Skin/Soft Tissue and Bone Infections
About this set
Created by:
Nygrl89 on October 5, 2011
Subjects:
comprehensive disease management 4
Log in to favorite or report as inappropriate.
Order by
50 terms
Terms | Definitions |
|---|---|
 Skin, Soft Tissue Infections | Most COMMON infections seen in community and hospitalized patients, more severe as result of initial infection. May require both MEDICAL and SURGICAL management |
| Primary Infection, Surgery | One Microorganism, previously healthy..no risk factors. P____ I____ Can lead to Complicated infections (deeper skin involvement) Usually managed by s_____ |
| Uncomplicated, cellulitis, Secondary, polymicrobial | U________ infections usually have superficial skin involvement such as c____ and impetigo May lead to S______ infections that usually come with underlying risk factors and are p_______ |
| Staphylococci, Cornyebacterium, Propionbacterium, Bacillus, micrococcus, Enterbacteriacae | Normal Skin Flora + S________ Cor______ Pro_______ Bac_____ Mi_____ - E______ (Acinetobacter) |
| concentration, moisture, blood supply, nutrients, penetration | Predisposing factors for ssti Bacterial c_____ Degree of skin m_____ B____ S_____ Bacterial N_____ ease of bacterial skin p______ |
| Tetanus, normal saline, intact | Acute wounds (abrasions, puntures, lacerations) refer deep-non healing wounds to PCP Punctures are T_____-suspicious Irrigants --> N___ S___ preferred Antiseptics are all similar in efficacy (h202, Iodine) use caution when applying to i____ skin |
| Bacitracin, neomycin, Polymixin B | Abrasions, Punctures, lacerations, burns with OTC abx Allergic Reactions more common with Topicals B____ and N____ P_____ _ is also used. NOT necessary for CLEAN wounds |
| Folliculitis, S. Aureus, Pruritic | F_____ is Superficial inflammation on the hair shaft from infectious or non-infectious cause Usually _. ____ (organism) P_____ papules Abx USUALLY UNECESSARY |
| follicular, subcutaneous, S. Aureus, Furuncle, Carbuncle | F_____ Infections that are either dermal, epidermal or SC tissue Mostly caused by _.a_____ Single Boil or Pustule F______ Multiple Follicules C_____ |
| Erysipelas, erythema, edema, pain, demarcated, beta hemolytic streptococci, pyogenes, Penicillin VK, Clindamycin | E______ are more common in kids, adults, infants DIFFUSE E______ma Ed_____, and P_____ and is difficult to distinguish from cellulitis Raised, D______ margins on the LOWER extremeties B__-H_____ S______ (group A) S. P_____ Use P______ _ _ or C_____ for PCN ALL. |
| Impetigo, pruritis, bullous, pyogenes, dicloxacillin, cephalexin, mupirocin | I____ commonly occurs in children 2-5 years old Localized P_____ can cause disease spread B____ lesions (S. Aureus) more common in neonates NonBullous (staph and Strep P______) Penicillinse-Resistant PCN D________ and Cephalosporins C_____ Topical can be M____ |
| Cellulitis, trauma, blood, abscess, osteomyelitis, septic arthritis | _____! Acute skin infection that initially affects the epidermis/dermis Prevous t____ or underlying skin lesion usually precedes the infection Can spread from initial site to adjacent tissue and b_____ COMPLICATIONS A______, Os____, and s____ ar_____ |
| Erythematous, inflammation, poorly, malaise, fever, chills, leukocytosis | Cellulitis Clinical Findings! Site of infections usually E______ and edematous with _______tion Area warm/painful with (well/poorly) defined BORDERS!! Ma___, F______ and Ch____ along with le______sis |
| Pyogenes, Staph Aureus, C, G, Negatives, Anaerobes, Fungi | Cellulitis Etiologic pathogens Group A streptococci: Strep P_____ S___ A_____ (MSSA v MRSA) increased prevelance of MRSA over past 10 years Group _ (milleri) and Group _ Streptococci Gram _____, AN_____, and FU___ |
| ICU, IV, vancomycin | HA MARSA RF: Nursing Home, _ _ _, (route) drug use Strains Sensitive to V____ but emergence increasing |
| CA-MRSA | Genetically different from HA-MRSA Spread through direct contact and in close quarters in young/healthy persons |
