Skin & Skin Structure Infections
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If a patient with a diabetic foot ulcer has systemic symptoms such as fever, chills, tachycardia, hypotension, confusion, vomiting, leukocytosis, acidosis, severe hyperglycemia, or azotemia, but the cellulitis is only extended 1cm, the infection is classified as... severe hhyperglycemia, or azotemia severe
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Mild
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Moderate because it is less than 2cm
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Severe
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This quiz focuses on Skin & Skin Structure Infections, particularly diabetic foot infections. It assesses understanding of common pathogens, severity classification, treatment options including antibiotic coverage, and complications like osteomyelitis and peripheral neuropathy.
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- 2.
The 4 Cs are: crowing, cleanliness, contamination, and ________.
Explanation
The question asks for the missing word that completes the list of the 4 Cs. The previous words in the list are "crowing, cleanliness, contamination," and the missing word is "contact." This suggests that the 4 Cs are related to some sort of criteria or factors, possibly in a specific context such as hygiene or disease prevention.Rate this question:
- 3.
An osteomyelitis infection that is spread from adjoining soft-tissue infection and often inclues osteomyelitis secondary to direct inoculation from trauma and surgery (and usually occurs in the long bones, or feet and toes) is known as _______.
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Contiguous
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Hematogenous
Correct Answer
A. ContiguousExplanation
Contiguous osteomyelitis refers to an infection that spreads from an adjacent soft-tissue infection. It is often caused by direct inoculation from trauma or surgery and commonly occurs in the long bones, feet, and toes. This type of infection is different from hematogenous osteomyelitis, which occurs when bacteria from another part of the body spread through the bloodstream to the bone.Rate this question:
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- 4.
Which of the following are true regarding diabetic foot infections?
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S. aureus and e. faecalis are the most commonly isolated pathogens, although gram+, gram-, and anaerobic bacteria might occur
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Not all diabetic foot ulcers are infected
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Cultures should be taken from the wound
Correct Answer(s)
A. S. aureus and e. faecalis are the most commonly isolated pathogens, although gram+, gram-, and anaerobic bacteria might occur
A. Not all diabetic foot ulcers are infected
A. Cultures should be taken from the woundExplanation
Diabetic foot infections can be caused by various pathogens, but the most commonly isolated ones are Staphylococcus aureus and Enterococcus faecalis. However, it is important to note that gram-positive, gram-negative, and anaerobic bacteria can also be present in these infections. Additionally, not all diabetic foot ulcers are infected, so it is crucial to evaluate the wound and determine if an infection is present. Cultures should be taken from the wound to identify the specific pathogens and guide appropriate treatment.Rate this question:
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- 5.
If we use this drug for greater than 2 weeks, the chance of irreversible peripheral neuropathy and thrombocytopenia might occur.
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Telavancin
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Moxifloxacin
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Linezolid
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Quinupristin/dalfopristin
Correct Answer
A. LinezolidExplanation
Linezolid is the correct answer because it is known to have the potential to cause irreversible peripheral neuropathy and thrombocytopenia if used for more than 2 weeks. This side effect is important to consider when prescribing linezolid and monitoring patients who are on this medication for an extended period of time.Rate this question:
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- 6.
A foot puncture wound (through the shoe) is known for causing osteomyelitis due to _______.
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Staph aureus
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Salmonella
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Klebsiella
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Pseudomonas
Correct Answer
A. PseudomonasExplanation
A foot puncture wound through the shoe can lead to osteomyelitis, an infection of the bone, due to the presence of pseudomonas bacteria. Pseudomonas is a common cause of osteomyelitis in this type of injury, as it thrives in moist environments and can easily enter the wound. This bacterium is known to cause severe infections and can be difficult to treat, often requiring a combination of antibiotics. Therefore, it is important to promptly identify and treat pseudomonas infections in foot puncture wounds to prevent the development of osteomyelitis.Rate this question:
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- 7.
If somebody has elevated CRP we might suspect what type of infection?
