Skin Flashcards
Lydia is a caretaker who works in a rest home. She presented to your clinic 2 weeks ago with a wound on her forearm, which looked infected. You think it was a staph infection after thoroughly examined her. To be careful, you gave her flucloxacillin which is effective against penicillin-resistant S aureus. She comes back today and the wound doesnÕt look like it has healed at all. It is likely to be MRSA now. Which of these antibiotics is NOT effective against MRSA infections in NZ?
Select one:
Doxycycline
Vancomycin
Cotrimoxazole
Clindamycin
Cephalexin
Cephalexin
During your general surgery run as a house officer, you are asked to examine an obese 57 year old male patient who is complaining of a painful lower left leg. He points to an area of skin around his shin that looks very red and swollen.To touch it feels hot and is tender. He tells you he scratched his leg on the side of his bed three days ago and has noticed the area of redness getting larger each day.The bacteria causing his condition when grown in the lab is a gram-positive coccus, that is coagulase positive. What is the first choice of antibiotic treatment for your patient?
Select one:
Vancomycin
Metronidazole
Gentamicin
Flucloxacillin
Flucloxacillin
(He has cellulitis from Staph aureus)
Mr AB, 79y, has returned to the GP after 5 days of oral Flucloxacillin, 500mg qds for mild cellulitis of his left lower leg. He reports no improvement, and his leg remains red, hot and tender, with no regression in the area of redness. He is not systematically unwell. You suspect MRSA is the culprit here. What is the most appropriate course of action?
Select one:
Increase the dose of Flucloxacillin to 1g po qds for 10 days
Change to Erythromycin 800mg bd po for 5 days
Change to Cefaclor 250mg po tds for 5 days
Change to Amoxycillin 500mg po tds for 5-7 days
Change to Erythromycin 800mg bd po for 5 days
(MRSA is susceptible to -mycin, and co-trimoxazole. It is resistant to penicillins)
A 9 year old presents to E.D. following a dog bite on their leg. Which antibiotic is MOST EFFECTIVE and provides BEST COVERAGE for the bite?
Select one:
Amoxicillin
Ciprofloxacin
Penicillin
Amoxicillin clavulanate
Ceftriaxone
Amoxicillin clavanate
You are a student in a GP clinic. A 45 year old man comes into the clinic with a two day history of fever with and “bad” rash on his arm that has been growing quickly since the day before yesterday. On examination his temperature is elevated and he is mildy tachycardic. The rash is warm, tender, and erythematous with raised, well-demarcated borders. The GP takes a picture for your notes, shown below:The GP asks what the likely causative organism for erysipelas (superficial, demarcated, rapid onset rash with fever) is?
Select one:
Staphylococcus epidermidis
Streptococcus pyogenes
Candida albicans
Staphylococcus aureus
Pyogenes.
(Epidermidis is normal skin flora, staph aureus causes deeper infection like cellulits, and candida is more itchy and slow growing)
A mum comes in with her 4-year-old boy. She’s taken him home from kindy because he has a rash, only around his chin. It started a couple of days ago so she put some fatty cream on it and thought it would go away, but it has now started to blister. On examination, the rash is bullous, but the underlying skin is not swollen. The boy does not have a fever. What is the causative organism of this type of rash and the appropriate management?
Select one:
Staph aureus -Fusidic acid cream three times a day for 7 days
Staph aureus or Strep pyogenes - Flucloxacillin 500mg 4x daily for seven days
Staph aureus - Flucloxacillin 500mg 4x daily for seven days
Staph aureus or Strep pyogenes -Fusidic acid cream three times a day for 7 days
Staph aureus or Strep pyogenes -Fusidic acid cream three times a day for 7 days
Both r common and this cream is good
Which of the following bacteria is the most common cause for skin infections including impetigo, furuncles and carbuncles?
