Skin Infections and Treatments Quiz

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Questions and Answers

Which bacteria are commonly responsible for skin infections?

Escherichia coli and Pseudomonas aeruginosa

Staphylococcus aureus and streptococcus pyogenes (correct)

Klebsiella pneumoniae and Neisseria gonorrhoeae

Clostridium difficile and Salmonella

Under what circumstances should a systemic agent be used instead of a topical agent for skin infections?

When the patient is pregnant

When the patient has minor irritation

When topical treatments are ineffective (correct)

When the infection is localized and mild

What is the primary treatment recommendation for a MRSA abscess?

Incision and drainage with culture and sensitivity (correct)

Immediate surgical intervention

Topical antibiotics and wound ointment

Oral antibiotics and regular monitoring

What is the mechanism of action of Podophyllin in treating venereal warts?

Inhibits DNA synthesis and mitosis Signup and view all the answers

Which of the following is a safety concern associated with Bichloroacetic acid?

Risk of spreading onto healthy tissue Signup and view all the answers

How many times per week can Imiquimod be applied for venereal warts?

1-3 times per week Signup and view all the answers

What patient education should be provided after applying Podophyllin?

Wash the area with soap and water after a few hours Signup and view all the answers

Which of the following is true regarding the safety of Imiquimod?

It has minimal absorption and systemic effects are not a concern Signup and view all the answers

What is the mechanism of action for Podofilox (Condylox)?

Inhibits mitosis Signup and view all the answers

Which medication should be avoided during pregnancy and lactation due to safety concerns?

Podofilox (Condylox) Signup and view all the answers

What is a possible side effect of Kunecatechins?

Erythema Signup and view all the answers

What is the primary indication for the use of systemic antifungal medications?

Tinea capitis and tinea unguium Signup and view all the answers

Which of the following medications suppresses the growth of P. and is also a keratolytic?

Benzoyl Peroxide Signup and view all the answers

What is a significant safety consideration when using azoles?

QT prolongation Signup and view all the answers

What can be a consequence of using oil-based topical creams for yeast infections on condoms?

Weakens condoms Signup and view all the answers

During the treatment of systemic fungal infections, what is important to monitor?

Liver function tests (LFTs) Signup and view all the answers

What is the main mechanism of action of isotretinoin in treating severe nodulocystic acne vulgaris?

Decreases inflammation and sebum production Signup and view all the answers

Which patient group should exercise caution when using isotretinoin?

Patients with liver disease Signup and view all the answers

What is the cornerstone treatment for mild to moderate acne?

Adapalene Signup and view all the answers

What changes occur in ovarian function when using contraceptive pills for acne management?

Reduction of ovarian androgen production Signup and view all the answers

Which of the following is NOT a safety concern for COC use in acne treatment?

History of eczema Signup and view all the answers

What effect do estrogens have on sebum production in patients taking COCs?

Decrease sebum production Signup and view all the answers

What is a known drug-to-drug interaction with isotretinoin?

Tetracyclines Signup and view all the answers

What is the purpose of sex hormone-binding globulin in the context of COCs?

Inactivates androgens Signup and view all the answers

Which of the following medications is contraindicated for women who are over 35 and smoke?

Spironolactone Signup and view all the answers

What is the primary mechanism of action of Spironolactone?

Blocks steroid receptors including aldosterone and sex hormones Signup and view all the answers

How long should patients expect to see significant improvement when using first-line treatments for acne?

4-6 weeks Signup and view all the answers

Which of the following antibiotics is considered safe during pregnancy?

Erythromycin Signup and view all the answers

What is a recommended first-line non-pharmacologic approach for managing acne?

Washing the face gently with mild soap Signup and view all the answers

Which of the following treatments for acne is contraindicated during pregnancy?

Differin Signup and view all the answers

What is the expected time frame for oral antibiotics to show significant improvement for acne?

6 weeks Signup and view all the answers

What measure should be taken for patients to help prevent acne development?

Changing pillowcases regularly Signup and view all the answers

What are the primary characteristics of ointments?

Thick and greasy, often with a Vaseline base Signup and view all the answers

For how long should children typically use topical steroids?

One week Signup and view all the answers

Which of the following is a common adverse effect of long-term use of topical steroids?

Skin atrophy Signup and view all the answers

Where are low potency steroids recommended for use?

Face and intertriginous areas Signup and view all the answers

What is one of the indications for using systemic corticosteroids in dermatology?

Exfoliative dermatitis Signup and view all the answers

What potential serious side effect can result from prolonged use of systemic corticosteroids?

Severe infection Signup and view all the answers

Which of the following characteristics distinguishes creams from ointments?

They are generally thicker than lotions but thinner than ointments Signup and view all the answers

What is one of the mechanisms by which systemic corticosteroids exert their effects?

Suppress influx of inflammatory cells Signup and view all the answers

What is the recommended dosage of amoxicillin for a child with acute otitis media who meets certain criteria?

80-90 mg/kg/day Signup and view all the answers

Under which condition is amoxicillin-clavulanate recommended for treating a child with AOM?

Child has recurrent AOM unresponsive to amoxicillin Signup and view all the answers

What is the primary reason for discouraging the use of antibiotics in all children with AOM?

Most AOM episodes resolve spontaneously within a week Signup and view all the answers

Which antibiotic class is FDA approved for treating acute otitis externa with a ruptured tympanic membrane?

Fluoroquinolones Signup and view all the answers

What pain medication is safe to use for a child with acute otitis externa and a ruptured tympanic membrane?

