellulitis that spreads from central localized infection such as abscess, folliculitis or an infected foreign body

Answer 18

Purulent cellulitis caused by S. Aureus

Question 19

Pathogen of cellulitis that rapidly spreading, diffuse process frequently associated with lymphangitis and fever

Answer 19

Nonpurulent cellulitis caused by S. Pyogenes

Question 20

Cellulitis caused by cat bites

Answer 20

Pastuerella multocida

Question 21

Pastuerella is notoriously resistant to what but sensitive what?

Answer 21

Resistant: dicloxacillin, nafcillin
Sensitive: beta lactams, quinolones, tetracycline and erythromycin

Question 22

Good choices for treatment of animal or human bite infections

Answer 22

Amoxicillin- clavulanate
Ampicillin sulbactam
Cefoxitin

Question 23

Causes agressive cellulitis and occasionally Necrotizing Fasciitis in tissues surrounding lacerations sustained in freshwater

Answer 23

Aeromonas hydrophila

Question 24

Three soft tissue infection caused by P Aeruginosa

Answer 24

Ecthyma gangrenosum in neutropenic patients
Hot tub folliculitis
Cellulitis following penetrating injury

Question 25

Cellulitis among bone renderer and fishmonger caused by a gram. Positive aerobic rod

Answer 25

Erysipelothrix rhusiopathiae

Question 26

Pathogen that produce Panton-Valentine-Leukocidin (PVL) toxin and cause Necrotizing Fasciitis

Answer 26

MRSA

Question 27

MRSA infection that spread to perineal area

Answer 27

Fourniers gangrene

Question 28

Severe muscle pain is a hallmark of what infective agents

Answer 28

Coxsackievirus B | Trichinellosis

Question 29

Causative agent of traumatic gangrene

Answer 29

Clostridium perfringens, septicum, histolyticum

Question 30

Causative agent of gas gangrene of the uterus after illegal abortion or self induced abortion

Answer 30

Clostridium sordellii

Question 31

Causative agent for spontaneous nontraumatic gangrene among patients with neutropenia, GI malignancy, diverticulosis and recent radiation to the abdomen

Answer 31

C. Septicum

Question 32

Best way to determine extent and severity of infection and to obtain Gram staining and culture

Answer 32

Open Surgical inspection with debridement

Question 33

Primary and alternative treatment. Early animal bite

Answer 33

P: co amoxiclav A: doxycycline

Question 34

Primary and alternative treatment. Animal bite with established infection

Answer 34

P: ampicillin sulbactam A: Clindamycin + ciprofloxacin /cefoxitin

Question 35

Primary and alternative treatment. Bacillary angiomatosis

Answer 35

P: erythromycin A: doxycycline

Question 36

Primary and alternative treatment. Herpes simplex

Answer 36

P: acyclovir 400 mg TID x 10 days A: famciclovir, valacyclovir

Question 37

Primary and alternative treatment. Herpes zoster. Immunocompetent. More than 5 years old.

Answer 37

P: acyclovir 800.mg 5x a day A: famciclovir, valacyclovir

Question 38

Primary and alternative treatment. Cellulitis

Answer 38

P: nafcillin, oxacillin A: ampicillin sulbactam or cefazolin or erythromycin or Clindamycin

Question 39

Primary and alternative treatment. MRSA skin infections

Answer 39

P: Vancomycin A: linezolid

Question 40

Primary and alternative treatment. Necrotizing Fasciitis. Group A strep

Answer 40

P: Clindamycin + Pen G A: Clindamycin + first or second gen cephalosporins

Question 41

Primary and alternative treatment. Necrotizing Fasciitis. Mixed aerobes and anaerobes

Answer 41

P: ampicillin+ clindamycin+ ciprofloxacin A: Vancomycin + Metronidazole + ciprofloxacin

Question 42

Primary and alternative treatment. Gas gangrene

Answer 42

P: Clindamycin + Pen G A: Clindamycin + cefoxitin