ID

Question 1

Cellulitis

Answer 1

acute, spreading pyogenic inflammation of debris and subcutaneous tissue

Question 2

cellulitis usually complicates a ____

Answer 2

would or ulcer

Question 3

cellulitis is usually ___, ___ and ___

Answer 3

warm, tender, and erythematous

Question 4

cellulitis lacks _____ from unaffected skin

Answer 4

sharp demarcation

Question 5

impetigo occurs mostly in children during -___

Answer 5

hot, humid weather

Question 6

common sx of impetogi

Answer 6

pruritus – scratching causes secondary staph infection

Question 7

treat impetigo wiht

Answer 7

benzathine PCN, single IM injection

Question 8

severe manifestation of s aureus infection

Answer 8

staphylococcal scaled skin syndrome

Question 9

SSSS is caused by ____

Answer 9

exfoliative exotoxin

Question 10

SSSS may produce epidemics in ___

Answer 10

neonatal nurseries

Question 11

mortality of SSS

Answer 11

~3%

Question 12

treat SSSS with ___

Answer 12

penicillinase resistant PCN, nafcillin

Question 13

folliculitis

Answer 13

a pyoderma in the hair shaft

Question 14

etiology of folliculitis

Answer 14

s aureus, pseudomonas, candida

Question 15

tx of folliculitis

Answer 15

local (topical) abx, antifungals

Question 16

furuncle

Answer 16

deep inflammatory nodule

Question 17

carbuncle

Answer 17

larger than furuncle; extends into subQ fat (abscess)

Question 18

boils are invariably caused by ___

Answer 18

s aureus

Question 19

predisposing factors for boils

Answer 19

obesity
blood dyscrasias
steroid tx
diabetes

Question 20

tx for boils

Answer 20

antistaphlococcal abx

Question 21

dose o dicoxacillin for boils

Answer 21

250mg PO q6h

Question 22

dose of clindamycin for boils

Answer 22

150-300mg PO q6h if PCN allergic

Question 23

dose of Vance for boils

Answer 23

linezolid or daptomycin (possible MRSA)

Question 24

cancriform lesions were previously assoc w/

Answer 24

wool and animal hides

Question 25

cancriform lesions are caused by spores of

Answer 25

bacillus anthracis

Question 26

chancriform lesions are ___

Answer 26

painless

Question 27

tx for chancriform lesions

Answer 27

avoid incision and debridment | ciprofoxacin 500mg PO q12h x 7-10d (60 for bioterror)

Question 28

erysipelas

Answer 28

distinctive type of superficial cellulitis

Question 29

erysipelas is characterized by

Answer 29

prominent lymphatic involvement

Question 30

erysipelas is has a ___

Answer 30

raised border that is sharply demarcated

Question 31

treat mid/early cases of erysipelas with

Answer 31

penicillin pen V 250-500mg PO q6h or erythromycin 250-500mg PO q6h

Question 32

treat extensive/hospitalized cases of erysipelas

Answer 32

pen G 2,000,000 units IV q6h or nafcillin 2g IV q4h or cefzolin 1-2g IV q8h

Question 33

initiating sources of cellulitis

Answer 33

``` skin trauma (MC) bites wounds hot tubs/pools edema ```

Question 34

80% of cellulitis cx are ___

Answer 34

``` gram + organisms: s aureus group a and b strep viridian's strep e faecalis (rare) ```

Question 35

cultures for cellulitis are usually not ___

Answer 35

helpful (especially swabs)

Question 36

to cx for cellulitis, reveal ___

Answer 36

typical skin flora

Question 37

cultures for cellulitis are reserved for ___

Answer 37

special cases (blisters)

Question 38

focus empiric therapy of cellulitis against ___

Answer 38

gram +

Question 39

exception to starting gram + as empiric therapy for cellulitis:

Answer 39

diabetics (add anaerobic coverage)

Question 40

necrotizing fasciitis affects ___

Answer 40

extremities, abdominal wall, perianal, groin

Question 41

Fournier's gangrene

Answer 41

NF of the genitalia.

Question 42

in NF, affected area is ___

Answer 42

swollen, hot and very painful (Clue)

Question 43

NF causes

Answer 43

thromboses sub q vessels

Question 44

anesthesia may precede ___

Answer 44

skin necrosis

Question 45

an important clue to NF

Answer 45

disproportionate pain

Question 46

for NF, prompt diagnosis is ___

Answer 46

critical

Question 47

mortality rate for NF

Answer 47

~20-50% (10-20% for FG)

Question 48

empiric abx for NF

Answer 48

ampicillin, gentamicin, clindamycin metronidazole Clinda (inhibits exotoxin production)

Question 49

Sinusitis is usually secondary to ___

Answer 49

colds (viral rhino sinusitis) (VRS)

Question 50

1-2% of VRS progresses to ___

Answer 50

bacterial sinusitis

Question 51

secondary obstruction favors ___

Answer 51

bacterial growth, resulting in acute bacterial sinusitis (ABS)

Question 52

50% of ABS cases

Answer 52

s pneumo and h flu

Question 53

VRS symptoms improve in __

Answer 53

7-10 days

Question 54

clx dx of ABS is either

Answer 54

symptom persistance <10 days worsening sx after 5-7 days + transillumination of maxillary sinus

Question 55

90% of ABS is cured after ___ days of abx

Answer 55

10 days

Question 56

current abx recommended for ABS

Answer 56

amox-clav | cefdinir

Question 57

MC reason for abx in children

Answer 57

OM

Question 58

38% of AOM is

Answer 58

s pneumo

Question 59

27% of AOM

Answer 59

hflu

Question 60

10% of AOM

Answer 60

m cat

Question 61

most m cat produces ___

Answer 61

b lactamase

Question 62

diagnosis of AOM requires s/sx and:

Answer 62

inflammation (red TM) | fluid in the middle ear (bulging membrane)

Question 63

retracted ear drum is ___

Answer 63

painful, but not AOM

Question 64

retracted eardrum is caused by ___

Answer 64

negative middle ear pressure

Question 65

a red membrane w/o middle-ear fluid is ____

Answer 65

not AOM

Question 66

methods of detecting middle ear fluid

Answer 66

otoscope (Visual)

Question 67

tympanocentesis is indicated in:

Answer 67

parents critically ill at sx onset toxic pts not responding in 48-72h pts with altered host defenses (immune defect, newborn)

Question 68

drug of choice for OM

Answer 68

amox

Question 69

dose of ammox for OM

Answer 69

80mg/kg/d -- high dose

Question 70

alternative abx for pts who failed recommended OM therapy

Answer 70

amox/clav 80-90 mg/kg/d -- divided BID curfuroxime axetil or cefdinir ceftriaxone IM