Oral acetaminophen Signup and view all the answers

What effect do topical otic steroids have when treating acute otitis externa?

They reduce pain by decreasing inflammation Signup and view all the answers

What might occur if otic steroids are used in the presence of herpes zoster?

Disseminated varicella Signup and view all the answers

When are fluoroquinolone eardrops indicated for children with acute otitis externa?

When there is a risk of tympanic membrane perforation Signup and view all the answers

Study Notes

Module 9 Study Guide

Skin Infections: Common pathogens are Staphylococcus aureus and Streptococcus pyogenes (gram-positive bacteria).
Topical vs. Systemic Treatment: Topical agents are suitable for localized, mild infections; systemic treatment is used for infections resistant to topical therapies.
MRSA Abscess Treatment: Treatment involves incision and drainage, culture and sensitivity, wound care education, and follow-up (excluding systemic symptoms, severe local symptoms, and immunosuppression).
Venereal Warts: Pharmacological treatments include podophyllin, bichloroacetic acid (BCA), trichloroacetic acid (TCA), imiquimod, and podofilox. Each has a specific mechanism of action (MOA), safety profile, and patient education considerations. Imiquimod enhances the immune response against HPV, while podofilox inhibits mitosis. The others have a caustic MOA (e.g., inhibiting DNA synthesis/mitosis, destroying warts by chemical coagulation, or causing cellular death). Safety concerns for several include potential toxicity for systemic absorption.
Topical Antifungal Medications (Azoles): Used for common skin infections. Their mechanism of action impairs ergosterol synthesis, increasing cell membrane permeability and causing cell death. Usually treated for 2-4 weeks, with a follow-up week after lesion disappearance.
Systemic Antifungal Medications (Azoles): Indications include tinea capitis and tinea unguium. MOA inhibits fungal cytochrome P450. Duration of treatment should be avoided routinely. Monitoring must include liver function tests. Drug-to-drug interactions with warfarin, theophylline, and macrolides are possible.
Acne Treatment: Benzoyl peroxide, isotretinoin (Accutane), adapalene (Differin), and oral contraceptives (COCs) are drugs used to treat acne.
Acne Treatment Indications/MOA/Safety: Benzoyl peroxide is a first-line treatment for mild-to-moderate acne, suppressing P. acnes growth and reducing inflammation through active oxygen release. It is not contraindicated in pregnancy, though some other acne medications are. Isotretinoin (Accutane) helps reduce sebum production, inflammation, and keratinization. Adaptedane is effective with comedones. Oral contraceptives (COCs) increase sex hormone-binding globulin to decrease androgen availability, and sebum production.
Acne Rosacea Treatment: Initial treatment involves topical metronidazole (Flagyl, metro-cel). Other topical or oral antibiotics may be used.
Medication Delivery Systems: Ointments are thick, greasy (often containing petroleum jelly), good for lesions in thick skin. Creams are oil-and-water (thicker than lotions, not as thick as ointments) which may penetrate deeper. Lotions are mostly water-based, containing little or no oil. Solutions are used on dry lesions and consist of mainly an aqueous solution with a thickening agent, and potentially alcohol. Gels are solutions with thickening agents, typically thinner and disappear quickly.
Topical Steroid Use: Prolonged use can lead to adverse effects such as skin atrophy, ecchymosis, striae, and others. Duration of use for children is one week, and for adults is two weeks.
Low/High Potency Steroids: Indicate appropriate areas of topical application, such as low potency for areas with more skin-to-skin contact.
Systemic Corticosteroids: Inhibit cytokine and mediator release, reduce mucus secretion, and increase beta-adrenergic receptors attenuating inflammatory responses.
Adverse effects of systemic corticosteroids: Can mask infection, cause GI upset, strip the stomach of its protective barrier, cause prolonged GI bleeding, mood changes, sleep disturbances, and weight gain (increased appetite).
Ophthalmic Drugs: Beta-blockers, prostaglandin analogs, and alpha-adrenergic agonists are indicated for open-angle glaucoma. Potential adverse effects include heart block, bradycardia, hypotension, and other related side effects. Monitoring is necessary to assess pulse rate.
Otitis Media: Amoxicillin (80-90 mg/kg/day) is a strong first-line recommendation in acute otitis media (AOM). Alternatives like amoxicillin-clavulanate are used for cases resistant to amoxicillin. Considerations include a 30-day history of amoxicillin use and/or concurrent purulent conjunctivitis.
Acute Otitis Externa: Fluoroquinolone ear drops (often with steroids) are a common treatment. Some consider alternative pain medications (e.g., acetaminophen, ibuprofen) if the tympanic membrane is intact; topical analgesics may be contraindicated if the tympanic membrane is ruptured.
Pediculcides/Scabicides: Topical permethrin (5%) or oral ivermectin (Stromectol) are used for scabies. Topical lindane is also used for lice (but is associated with neurotoxicity). Permethrin for lice should be applied and left on for 8-14 hours (repeated a week later). Treatment for permethrin must include appropriate skin areas.
Otic Steroid Application: Use in the presence of herpes zoster is contraindicated.
Patient Education: Key elements for patient education include drug application methods, frequency, and potential side effects.

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Description

Test your knowledge on the bacteria responsible for skin infections and the appropriate treatment options. This quiz covers the use of systemic versus topical agents, mechanisms of action for specific medications, and safety concerns with topical treatments. Enhance your understanding of skin infection management and therapeutics.