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Host and Defense COPY > Skin and Soft Tissue > Flashcards

Skin and Soft Tissue Flashcards

1
Q

What are the 4 classic presentations of an SSTI?

A

1-Rubor (erythema)
2-Calor (warmth)
3-Tumor (edema/swelling)
4-Dolor (tenderness)

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2
Q

What term is described as a crackling or the feeling of rice krispys under a tissue?

A

Crepitus

*often gas gangrene

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3
Q

Rebound of a furuncle is called what?

A

Fluctuance

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4
Q

Bruising can be called?

A

Purpura

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5
Q

Another word for blisters is?

A

Bullae

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6
Q

Folliculitis is a minor infection associated with friction and sweat gland activity and is caused by what bacteria most often? what is it caused by if a hot tub was involved? how is it treated?

A
  • Staph aureus
  • Hot tub folliculitis is pseudomonas aeruginosa

*treated with soap and water and topical antibiotics

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7
Q

Acne is inflammation of hair follicle and associated sebaceous gland and is caused by what?

A

Propionibacterium acnes as well as hormonal influences

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8
Q

Pus is comprised of what?

A

WBC’s accumulation and cellular debris

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9
Q

A fluctuant, tender, erythematous nodule with surround erythema that results from the nacres/liquefying of tissue is likely what? How is it treated?

A

Soft tissue abscess

Treated by incision and drainage, maybe systemic antibiotics

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10
Q

Multiple furuncles (boils) congregate to form what? What general layer are they found in? what is the common bacterial cause? What is the treatment?

A

Carbuncle

*infection spreads to subcutaneous tissue, usually s. aureus, treated by I and D

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11
Q

“Ringworm” is really a yeast infection in the keratinized layers cause by what? These type of infections are caused most commonly by what?

A

Dermatophyte fungi

Caused most commonly by candida albicans

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12
Q

Impetigo has characteristic honey crusts, is highly contagious, is in the epidermis and is caused by what?

A

Group A strep or Staph aureus

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13
Q

Erysipelas is a deep dermis infection with rubor, calor, tumor and dolor and is caused by what? What do you usually treat with?

A

Group A strep

*treat with penicillin usually

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14
Q

Cellulitis is caused by group A strep or staph Aureus or gram negatives (in susceptible patients) and effects primarily what skin layer?

A

Subcutaneous tissue

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15
Q

“Flesh eating” Group A strep or S. aureus that cause a rapid extension of infection are referred to as?

A

Necrotizing fasciitis - produce an enzyme to digest barriers

*able to digest fascial barriers. many times polymicrobial with G (+) and anaerobes

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16
Q

Which anaerobe has spores and can cause necrotizing fasciitis?

A

Clostridium perfringens

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17
Q

Polymicrobial Necrotizing Fasciitis infection of the genitals and perineum is referred to as?

A

Fournier’s gangrene

*a necrotizing fasciitis

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18
Q

What factors increase risk of wound infections?

A 
higher number of organisms
higher virulence factors
poor circulation near wound
poor general health/nuturition
immunocompromised or diabetic
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19
Q

What potential pathogen is the all-time champ, is acute, aggressive, causes locally destructive purulent lesions, and colonizes anterior nares in 10-30% of the population? What is its gram stain and shape?

A

Staphylococcus Aureus

*gram (+) cocci in clusters

20
Q

Alpha-toxin of S. Aureus causes what?

A

Scalded skin syndrome

21
Q

A problem in super absorbent tampons or sinus surgeries if the dressings are not changed frequently, TSST-1 is an S aureus toxin that causes what?

A

Staph toxic shock syndrome

22
Q

What does the staph exotoxin do in the GI tract?

A

Acts as an enterotoxin and causes staphylococcal food poisoning

23
Q

What gene is required for MRSA strains?

A

mecA gene (makes new PBP with reduced affinity for B-lactams)

24
Q

What are the drugs of choice for MSSA?

A
  • Anti-staph pcn (nafcillin, oxacillin)

- cephalosporins

25
Q

With higher risk in crowded living, skin-skin contact, poor hygiene and IV drug users, what is the treatment for MRSA?

A
  • Trimethoprim-sulfa
  • doxycycline
  • vancomycin,
  • linezolid
  • daptomycin
26
Q

What are two sequelae (illnesses that come after another illness) of Group A strep (strep pyogenes)?

A
  • Rheumatic fever after pharyngitis

- Post-strep glomerulonephritis after pharyngitis

27
Q

Which Strep exotoxins can act as super antigens?

A

Exotoxins A and B

28
Q

Which strep exotoxins are cytotoxic and lyse leukocytes, tissue cells and platelets?

A

Streptolysins O and S

29
Q

What are three strep inflammatory enzymes?

A

1-Streptokinase (protease)
2-Hyaluronidase (degrades carbohydrate)
3-DNase

30
Q

What anaerobic, spore-forming, gram-positive rod with square ends is found in soil and human colon and produces hydrogen, CO2 gases and exotoxins?

A

Clostridium perfringens

*can result in gas gangrene. more typical in crushing injuries where blood flow is decreased

31
Q

What gram negative rod is associated with animal bites?

A

Pasteurella multocida

32
Q

What gram negative rod is a prototypical non-fermenter, is an environmental pathogen and causes hot tub folliculitis or infection after burns?

A

Pseudomonas aeruginosa

33
Q

What gram negative rod is in salt-water environments (shellfish) causes fever, sepsis and hemorrhagic bullae and is associated with iron overload (cirrhosis)?

A

Vibrio Vulnificus

34
Q

A mycetoma of “Madura foot” is caused by what?

A
  • Bacterial actinomyces or nocardia

- Fungal

35
Q

“Rose gardeners thumb” presents usually as erythematous furuncles up the lymph chain and is caused by what?

A

Sporothrix schenckii

*Called sporotrichosis

36
Q

What is the best specimen when trying to diagnose an SSTi?

A

Pus or fluid from the infection

37
Q

When the abscess is in the skin think?

A

Staph aureus

38
Q

When the abscess is in the mouth/rectum/vagina think?

A

Polymicrobial

39
Q

With Cellulitis and erysipelas think?

A

Strep Pyogenes (group A strep)

40
Q

soft tissue abscesses are usually caused by what bacteria?

A

S. aureus including MRSA

41
Q

What is one sign of Necrotizing Fasciitis?

A

pain out of proportion to exam findings

42
Q

How is Necrotizing Fasciitis acquired?

A

surgery
bites
deep cut

43
Q

what is the most common pathogen in surgical wounds? what 3 areas does the bacteria usually come from?

A

staph aureus
comes from patients own skin
transmission by fomites, hands, or air
environmental

44
Q

what is intertrigo?

A

yeast infection under the breasts

45
Q

what causes impetigo most often? What are the clinical observations of an impetigo patient?

A

group A strep

present with honey crust lesions on the face usually

46
Q

what does the exfoliatin exotoxin cause?

A

bullous impetigo which are yellow filled blisters basically

47
Q

What is the gram stain and shape of clostridium perfringens?

A

gram positive rod

Host and Defense COPY (81 decks)

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