Skin Infections

Question 1

define epidermis

Answer 1

outermost, nonvascular layer of skin

Question 2

define dermis

Answer 2

consists of connective tissue, blood vessels, lymphatics, sensory nerve endings, sweat and secaceous glands, hair follicles, and smooth muscle fibers

Question 3

define subcutaneous tissue

Answer 3

layer of loose connective tissue containing primarily fat cells

Question 4

Define fascia

Answer 4

connective tissue surrounding muscle

Question 5

Health care acquired MRSA risk factors

Answer 5

Hospital attendance in the past 3 months
antimicrobial usage
surgery
dialysis
diabetes
indwelling devices
residency in LTCF

Question 6

Community acquired MRSA risk factors

Answer 6

Recurrent infections
Prison inmates
athletes
military recruits
native americans
children 
IVDU

Question 7

define folliculitis

Answer 7

superficial inflammatory reaction involving the hair follicle

Question 8

treatment for folliculitis

Answer 8

moist heat

Question 9

describe the appearance of folliculitis

Answer 9

small, pruritic, erythematous papules

Question 10

define furnuncle

Answer 10

infections of the hair follicle extending through the dermis into subcutaneous tissue

Question 11

most common areas for furnuncles

Answer 11

face, neck, axilla, buttock

Question 12

describe the appearance of a furnuncle

Answer 12

small, red, tender nodule -> painful and pustular

Question 13

common pathogen of furnuncles and carbuncles

Answer 13

S. aureus

Question 14

Define carbuncle

Answer 14

multiple furnuncles - very broad multiple hair follicles

Question 15

most common area for carbuncles

Answer 15

back of the neck

Question 16

describe the appearance of a carbuncle

Answer 16

broad, swollen, erythematous, deep, and painful masses

Question 17

Empiric therapy for furnuncles/carbuncles with no surrounding cellulitis

Answer 17

moist heat

Question 18

empiric therapy for furnuncles/carbuncles with large, focal, fluctuant lesions

Answer 18

incision + drainage

Question 19

when are antibiotics required in addition to incision and drainage for furuncles/carbuncles

Answer 19

extensive surrounding cellulitis
face
fever

Question 20

antibiotics for furuncles/carbuncles if no MRSA risk factors

Answer 20

Nafcillin IV -> Dicloxacillin PO
Cefazolin -> cephalexin
Amp/sulbactam -> amox/clav

Question 21

antibiotics for furuncles/carbuncles if MRSA risk factors

Answer 21

bactrim
doxy
clinda

Question 22

duration of treatment for furuncles/carbuncles

Answer 22

5-10 days

Question 23

when is bactrim not used

Answer 23

SCr > 1.5
Hyperkalemia > 5.5
Plts

Question 24

when is bactrim not used

Answer 24

SCr > 1.5
Hyperkalemia > 5.5
Plts

Question 25

when is doxy not used

Answer 25

photosensitivity | tetracycline allergy

Question 26

When is clinda not used

Answer 26

C.diff - severe or recurrent

Question 27

Prevention for furuncles/carbuncles

Answer 27

Improve personal hygiene (chlorhexidine soap/seperate use of towels, clothing, bed wear) mupirocin ointment to anterior nares clindamycin x 3 months

Question 28

define cellulitis

Answer 28

deeper into dermis and subcutaneous tissue; due to skin break

Question 29

describe cellulitis

Answer 29

rapidly spreading areas of edema, redness, and heat with inflammation of lymph nodes lesions are non-elevated and have poorly defined margins commonly affect the lower extremities

Question 30

common pathogens in cellulitis

Answer 30

Beta hemolytic strep | S. aureus

Question 31

cellulitis with bollae + vessicles causative organism

Answer 31

Staph

Question 32

treatment for cellulitis with bullae

Answer 32

treat like furuncle/carbuncle

Question 33

non-pharmacologic therapy for cellulitis

Answer 33

immobilization and elevation of a limb to reduce swelling cool, sterile, saline dressing - remove purulent exudate and decrease pain drainage of abscess

Question 34

what makes cellulitis severe

Answer 34

abnormal skin or wounds immunocompromised requiring surgery

Question 35

when should hospitalization and IV antibiotics be used for cellulitis

Answer 35

systemic signs of infection significant comorbid conditions cellulitis is spreading rapidly

Question 36

treatment of cellulitis with no risk factors for MRSA

Answer 36

Dicloxacillin PO / nafcillin/oxacillin IV Cephalexin / cefazolin Levofloxacin

Question 37

duration of treatment for uncomplicated cellulitis

Answer 37

5 days

Question 38

duration of treatment for complicated/more severe cellultis

Answer 38

5-10 days

Question 39

duration of treatment for complicated/more severe cellultis

Answer 39

5-10 days

Question 40

treatment of cellulitis with risk factors for MRSA

Answer 40

``` clindamycin doxycycline Bactrim vanco linezolid daptomycin ```