| Streptococcus, Staphylococci, Oral, Dicloxacillin, clindamycin, 5-10, hospitalization, nafcililn, vancomycin | Cellulitis Empiric Treatment Consider ABX with activity against S________ and Sta_______. for MILD can use OutPt. O___ therapy with D______ or C______(mrsa) (for PCN all) for #-## days Moderate -> Severe need h______ along with n______ or va_______ for PCN allergy |
| Cutaneous, antibiotics, beta-hemolytic, CA-MRSA | Empiric Tx for Cellulitis C____ Abscess (incision and drainage) Abscesses in which ? are recommended are Severe disease, comorbidities, immunosuppressed Outpatients with NON-Purulent Cellulitis No drainage, no exudate Consider empiric b___-h____ strep coverage (mrsa in nonresponders) OUtpatients with purulent cellulitis Empiric __-_____ coverage. B-Hemolytic strep coverage unnecessary |
| Clindamycin, 300-450, TID, TMP/SMX, tetracycline, beta lactam, Rifampin | Outpatient Empiric CAMRSA options Bactrim DS 1-2 DS PO BID C_____ ###-### mg (frequency). Can also be used for Outpatient CAMRSa and beta hemolytic strep. OP CAMRSA + BH Strep T___/____ or T_____ + B___ L___ R____ SHOULD NEVER be used for Cellulitis |
| Vancomycin, 15-20, IV, 8-12, Daptomycin 4 mg/kg, IV, daily, cefazolin. MRSA | Empiric Treatment (2011 IDSA Guidelines for Adults) Hospitalized/Complicated SSTIs Deep, surgical/wound infections, ulcers, burns, cellulitis V______ ##-## mg/kg/dose (route) q#-## hours D_______ # m_/___ (route) (frequency) For hospitalized patients with NON-purulent SSTI Initial trial of a beta lactam, c____ appropriate. Consider _ _ _ _ coverage if no response |
| Vancomycin, Linezolid, Daptomycin | Complicated skin/soft tissue infections MRSA and VRE strains V______, L______ D______ and Ceftaroline |
| 5-10, 7-14 | Cellulitis treatments: Initiate therapy promptly to minimize clinical complications. Immobilization and elevation of affected areas Treatment DURATION based on presentation Outpatient (purulent/non) SSTI #_## days Inpatient/COmplicated #-## days |
| Diabetic Foot Infection | Common complication, over 25% of diabetics will experience at least ONE infection Amputations generally required in uncontrolled infection |
| Foot ulceration, peripheral neuropathy, vascular insufficiency, cell-mediated | Diabetic Foot Infections Major Predisposing factor F____ U_____ (caused by MINOR trauma) existing P____ N_____ and vasc____ In_____ Deficiency in c____-_____ immunity Increased susceptibility for infections and poor wound healing |
| Staph Aureus, agalactae, Enterococcus, Proteus, Enterobacter, E. Coli, Klebsiella, Pseudomonas, Anaerobes | Eitology of DFI MOST COMMON are gram + S_____ A___ and GROUP B strep a_____ and E______ Gram _ include P_____, En____ _. C___, K_____, P_____ Aeurginosa Also A____ such as Peptostreptococcus, Bacteriodes, Clostridim, others |
| Pain, Swelling, Asymptomatic, Cellulitis, Abscess, Ulcer | Typical signs and symptoms of foot infection would be P____, S_____ but most diabetic are A____ because of neuropathy. May appear as C_____, A______ or U____. (Arch, web spaces, or soles of the foot) |
| 2, inflammation, Cellulitis, superficial | MILD DBFI > # signs of i_______. C______, erythema less than 2 cm limited to skin and s_____ tissue. No other local complications or systemic illness |
| Cellulitis, Lymph streaking, superficial fascia, abscess, gangrene, muscle, bone | Moderate DBFI > 1 of the following: C______ > 2 cm, l____ s______, su____ fa_____ spread, Ab_____, Gang______ INVOLVES M____, Tendon or ____! |
| Systemic, metabolic, fever, tachycardia, hypotension, leukocytosis, acidosis, hyperglycemia | SEVERE DBFI! S____ toxicity or me_____ instability F___/Chills Ta______, H______ Confusion, Vomiting, L________is, Ac_____ Hyp______ia or azotemia |
| positive, dicloxicillin, clindamycin, MRSA | DBFI Empiric Treatment Mild --> Most likely Gram ______ organisms use D______ Cl______ cephalexin or bactrim Consider _ _ _ _? |
| positive, negative, anaerobes, Augmentin, Ceftriaxone, clindamycin, levofloxacin | MODERATE DBFI Empiric treatment gram p_____, n_____ and a______ AU______, CE______ (3genCeph) or C_____ PLUS L_______ |
| Zosyn, Clindamycin, Levofloxacin, Vancomycin | SEVERE DBFI Empiric Consider gram +/- and anaerobes Z_____ Cl____ PLUS L______ or V_______ |