Select one:
Staphylococcus aureus
Haemophilus influenzae
Pseudomonas aeruginosa
Streptococcus mitis
Enterococcus faecalis
Staph aureus
Thomas Train (17y, M) presents to you (his GP) witha painful, fluctuant, erythematous nodule on the anterior surface of his right thigh.The nodule discharged purulent material spontaneously and was surrounded by a large area of skin erythema, oedema, and warmth.It started off as a tiny boil that developed about 2 weeks ago. He reported that it grew much larger and more painful over the past week.He has no past history of an MRSA infection.Upon examination, his vital signs were stable and regional adenopathy was not observed.You manage to drain his abscess successfully in clinic and cover it up with a nice, dry dressing.Which of the following antibiotic(s) will you give him after draining his abscess?
Select one:
Vancomycin
Co-trimoxazole and erythromycin
Flucoxacillin
No antibiotics
No antibiotics
(It was drained)
A 68 year old gentleman presents to your GP practice with an area of clean, enclosed, red swelling on his right upper forearm. There is no discharge of any kind, no apparent loss of skin integrity, and is slightly warm to the touch. The swelling and redness appear to be affecting layers of the skin deeper than the epidermis. The gentleman reports slight tenderness to the touch and says the area of redness has grown since he first noticed it yesterday morning. On questioning, the gentleman recalls scraping his right elbow outside 3 days ago, but did not attribute any effect of this until noticing the redness yesterday morning. He reports no known allergies, and has not had previous MRSA infection.Considering the most likely diagnosis, which of the following antibiotics would be most appropriate in treating this gentleman?
Select one:
Penicillin
Cotrimoxazole
Amoxicillin
Flucloxacillin
Vancomycin
Flucloxacillin
A young girl presents to your clinic with an abscess on her thigh, which you suspect to be a staphylococcus aureus skin infection. The abscess is not fluctuant or pointing and you assess it will not be possible to drain today. The patient has no history of MRSA.Which antibiotic is the first line treatment for this?
Select one:
Cotrimoxazole (Trimethoprim Sulfamethoxazole)
Penicillin
Amoxicillin clavulanate (Augmentin)
Flucloxacillin
Amoxicillin
Flucloxacillin
Mrs Santiago and her wife present to ED with a painful red rash on her lower leg. The area is red, swollen, hot and painful to touch. She also states that she is highly allergic to penicillin. She is otherwise well, and takes no regular medications.What investigations should you do and what antibiotic is the best choice for Mrs Santiago
Select one:
Blood culture and swabs Flucloxacillin
Blood culture and swabs Erythromycin
No investigations needed Flucloxacillin
No investigations needed Erythromycin
No investigations erythromycin
(She isn’t feverish so no blood culture, no pus to swab)
A young child presents with a blistering and crusting rash which the GP suspects to be impetigo. Which of the following is false regarding impetigo?
Select one:
bulllous impetigo is caused by exfoliative toxins
oral antibiotics are first line treatment in all cases
itis highly contagious
infection is restricted to the epidermis
it is commonly caused by Staphylococcus aureus
Oral Antibiotics first line in all cases
(Can sometimes use topical)
Tanya bring hers 8 year old son Sefa into your GP clinic as he has developed a rash on his right forearm. Over the past few days the rash has changed and started blistering and crusting.He says its quite painful and on examination you notice it is hard to touch, yet it is not raised. He is otherwise well, with no fever. She said she first noticed it on him once he came home from school about three days ago and it hasn’t gone away. You determine that Sefa has a highly contagious skin infection restricted to the epidermis and write a script for first line treatment. What have you prescribed?
Select one:
Fusidic acid cream four times a day for seven days
Cephalexin 500mg four times a day for seven days
Flucloxacillin 500mg four times a day for seven days
Fusidic acid cream three times a day for seven days Tanya bring hers 8 year old son Sefa into your GP clinic as he has developed a rash on his right forearm. Over the past few days the rash has changed and started blistering and crusting.He says its quite painful and on examination you notice it is hard to touch, yet it is not raised. He is otherwise well, with no fever. She said she first noticed it on him once he came home from school about three days ago and it hasn’t gone away. You determine that Sefa has a highly contagious skin infection restricted to the epidermis and write a script for first line treatment. What have you prescribed?
Select one:
Fusidic acid cream four times a day for seven days
Cephalexin 500mg four times a day for seven days
Flucloxacillin 500mg four times a day for seven days
Fusidic acid cream three times a day for seven days
Fusidic acid cream three times a day for seven days
(Four times a day is overkill)