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Diabetic foot infection
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Cellulitis
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Necrotizing fasciitis
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Osteomyelitis
Correct Answer
A. OsteomyelitisExplanation
Elevated CRP levels can indicate inflammation in the body, and in the context of infections, it is commonly seen in osteomyelitis. Osteomyelitis is a bone infection caused by bacteria or fungi, leading to inflammation and increased CRP levels. Diabetic foot infection, cellulitis, and necrotizing fasciitis can also cause elevated CRP, but osteomyelitis is specifically associated with bone infections.Rate this question:
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- 8.
Which of the following are true regarding erysipelas?
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Intense red color, raised and well demarcated edges
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Most commonly associated with streptococci (s. pyogenes) and sometimes staph
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PCN is usually the treatment if it is strep
Correct Answer(s)
A. Intense red color, raised and well demarcated edges
A. Most commonly associated with streptococci (s. pyogenes) and sometimes staph
A. PCN is usually the treatment if it is strepExplanation
Erysipelas is a bacterial skin infection characterized by intense red color, raised, and well-demarcated edges. It is commonly associated with streptococci (s. pyogenes) and sometimes staphylococcus bacteria. Penicillin (PCN) is typically the treatment of choice if the infection is caused by streptococci.Rate this question:
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- 9.
Which of the following is FALSE regarding cellulitis?
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A previously healthy patient that gets cellulitis is probably infected with a gram + bacteria such as MSSA, group A strep, or MRSA
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Blood cultures are positive in >90% of cases
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The lesion is indistinguishable from rest of skin (other than by color)
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It is an infection of deeper dermis and subcutaneous fat
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Usually bacteria enter through a break in the skin
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At risk populations include the obese and those with lymphatic obstruction
Correct Answer
A. Blood cultures are positive in >90% of casesExplanation
blood cultures are positive inRate this question:
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- 10.
Which of the following are true regarding cellulitis treatment?
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IV therapy is preferred for both simple and complicated infections
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5 days has been shown as effective as 10 day treatment for simple infections
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Tigecycline, Nafcillin, Cefazolin, Vanco, Linezolid, Daptomycin, Telavancin, and Ceftaroline are IV treatments used
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Daptomycin is avoided because it causes severe nausea and vomiting in about 1 out of every 3 patients
Correct Answer(s)
A. 5 days has been shown as effective as 10 day treatment for simple infections
A. Tigecycline, Nafcillin, Cefazolin, Vanco, Linezolid, Daptomycin, Telavancin, and Ceftaroline are IV treatments usedExplanation
Oral therapy preferred for simple infections. Tigecycline is generally avoided because of N/V...not daptomycin.Rate this question:
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- 11.
Which of the following is not traditionally recommended for MRSA secondary to inducible resistance?
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Bactrim
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Doxycycline
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Minocycline
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Clindamycin
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Televancin
Correct Answer
A. ClindamycinExplanation
Clindamycin is not traditionally recommended for MRSA secondary to inducible resistance. This is because MRSA strains can develop resistance to clindamycin through a mechanism called inducible resistance. Inducible resistance means that the bacteria can switch on genes that confer resistance to clindamycin when exposed to certain antibiotics. Therefore, clindamycin may not be effective against MRSA strains that have inducible resistance.Rate this question:
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- 12.
Over 90% of this type of infection occurs on the leg and is associated with an intense burning pain.
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Cellulitis
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Impetigo
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Osteomyelitis
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Erysipelas
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Necrotizing fasciitis
Correct Answer
A. ErysipelasExplanation
Erysipelas is a type of infection that commonly occurs on the leg and is characterized by an intense burning pain. This infection affects the skin and underlying tissues, causing redness, swelling, and warmth. It is usually caused by bacteria entering through a break in the skin. Erysipelas can be differentiated from other similar infections like cellulitis, impetigo, osteomyelitis, and necrotizing fasciitis based on its specific symptoms and location.Rate this question:
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- 13.
Which antibiotic is given in necrotizing fasciitis for a streptococcus infection because it has additional benefits beyond antimicrobial benefits such as modification of cytokine production and toxin suppression.
