FINAL EXAM NR 511 | QUESTIONS AND ANSWERS | VERIFIED
ANSWERS | LATEST EXAM UPDATE
Impetigo caused by - CORRECT ANSWER - Staph aureus
Group Streptococcus (GAS)
Occasional MRSA
Most commonly seen in 2-5 years of age population. Easily spread in close
environments.
Risk Factors: Poverty, crowding, poor hygiene, and underlying scabies
Nonbullous impetigo - CORRECT ANSWER - papulues that progress to
vesicles and pustules rupture and become encrusted sores. Golden honey
appearance.
Involving face and extremities
Bullous impetigo - CORRECT ANSWER - Vesicles enlarge to form a faccid
bullae with clear yellow fluid, leaving a thin brown crust. Trunk is more
frequently affected.
If an adult w/ appropriate demographic risk factors should prompt an HIV
investigation.
Ecthyma - CORRECT ANSWER - Group A beta-hemolytic streptococci- GAS
ulcerative form in which the lesions extend through the epidermis and deep into
the dermis.
,"punched out" ulcers, with yellow crust.
Poststreptococcal glomerulonephritis (PSGN) - CORRECT ANSWER -
Nephritic syndrome that arises after group A beta-hemolytic streptococcal
infection of the skin (impetigo) or pharynx.
Edema, HTN, Fever, and Hematuria
Must treat with oral antibiotic
Treatment for Impetigo - CORRECT ANSWER - Limited skin involvement
Mupirocin (Bactroban) TID
Retapamulin BID
Patient's with numerous affected areas (Tx: S.Aureus and GAS)
Dicloxacillin seven days
Cephalexin seven days
if is only only GAS then Penicillin is preferred
MRSA impetigo tx - CORRECT ANSWER - mupirocin - inhibits bacterial
protein synthesis
Doxycycline, clindamycin, or tiimethoprim-sulfamethoxazole (Bactrim)
Staphylococcal Scalded Skin Syndrome (SSSS) - CORRECT ANSWER -
Staphylococcus aureus, epidermal necrosis caused by bacterial exotoxins.
Epithelial layer peeling off in large sheetlike pieces. Mimics scalded-skin
thermal burn.
,More common in children. Found in places where skin rubs together.
Cellulitis - CORRECT ANSWER - an acute, diffuse inflammation of the skin
and subcutaneous tissue characterized by local heat, redness, pain, and swelling.
Typically unilateral common site is lower extremities
Middle aged and older adults
Erythema, edema, warmth, and pain. "peau d'orange"
Cellulitis caused by - CORRECT ANSWER - The most common are beta-
hemolytic streptococci (A,B,C,G, and F)
S. Aureus (gram +)
Predisposing factor to cellulitis - CORRECT ANSWER - Tina pedis,
lymphedema, and chronic venous insufficiency.
Cellulitis treatment - CORRECT ANSWER - Beta-hemolytic streptococci and
methicillin-susceptible staphylococcus areus (MSSA):
tx: Cephalexin 500mg QID (alternative for mild PCN allergy)
Clindamycin 300mg QID (severe PCN allergy)
Not associated with Human or animal bites uncomplicated (Dicloxacillin or
cephalexin 10-14 days. PCN allergy=Erythromycin
If caused by human or animal bite
Augmentin 2 weeks
, MRSA Coverage Cellulitis - CORRECT ANSWER - Add Amoxicillin to
bactrim DS bid, doxycycline bid, minocycline 200 once and then 100 bid,
Clindamycin No other coverage needed
Erysipelas - CORRECT ANSWER - -Involves upper dermis, superior
lymphatics
-raised above level of surrounding skin
-fever and chills with acute onset
-often affects ear (Milian's ear sign), face, and lower extremities
-commonly caused by group a strep infection
necrotizing fasciitis - CORRECT ANSWER - inflammation of fascia
producing death of the tissue. Progressive infection measured in terms of hours
instead of days. progressive destruction of the muscle fascia.
Pressure on the skin reveals crepitus due to gas production is caused by
clostridium perfringens
Human or animal bite - CORRECT ANSWER - amoxicillin-clavulanic acid +
tetanus prophylaxis +/- rabies prophylaxis 3 to 5 days.
Human=Staph aureus or strep.
Do not suture hand wounds wait 3 to 5 days post treatment.
Pasteurella multocida - CORRECT ANSWER - -Cellulitis, osteomyelitis
-Animal bite, cats, dogs.
