bacterial infections

Question 1

organisms for cellulitis

Answer 1

1 = strep pyogenes // 2 = staph A

Question 2

criteria for admission cellulitis

Answer 2

eron class III or IV // severe deteriorating // very young or frail // immunocompromised // lymphoedema // facial

Question 3

eron classification cellulitis

Answer 3

I = no systemic symptoms or morbididty // 2 = systemic symptoms or well with uncontrolled morbidity // III = v unwell and comorbid // IV = sepsis or nec fasc

Question 4

mx mild cellulitis

Answer 4

oral fluclox // pen allergy = clarithro, erythro, doxy

Question 5

mx severe cellulitis

Answer 5

co-amox // clinda // cetriaxone

Question 6

organism impetigo

Answer 6

staph A // strep pyogenes

Question 7

when does secondary impetigo usually occur

Answer 7

scabies, insect bite, eczema

Question 8

spread, incubation and features impetgigo

Answer 8

direct contact from scab of infected person // 4-10 days // golden crust, v contagious

Question 9

1st line topical treatment impetigo

Answer 9

hydrogen peroxide 1% cream

Question 10

2nd line topical mx impetigo

Answer 10

fusidic acid // MRSA = mupirocin if resistant

Question 11

mx extensive disease impetigo + school rules

Answer 11

oral fluclox (or erythromycin) // keep of school until crusted or 48 hours after starting treatment

Question 12

what is MRSA

Answer 12

methicillin resistant staph A

Question 13

invx MRSA

Answer 13

nasal + skin swab

Question 14

suppression of a MRSA carrier

Answer 14

nose = mupirocin 2% 5 days // skin = chlorhexidine gluconate 5 days

Question 15

abx for MRSA

Answer 15

oral vanc!!! // teicoplanin // linezolid

Question 16

cause type 1 nec fasc + who gets it

Answer 16

mixed anaerobes + aerobes post surgery in diabetics (most common)

Question 17

type 2 nec fasc cause

Answer 17

strep pyogenes

Question 18

RF nec fasc

Answer 18

recent trauma // diabetes // SGLT2 inhib eg dapagloflozin // IV drugs // immunosuppresed

Question 19

most common site of nec fasc

Answer 19

perineum (fournier’s gangrene)

Question 20

symptoms nec fasc

Answer 20

acute onset // pain, swelling, redness (rapid cellulitis with extreme pain) // extreme tenderness

Question 21

mx nec fasc

Answer 21

urgent surgical debridement + IV abx

Question 22

single room isolation skin infections

Answer 22

GAS // MRSA // scabies

Question 23

what orgnaism causes toxic shock

Answer 23

staph exotoxin –> TSST1

Question 24

causes toxic shock

Answer 24

infected tampons

Question 25

symptoms toxic shock

Answer 25

fever 39+ // BP <90 // red rash // desquamatised on palms and soles // 3 or more organ involvement

Question 26

mx toxic shock

Answer 26

remove tampon //IV fluid // IV abx

Question 27

what is erysipelas

Answer 27

local infection of strep pyogenes eg superficial and limited cellulitis (well demarcated rash)

Question 28

mx erysipelas

Answer 28

fluclox

Question 29

organism erythasma

Answer 29

diphtheroid Corynebacterium minutissimum

Question 30

symptoms erythasma

Answer 30

flat, scaly pink or brown rash in groin or axilla

Question 31

invx erythasma

Answer 31

wood light –> coral red