Infections

Question 1

Give examples of bacterial infection

Answer 1

1. Impetigo
2. Syphilis

Question 2

What is impetigo

Answer 2

A superficial infection of the skin by staphylococcus aureus or streptococcus pyogenes

Question 3

How can impetigo be classified

Answer 3

non-bullous or bullou

Question 4

How does non bullous impetigo present

Answer 4

Erosion, cluster of erosions or small vesicles or pustules that have an adherent or oozing honey yellow crust

Question 5

What is non bullous impetigo usually caused by

Answer 5

staphylococci or streptococci

Question 6

How does bullous impetigo present

Answer 6

As a large thin walled bull (2.5cm) containing yellow serous fluid
These can rupture leaving a complete or partially denuded area with a ring or arc remaining bulla

Question 7

What is bullous impetigo caused by

Answer 7

almost always caused by S. aureus.

Question 8

Where is impetigo commonly seen

Answer 8

On the face especially around the nostrils

Question 9

How do we manage impetigo

Answer 9

Topical muporicin may be given for localised disease,
Widespread involvement an oral antibiotic eg cephalexin, dicloxacillin or erythromycin is effective.

Question 10

What is syphilis

Answer 10

A sexually transmitted disease caused by Treponema pallidum

Question 11

What is syphilis characterised by

Answer 11

Several stages:
1. Primary
2. Secondary
3. Tertiary

Question 12

What lesion is primary syphilis associated wit

Answer 12

A chancre

Question 13

Where does the chancre in primary syphilis form

Answer 13

At the site of penetration of the bacterium into the mucosa after 3-4 weeks usually genitalia but can occur in the oral mucosa in about 10% of cases

Question 14

Name the most frequent sites for an oral chancre due to primary syphilis to form

Answer 14

1. Lips
2. Tongue
3. Palate (rare)
4. Tonsillar area (Rare)

Question 15

Describe a chancre

Answer 15

Starts as a solitary firm nodule that soon erodes leaving a painless ulcer with raised border and indurated base

Question 16

How do we manage a chancre

Answer 16

If not treated, the chancre heals spontaneously without scarring in 3–8 weeks.

Question 17

When does secondary syphilis deveop

Answer 17

1-4 months after infection

Question 18

List some of the symptoms of secondary syphilis

Answer 18

1. Low grade fever
2. Malaise
3. pharyngitis,
4. loss of appetite,
5. weight loss,
6. polyarthralgias
7. myalgias,
8. generalised lymphadenopathy with splenomegaly

Question 19

Give examples of Mucocutaeneous manifestations of secondary syphilis

Answer 19

Variable skin rash symmetrical and generalised, consisting of several small erythematous macules and papules on the face, trunk, palms, soles and genital regions

Question 20

When does tertiary syphilis develop

Answer 20

4-7 years or more

Question 21

What is the characteristic lesion of tertiary syphilis

Answer 21

Local destructive granuloma called a ‘gumma’ or a glossitis with mucosal atrophy, which may undergo malignant transformation

Question 22

How do Gummas appear

Answer 22

As painless swellings which undergo necrosis leaving indolent deep ulcers

Question 23

Where do gummas frequent form in the oral mucosa

Answer 23

On the palate, perforating the hard palate

Question 24

Give examples of immunologically mediated skin diseases

Answer 24

1. Lichen planus
2. Psoriasis
3. Lupus erythematosus
4. Scleroderma
5. Dermatomyositis
6. Erythema multiforme
7. Acquired bullous disease
8. Dermatitis
9. Eczema

Question 25

What is lichen planus

Answer 25

An inflammatory mucocutaneous condition