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23 Cards in this Set
- Front
- Back
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gram positives how to differentiate?
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STREPTOCOCCUS vs. STAPHYLOCOCCUS
gram-stain, Catalase differentialt |
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streptococci how to differentiate?
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beta-hemolytic (complete lysis)
alpha-haemolytic (incomplete; green discoloration) non-haemolytic --- lancefield groups A, B, (C), D ... S only 5 groups human pathogens |
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GROUP A BETA-HAEMOLYTIC STREPTOCOCCI
infections |
skin infections (incl. necrotising fasciitis!)
scarlet fever TSS delayed antibody mediated: rheumatic fever glomerulonephritis |
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GROUP B STREPTOCOCCI
infections |
neonatal meningitis
when treated, also cover: E.COLI LISTERIA |
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non lancefield
VIRIDANS GROUP ALPHA HAEMOLYTIC STREPTOCOCCI infections |
dental infections
abscess endocarditis |
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GROUP D ALPHA HAEMOLYTIC STREPTOCOCCI (ENTEROCOCCI and NON-ENTEROCOCCI)
infections |
ENTEROCOCCI (e. faecalis, e. faecium)
urinary infections bilary infections endocarditis VRE!!!! NON-ENTEROCOCCI ? colon Ca |
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non-lancefield
STREPTOCOCCUS PNEUMONIAE (PNEUMOCOCCI) infections |
bacterial meningitis (most common organism in adults)
otitis media pneumonia |
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risk factors for malignant melano ma
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sun exposure
family history atypical mole syndrome giant congenital melanocytic naevic lentigo maligna |
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what is lentigo maligna
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melanoma in situ
dysplastic naevus cells grow slowly appears as brown/black nodule with indefinite borders patients >60 with sun exposure change in color or bumps appearing signals transformation to lentigo maligna melanoma |
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HHT (haemorragic heredetary teleangiectasy) clinical features
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autosomal dominant
nose and gastrointestinal tract most commonly affected epistaxis and GI bleeding iron deficiency anaemia |
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Treatment of tinea
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1. localised tinea corporis/cruris (flexures)
topical TDS 1-2 weeks 2. more widespread or tinea manuum/pedis/capitis itraconazole 100mg OD terbinafine 250mg OD 1-2 months 3. tinea capitis in children 15-20mg/kg griseofulvin per day for 8 weeks |
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scabies clinical features
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any age, social background
close contact 4-6 weeks after infection, hypersensitivity rash extremely itchy, especially during night usually face spared. |
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person with scabies and rash not disappearing
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consider reaction to malathion
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scabies management
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* 5% malathion/permethrin
* treat all skin below neck incl. genitalia and under nails (infants: face and neck too) * treat all close contacts, even if asymtomatic * warn patient that rash still itchy for 4 weeks * adjunct with emollient/mild steroid or crotamiton helpful. |
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lichen planus clinical features
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unknown etiology
mauve (violaceus) plaque, flat topped shiny white streaky areas (wickam striae) itchy, mucousal involvement in black people: hypopigmentation around disappears after 9-18 months |
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lichen planus treatment
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potent topical steroid (+/- occlusion) or occasional oral steroid
if fails, PUVA, azathioprine, retinoids, topical tacrolimus. |
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pityriasis versicolor
clinical features |
pityrosporum infection
young adults trunc asymptomatic caucasians: reddish brown scaly macules black: macular areas of hypopigmentation |
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pityriasis versicolor treatment
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selenium sulpide shampoo or topical imidazole cream.
if fails, oral itraconazole pigmentation takes months to recover can reoccur |
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herpetic whitlow clinical features
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recurrent "cellulitis" in young adults
vesiculo-papular rash on fingers lymphangiits, lymphadenopathy and lymphoedema complications |
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oral hairy leucoplakia
associations |
HIV, especially if smokers
bechet's, inflammatory bowel disease |
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CDLE - chronic discoid lupus erythematodes
clinical features |
fixed erythematous, scaly atrophic plaque with teleangiectasia
sun exposed areas UV light can aggravate alopecia and mucous involvement in 25% 5% will develop SLE ANA positive in 30% |
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CDLE treatment
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sun screens
potent topical steroids oral antimalarials (hydroxychloroquin) |
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bechet's disease
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IS A VASCULITIS
recurrent aphtous oral ulcers (99%) gastrointestinal ulcers (pain, malaena (50%) genital ulcers anterior/posterior uveitis other: musculoskelettal/CNS, skin (EN) venous AND arterial thromboses/thrombophlebitis, aneurism, stenoses (up to 40%) |