| 7-14, 2-4, 4-6 | DBFI Durations Mild is #-## days (may req. addl 1-2 wks) Moderate/Severe #-# WEEKS Osteomyelitis #-# weeks OR LONGER |
| Wound, bedrest, elevation, glycemic | BEST resolution of DBFI therapy proper W_____ care is essential Debridement, drainage Restrict Patient activities B____, E_____ of limb G______ CONTROL |
| hematogenous | Osteomyelitis that results from infection spread through the blood stream. Most common in those < 16 years old |
| soft, vascular insufficiency | Osteomyelitis Contiguous Develops adjacent from s___ tissue infection Comprises 47% percent of cases With or WITHOUT V____ I_____ Acute V. Chronic |
| Staph Aureus, streptococci, E. Coli | In hematogenous osteomyelitis, _. A_____ and s_______ most common in children under 5. Gram negative also id, _.C___ more common in Newborns |
| Vertebral, Pseudomonas, Salmonella | Hematogenous Osteomyelitis V____ disease increasing incidence with age IVD Abuse: 50% in vertebral column mostly GRAM NEGATIVE, P_____ Sickle Cell disease; S______ causes about 66% percent of infections |
| Trauma, S. Aureus, Pseudomonas, E. Coli, Proteus, S. Epidermis, Streptococci, Anaerobes | Contiguous Osteomyelitis WITHOUT vascular insufficiency! T_____! open fractures, invasive orthopedic procedures Organisms directly inoculated into the bone. _. A_____ most common organism Gram Negatives such as P_______, _.C____, P_____, S. Ep______, S_____cocci and A_____ although uncommon |
| Atherosclerosis, trauma, polymicrobia, anaerobes | Contiguous Osteomyelitis! WITH vascular Disease! Usually DM or A_____. Some sort of t____; foot ulcer, cellulitis. Affects older patients >50. P______(Staph, Strep, Bacteriodes, Enterococcus)! A______ More likely than in patients W/O! |
| Fever, inflammation, 3, month, low grade, drainage, WBC | CLINICAL PRESENTATION! C. Osteo. HEMATOGEOUS F_____, vague/nonspecific symptoms, irritability, in______ for about # weeks Contigious Sx/Infection within a m___ (time) L___-G___ Fever, D_____, Elevated WBC |
| Bone biopsy, cultures, radionucleotide | Long Boen Osteomyelitis B____ B____ provides definitive diagnosis Blood C_____ debridement cultures X-rays (lag behind infection); subtle changes contiguous chronic disease R_______ scans |
| Rapid, Accurate, debridement, parenteral, oral, confirmed diagnosis, organism, antibiotic, compliance | Osteomyelitis R____ and A______ diagnosis (prognosis and cure rate) Surgical d______ and drainage of soft tissue abscesses P____ and o____ antibiotic administration routes should be considered Treatment success improved with C_____ Di_____ O_____ Identified w/sensitivies Approriate a______ choice available C_____ WITH THERAPY |
| 4-6, 8, TMP/SMX, Rifampin, Quinolones, Clindamycin | Treatment Duration #-# weeks has been recommended. MRSA for at least # weeks ___/____ and r______ and doxy/minocycline Q____ (excellent bioavailability) or Emerging Resistance C_____ |
| Nafcillin, Cefazolin, Ceftazidime, Tobramycin, nafcillin, Ceftazidime | EMPIRIC TX for OSTEO Myl Adults N____ or Ce_____ IVDU C_____ (antipseu) + T_____ POST TRAUMA Na____ + Cef______ |
| Nafcillin, Ceftazidime, Clindamycin, Ceftazidime | Vascular Insuffiency with Osteomyelitis N____ + C_____ (NO Anaerobes) If Anaerobes Suspected do Cli_____ + antipseudomonal Ceph C____ (some answers used twice) |
| Daptomycin, 6 mg/kg, day, bactrim, 4 mg/kg, twice, rifampin 600 | Osteo: MRSA!! Recommend Parenterals such as D______ # m__/____ once d____ Or B____ # m__/___ (how many times) PLUS r____ ### mg |
| Necrotizing, 2, Clostridial | These infections are very severe and require immediate treatment and management (antibiotics, surgical debridement, ICU care) There are # types. Also C____ Myonecrosis (Gas Gangrene) |
| Immunosuppression, Skin Integrity | Risk factors for Necrotizing fasciits I_______ from either malignancy or medications Comprimised S____ I____! Psoriasis, Decubitis Ulcers Poor Surgical Wounds, Needle Sticks |
| surgery, Trauma, Anaerobes | dfd |
First Time Here?
Welcome to Quizlet, a fun, free place to study. Try these flashcards, find others to study, or make your own.