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Chapter 151 Cellulitis and Erysipelas

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

Patchy, ill-defined erythema with "skip areas" is a pattern that may be observed more frequently in:

a)

Recurrent cellulitis

b)

Non-purulent cellulitis

c)

Purulent cellulitis

d)

Erysipelas

2.

Pustule or abscess development alongside cellulitis increases suspicion for what etiologic agent:

a)

Staphylococcus aureus

b)

Streptococcus pyogenes

c)

Streptococcus agalactiae

d)

Staphylococcus epidermidis

3.

During the 2022 Oscars, Will Smith got on stage and punched Chris Rock in the mouth. A few days later, he developed swelling, erythema, and warmth over his hand. Who do you think was in the right What is the most likely isolate from his infection if cultures were to be taken?

a)

Bartonella henslae

b)

Capnocytophaga canimorsus

c)

Polymicrobial infection

d)

Aeromonas spp.

e)

Escherichia coli

4.

All of the following are established systemic or environmental risk factors for routine cellulitis, EXCEPT FOR:

a)

Age

b)

Obesity

c)

Immunosuppression

d)

Summer season

e)

Renal or hepatic disease

5.

What is the most common portal of entry of patients with cellulitis?

a)

Tinea pedis

b)

Irritant contact dermatitis

c)

Penetrating trauma

d)

Surgical site intervention

e)

IV line placement

6.

What local risk factor confers the highest risk for developing cellulitis?

a)

Lymphedema

b)

Toe web infection

c)

Penetrating trauma

d)

Venous insufficiency

e)

Peripheral arterial disease

7.

Routine cultures are recommended for which of the following scenarios:

a)

Cellulitis with abscess formation

b)

Cellulitis with negative gram stain

c)

Erysipelas variant

d)

Cellulitis after tinea pedis infection

8.

You have a 72 year old admitted patient in the ward who developed unilateral erythema and swelling of the right lower leg. His vitals were as follows: BP of 140/90, HR 78, and RR 18. All other laboratory examinations were normal. TRUE OR FALSE: Based on the ALT-70 Risk Prediction for Cellulitis, this patient has an 82.2% likelihood of true cellulitis.

a)

TRUE

b)

FALSE

9.

A 50-year old male came to you for unilateral erythema, swelling, and warmth of his left lower leg with associated tenderness. No pustules or abscess development was noted. He had no fever or other systemic signs and his vitals were normal. All of the following examinations are warranted to clinch your diagnosis of cellulitis. SELECT ALL THAT APPLY.

a)

CBC

b)

Culture

c)

Tissue biopsy

d)

Ultrasonography

e)

None of the above

10.

A patient came to you with a complaint of unilateral swelling, erythema, warmth and tenderness of his right lower leg. He was afebrile with the following vitals - HR 79, RR 17. He has no other comorbidities but has a history of wheal formation and lip swelling after intake of Cephalexin. Which of the following antibiotics is most appropriate for this case?

a)

Dicloxacillin

b)

Penicillin V

c)

Azithromycin

d)

Vancomycin

11.

A patient came to you with a complaint of unilateral swelling, erythema, warmth and tenderness of her left lower leg that developed gradually for the past few days. She was febrile at 38.7, with a HR 98, RR 18 with a BP of 120/80. The patient has no other comorbidities and laboratory work-up was unremarkable. She was previously treated for another skin infection last year, with cultures showing MRSA growth. Which of the following antibiotics is most appropriate for this case?

a)

Ceftriaxone

b)

Penicillin G

c)

Oxacillin

d)

Vancomycin

12.

Your long-standing HIV(+) patient came to you for unilateral swelling, erythema, warmth and tenderness of his right leg, with overlying abscess formation. He was febrile at 39.0, with the following vitals: BP 90/60, HR 100, RR 22. Which of the following antibiotics is most appropriate for this case?

a)

Vacomycin + Piperacillin-Tazobactam

b)

Linezolid

c)

Doxycycline

d)

Trimethoprim-sulfamethoxazole

13.

Which of the following antibiotics have MRSA coverage? SELECT ALL THAT APPLY.

a)

Clindamycin

b)

Vancomycin

c)

Doxycycline

d)

Trimethoprim-sulfamethoxazole

e)

Linezolid

14.

All of the following are indications for parenteral administration of antibiotics, EXCEPT FOR:

a)

Temperature <36

b)

Leukocyte count <8000

c)

Heart rate >90

d)

Respiratory rate >20

e)

Failed outpatient treatment

15.

All of the following are TRUE regarding the treatment of cellulitis, EXCEPT FOR:

a)

Recommended duration of treatment for uncomplicated patients is 5-10 days

b)

Recommended duration of treatment for immunocompromised patients is 7-14 days

c)

Prophylactic antibiotics should be considered in patients with controlled risk factors but still with >6 recurrences per year

d)

Systemic corticosteroids can be used as an adjunctive treatment for non-diabetic adult patients

e)

NSAIDs help treat accompanying inflammation but may affect neutrophil chemotaxis