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Linezolid
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Daptomycin
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Tigecycline
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Clindamycin
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Minocycline
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Bactrim
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Zosyn
Correct Answer
A. ClindamycinExplanation
Clindamycin is the correct answer because it has additional benefits beyond antimicrobial effects in treating necrotizing fasciitis caused by streptococcus infection. Clindamycin can modify cytokine production and suppress toxins, which are important in managing the inflammatory response associated with this condition. This makes Clindamycin an effective choice for treating necrotizing fasciitis caused by streptococcus infection.Rate this question:
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- 14.
You are able to pick the treatment therapy for a patient suffering from a diabetic foot infection. You immediately start the patient on local wound care. You also pick empiric systemic therapy for a moderate to severe infection. Any systemic regimen (with the exception of _______ and ______) will likely have vanco added to cover for MRSA.
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Ertapenem
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Levofloxacin
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Ceftaroline
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Piperacillin/tazobactam
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Meropenem
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Tigecycline
Correct Answer(s)
A. Ceftaroline
A. TigecyclineExplanation
The correct answer is ceftaroline and tigecycline. These two antibiotics are not typically used to cover for MRSA, so any systemic regimen other than these two would likely have vancomycin added to provide coverage for MRSA.Rate this question:
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- 15.
Which of the following drugs must we obtain a negative pregnancy test before we can use it for MRSA?
Correct Answer(s)
televancin
telavancin - 16.
Which of the following are true regarding necrotizing fasciitis?
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Requires operative intervention in addition to antibiotics
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Causes severe, constant pain, bullae, gas in soft tissues, edema, and skin necrosis
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Rapid spreading may occur while on antibiotic therapy
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Over 66% of cases present with lower extremity involvement
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Subcutaneous tissues are usually hard to the touch with no distinguishing between muscle and fascia
Correct Answer(s)
A. Requires operative intervention in addition to antibiotics
A. Causes severe, constant pain, bullae, gas in soft tissues, edema, and skin necrosis
A. Rapid spreading may occur while on antibiotic therapy
A. Over 66% of cases present with lower extremity involvement
A. Subcutaneous tissues are usually hard to the touch with no distinguishing between muscle and fasciaExplanation
Necrotizing fasciitis is a severe and rapidly spreading soft tissue infection. It requires operative intervention in addition to antibiotics because surgical debridement is necessary to remove the necrotic tissue and control the infection. The infection causes severe, constant pain, bullae (fluid-filled blisters), gas in soft tissues, edema, and skin necrosis. Rapid spreading of the infection may still occur despite antibiotic therapy. Lower extremity involvement is common, with over 66% of cases presenting in this area. On physical examination, the subcutaneous tissues are usually hard to the touch, making it difficult to distinguish between muscle and fascia.Rate this question:
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- 17.
Which of the following are associated with impetigo?
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Most common sites include the trunk and extremities
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Yellow-brown, crusty lesions that are left when lesions dry (cornflakes)
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Almost always caused by b-hemolytic streptococci (Group A) or staph aureus
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Recommended treatment for MSSA is doxycycline 100mg po bid or bactrim ds po bid
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Recommended treatment for MRSA is dicloxacillin 500-1000mg po q 6-8h or cephalexin 500mg po tid
Correct Answer(s)
A. Yellow-brown, crusty lesions that are left when lesions dry (cornflakes)
A. Almost always caused by b-hemolytic streptococci (Group A) or staph aureusExplanation
Usually occurs on face and extremities. Treat MSSA with dicloxacillin/cephalexin. Treat MRSA with doxycycline/bactrim.Rate this question:
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- 18.
Which of the following are true regarding furuncles and carbuncles?
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Small, non-severe carbuncles can usually be treated with moist heat
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Larger abscesses or carbuncles require incision and drainage
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Outbreaks of both infections can occur in families or other close-contact situations
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Usually caused by strep
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A furuncle involves several adjacent hair follicles
Correct Answer(s)
A. Small, non-severe carbuncles can usually be treated with moist heat
A. Larger abscesses or carbuncles require incision and drainage
A. Outbreaks of both infections can occur in families or other close-contact situationsExplanation
Usually caused by s. aureus. A furuncle only involves individual follices.Rate this question:
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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
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Current Version
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Mar 20, 2023Quiz Edited by
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Apr 15, 2011Quiz Created by
Caitlinb
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