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Skin Infections Flashcards

(85 cards)

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1
Q

Primary bacterial infections involve what areas of skin and caused by how many pathogens?

A

Involve previous healthy skin and caused by a single pathogen

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2
Q

Secondary bacterial infections involve what areas of skin and caused by how many pathogens?

A

Involve areas of previously damaged skin and are polymicrobial

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3
Q

Examples of primary skin infections

A

erysipelas, impetigo, lymphangitis, cellulitis, necrotizing fasciitis

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4
Q

Examples of secondary infections

A

diabetic foot infections, pressure sores, bite wounds, burns

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5
Q

Bacterial cause of Erysipelas

A

Group A Streptococci pyogenes

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6
Q

Bacterial cause of Impetigo

A

Staph aureus, group A strep pyogenes

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7
Q

Bacterial cause of Lymphangitis

A

Group A strep

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8
Q

Bacterial cause of Cellulitis

A

Group A strep, Staph aureus (may include MRSA)

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9
Q

Bacterial cause of Necrotizing fasciitis type I

A

anaerobes (bacteroides, Peptostreptococcus), and faculatives (streptococci, Enterobacteriaceae)

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10
Q

Bacterial cause of Necrotizing Fasciitis type II

A

Group A streptococci

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11
Q

Bacterial cause of diabetic foot infections/pressure sores

A

S. aureus, Streptococci, Enterobacteriaceae, Bacteroides, Peptostreptococcus, Pseudomonas

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12
Q

Most common bacterial cause of animal bite wounds

A

Pasteurella

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13
Q

What is the primary initial Tx for a diabetic foot ulcer?

A

Debridement of affected area + Abx

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14
Q

Class I skin infection presentation

A

patients are afebrile and healthy

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15
Q

Tx of Class I skin infections

A

Topical/Oral antimicrobials

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16
Q

Class II skin infection presentation

A

patients are febrile/ill and without unstable comorbidities

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17
Q

Tx of Class II skin infections

A

IV antibiotics (OP or short term IP), some may be able to have PO antibiotics

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18
Q

Class III skin infection presentation

A

patients are toxic, with an unstable comorbidity or limb threatening infxn

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19
Q

Class IV skin infection presentation

A

patients are septic or with a life threatening infxn (necrotizing fasciitis)