ANSWERS | LATEST EXAM UPDATE
Impetigo caused by - CORRECT ANSWER - Staph aureus
Group Streptococcus (GAS)
Occasional MRSA
Most commonly seen in 2-5 years of age population. Easily spread in close
environments.
Risk Factors: Poverty, crowding, poor hygiene, and underlying scabies
Nonbullous impetigo - CORRECT ANSWER - papulues that progress to
vesicles and pustules rupture and become encrusted sores. Golden honey
appearance.
Involving face and extremities
Bullous impetigo - CORRECT ANSWER - Vesicles enlarge to form a faccid
bullae with clear yellow fluid, leaving a thin brown crust. Trunk is more
frequently affected.
If an adult w/ appropriate demographic risk factors should prompt an HIV
investigation.
Ecthyma - CORRECT ANSWER - Group A beta-hemolytic streptococci- GAS
ulcerative form in which the lesions extend through the epidermis and deep into
the dermis.
,"punched out" ulcers, with yellow crust.
Poststreptococcal glomerulonephritis (PSGN) - CORRECT ANSWER -
Nephritic syndrome that arises after group A beta-hemolytic streptococcal
infection of the skin (impetigo) or pharynx.
Edema, HTN, Fever, and Hematuria
Must treat with oral antibiotic
Treatment for Impetigo - CORRECT ANSWER - Limited skin involvement
Mupirocin (Bactroban) TID
Retapamulin BID
Patient's with numerous affected areas (Tx: S.Aureus and GAS)
Dicloxacillin seven days
Cephalexin seven days
if is only only GAS then Penicillin is preferred
MRSA impetigo tx - CORRECT ANSWER - mupirocin - inhibits bacterial
protein synthesis
Doxycycline, clindamycin, or tiimethoprim-sulfamethoxazole (Bactrim)
Staphylococcal Scalded Skin Syndrome (SSSS) - CORRECT ANSWER -
Staphylococcus aureus, epidermal necrosis caused by bacterial exotoxins.
Epithelial layer peeling off in large sheetlike pieces. Mimics scalded-skin
thermal burn.
,More common in children. Found in places where skin rubs together.
Cellulitis - CORRECT ANSWER - an acute, diffuse inflammation of the skin
and subcutaneous tissue characterized by local heat, redness, pain, and swelling.
Typically unilateral common site is lower extremities
Middle aged and older adults
Erythema, edema, warmth, and pain. "peau d'orange"
Cellulitis caused by - CORRECT ANSWER - The most common are beta-
hemolytic streptococci (A,B,C,G, and F)
S. Aureus (gram +)
Predisposing factor to cellulitis - CORRECT ANSWER - Tina pedis,
lymphedema, and chronic venous insufficiency.
Cellulitis treatment - CORRECT ANSWER - Beta-hemolytic streptococci and
methicillin-susceptible staphylococcus areus (MSSA):
tx: Cephalexin 500mg QID (alternative for mild PCN allergy)
Clindamycin 300mg QID (severe PCN allergy)
Not associated with Human or animal bites uncomplicated (Dicloxacillin or
cephalexin 10-14 days. PCN allergy=Erythromycin
If caused by human or animal bite
Augmentin 2 weeks
, MRSA Coverage Cellulitis - CORRECT ANSWER - Add Amoxicillin to
bactrim DS bid, doxycycline bid, minocycline 200 once and then 100 bid,
Clindamycin No other coverage needed
Erysipelas - CORRECT ANSWER - -Involves upper dermis, superior
lymphatics
-raised above level of surrounding skin
-fever and chills with acute onset
-often affects ear (Milian's ear sign), face, and lower extremities
-commonly caused by group a strep infection
necrotizing fasciitis - CORRECT ANSWER - inflammation of fascia
producing death of the tissue. Progressive infection measured in terms of hours
instead of days. progressive destruction of the muscle fascia.
Pressure on the skin reveals crepitus due to gas production is caused by
clostridium perfringens
Human or animal bite - CORRECT ANSWER - amoxicillin-clavulanic acid +
tetanus prophylaxis +/- rabies prophylaxis 3 to 5 days.
Human=Staph aureus or strep.
Do not suture hand wounds wait 3 to 5 days post treatment.
Pasteurella multocida - CORRECT ANSWER - -Cellulitis, osteomyelitis
-Animal bite, cats, dogs.
