Return to Scenario ListShow Learning Points most relevant to Phase 1:

Skin and soft tissue infection

Clinical Discipline(s)/Organ System(s)
Dermatology, Infectious Diseases, Microbiology, General Surgery, Orthopaedics
Progress Test Topic(s)
Infectious disease, Skin
A 55 year old NZ European man, who is overweight, attends his GP's practice with a painful red rash across his left foot. His foot is warm and swollen and he has an antalgic gait.
Progress Test-Type Questions:   Question 1 | Question 2 | Question 3 | Question 4
Applied Science for Medicine 
   - Anatomy and physiology of the skin
   - Skin and soft tissue infections caused by Staphylococcus aureus (including methicillin-resistant S. aureus (MRSA)) and Streptococcus pyogenes
   - Host response to bacterial infection
   - Colonisation with S. aureus and S. pyogenes
   - Pharmacology of penicillin, flucloxacillin, macrolides, clindamycin, antifungal agents; therapeutic options to treat MRSA
Clinical and Communication Skills 
   - Elicit a history from a patient with a rash
   - Examination of a rash; include other structures if relevant (e.g. joint if rash lies over it)
   - Describe a rash using dermatological terminology
   - Recognise dermatophyte infection
   - Interpret skin scrapings, skin swabs and blood cultures
   - Management of cellulitis, boils and tinea
   - Antimicrobial stewardship; non pharmacological management of boils
   - Antibiotic selection: intravenous/oral and consideration of antimicrobial resistance
   - Management of the patient with recurrent boils
   - Recognise and manage common skin and soft tissue infection (including ingrown toe nail) in primary healthcare setting
Personal and Professional Skills 
   - Importance of hand hygiene in the clinical environment
   - Communicate understanding of the social impact of skin and soft tissue infections
   - Confidentiality
Hauora Māori 
   - Ability to cater for differential health literacy needs of patient and whānau
   - Understanding of disproportionate impact of socioeconomic deprivation on Māori
Population Health 
   - Epidemiology of cellulitis, MRSA infections
   - Social determinants of skin and soft tissue infection (including consideration of overcrowding, cost of treatments)
Conditions to be considered relating to this scenario
cellulitis, boil/furuncle, carbuncle, allergic reaction, venous insufficiency, dermatitis, erysipelas, tinea pedis, impetigo
Less common but 'important not to miss'
necrotizing fasciitis, hidradenitis suppurativa