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20
Q

Tx of Class III and Class IV skin infections

A

Hospitalize with IV abx

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21
Q

DOC and dosing for erysipelas

A

Pencillin G (IM) or Pen VK (PO) for 7-10 days

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22
Q

DOC for Impetigo

A

Cephalexin, Pencillin

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23
Q

DOC for mild cellulitis

A

Dicloxacillin, Amoxicillin, Cephalexin

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24
Q

DOC for severe cellulitis

A

Nafcillin, Cefazolin, IV Vanco

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25
DOC for severe cellulitis with PCN allergy
Vancomycin, Clindamycin
26
Tx for necrotizing fasciitis
early/aggressive surgical debridement, Clindamycin+PCN
27
DOC for animal bites
Augmentin
28
Abx options for Tx of community acquired MRSA
Clindamycin, Bactrim, Doxycycline
29
Abx options for Tx of hospital acquired MRSA
Vancomycin, Daptomycin, Linezolid
30
What is the gene associated with high resistance in both community and nosocomial acquired MRSA strains?
mecA gene
31
What are the three pathogens that most commonly cause SSTIs?
S. aureus, S. pyogenes, MRSA
32
Local Tx for folliculitis
warm compresses, topical Abx therapy
33
What are the options/dosing for topical Abx for folliculitis
Clindamycin, Erythromycin, Mupirocin, Benzoyl peroxide applied 2-4xqd for 7 days
34
Tx for PCN allergic pts with Erysipelas
Clindamycin, Erythromycin
35
Tx for severe Erysipelas infxn
Hospitalize, IV Pen G 2-8million units qd
36
Tx for S.pyogenes caused Impetigo
PO Pen VK
37
Tx for PCN allergic pts with Impetigo with dosage
Clindamycin for 7-10 days
38
Tx and dosage for pts with mild cases of Impetigo
Mupirocin/Retapamulin ointment applied BID/TID for 7 days
39
MOA for Mupirocin (Bactroban)
Inhibits bacterial protein synthesis by binding to bacterial isoleycyl transfer RNA synthetase
40
What pathogens is Bactroban effective against
G+, MRSA
41
MOA for Retapamulin (Altabax)
inhibits bacterial protein synthesis at 50S ribosome subunit site
42
What pathogens is Altabax effective against
Staph aureus (methicillin susceptible), Strep pyogenes
43
What will the presentation of cellulitis look like if caused by S. aureus
furuncles, carbuncles, abscesses on the skin
44
What will the presentation of cellulitis look like if caused by streptococcus
diffuse skin infection and without a defined portal
45
In what cases will cellulitis be caused by mixed aerobes and anaerobes pathogens
diabetics, following traumatic injuries, at sites of abdomen/perineum surgical incisions, vascular insufficiency
46
DOC for PCN allergic pts with mild cellulitis
Clindamycin, Macrolide
47
What two diagnostic interventions are not helpful with cellulitis?
Skin aspiration, Blood Cx
48
Abx Tx for nonsevere diabetic foot infections
Augmentin 875 mg q 12 hrs
49
Abx Tx for severe diabetic foot inxns
Vancomycin
50
Why is Zosyn not a good option for Tx of severe diabetic foot inxns?
Covers G+, G- and anaerobes but doesn't cover MRSA
51
Abx Tx for PCN allergic for diabetic foot inxns
Meropenem
52
Examples and MOA of topical azoles
Ketoonazole, Miconazole, Itraconazole, Flucanozole; Inhibits synthesis of ergosterol
53
Examples and MOA of allylamine
Naftin, Lamisil; Inhibits squalene epoxide enzyme in ergosterol synthesis
54
Examples and MOA of polyene
Amphotericin B, nystatin; binds to fungal sterol
55
Examples and MOA of Echinocandins
Caspofungin, Micafungin; inhibits 1,3 beta D glucan
56
Major pathogen responsible for candidiasis
Candida Albicans
57
In what kind of patients can complicated VVC occur
immunocompromised, uncontrolled diabetes mellitus
58
Tx for complicated VVC
more aggressive, lengthen therapy to 10-14 days
59
Tx for resistant cases of VVC
Boric Acids, 5-Flucytosine
60
OTC Topical Tx for VVC
Butoconazole, Clotrimazole, Micaonazole, Ticonazole
61
Rx topical Tx for VVC
Nystatin, Terconazole
62
Rx PO Tx for VVC
Fluconazole
63
Which Tx is more effective for Onychomycosis, oral or topical?
Oral, topical will only work if nails are removed first
64
DOC for Onychomycosis
Terbinafine, Itraconazole
65
What properties are found in both Terbinafine and Itraconazole to make them effective for Tx of onychomycosis
lipophilic and keratinophilic properties
66
Is Terbinafine fungicidal or fungistatic
fungicidal
67
Is Itraconazole fungicidal or fungistatic
fungistatic
68
What fungi is Terbinafine active against?
dermatophytes, non-dermatophyte molds
69
What fungi is Itraconazole active against?
dermatophytes, nondermatophytes, Candida
70
SE for Terbinafine/Itraconazole
GI (diarrhea, dyspepsia, nausea, abd pain), dermatologic (rash, urticaria, pruritis), headache
71
DI for Itraconazole
Lovastatin, Simvastatin; Itraconazole inhibits CYP3A4 enzymes and reduces drug levels
72
DOC for HSV
Acyclovir, Famiciclovir, Valacyclovir
73
What dosing adjustment must you consider with all antiviral therapy?
Renal dosing adjustment
74
MOA for Acyclovir
acyclic guanosine analog, binds viral DNA polymerase, chain terminator to end replication
75
MOA for Valacyclovir
I valine ester prodrug of acyclovir, 5x greater bioavailability than acyclovir
76
MOA of Famciclovir
purine analog similar to acyclovir with high bioavailability
77
What virus causes warts
HPV
78
Tx options for Warts
Diethyl ether+propane (freeze), Nitrogen, Salicyclic Acid
79
What is the pathogen that commonly causes gas gangrene?
Clostridial perfringens (G+ bacilli)
80
What conditions are seen associated with gas gangrene?
Neutropenia, GI malignancy
81
What is the primary Tx for gas gangrene?
Debridement, TTX+Clindamycin+PCN+Chloramphenicol
82
When should Amphotericin B be prescribed for fungal infections?
When all other antifungal Tx fail, only available IV
83
Preferred Tx for oral candidasis
Clotrimazole, Nystatin suspension
84
SE of Clotrimazole
Altered taste, Nausea, Vomiting
85
SE of Nystatin
Nausea, Vomiting, Diarrhea

Derm Pharm (2 decks)

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