Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            resence of actively dividing infectious bacteria within the skin tissues. 
 Skin entry by pathogenic bacteria (scratch, ulcer, hair follicle). 
 Usually Gram +ve cocci (e.g. Streptococcus pyogenes, S. aureus). 
 Usually heals by resolution if treated promptly. 
 Spread may result in lymphangitis, suppuration results in a furuncle, carbuncle, or an 
abscess 
 
 
 
Cellulitis 
Clinical features: 
 Skin widely involved: warm, red, swollen, and exquisitely painful. 
 Crepitus indicates the development of gas-forming tissue necrosis which may be an 
emergency . 
Treatment 
Antibiotics: flucloxacillin, Amoxicillin , cephalexin ,Levofloxacin . 
__________________________________________________ 
Boil ( furuncle) : is a deep folliculitis, infection of the hair follicle.  
 Carbuncle: is a cluster of boils caused by bacterial infection, most commonly with 
Staphylococcus aureus or Streptococcus pyogenes 
Lymphangitis: is the presence of actively dividing infectious bacteria in the lymphatic 
vessels of an area of the body. 
Fasciitis: is inflammation of connective tissue . 
Myositis: is infection or inflammation of muscle tissue. 
د.أحمد صباح 
Surgery 
       المرحلة الثانية
 
2 
 
                                                                     Boil( furuncle)                      Carbuncle  
------------------------------------------------------------------- 
Abscess 
✓ Abscess is a liquid collection of pus in any part of the body.  
✓ Pathological features: Contain polymorphonuclear neutrophils (PMNs)/macrophages, 
lymphocytes (live and dead), bacteria (dead and viable), and liquefied tissue products. 
✓ May rupture (‘pointing’),  
✓ Incomplete treatment due to resistant organisms (mycobacteria) or poor treatment 
may lead to chronic abscesses. 
✓ Complete elimination of the organisms in a chronic abscess without drainage can lead 
to a ‘sterile abscess’ (‘antibioma’). 
✓ Example : skin abscess , liver abscess , brain abscess. 
 
 
 
Abscess  
 
د.أحمد صباح 
Surgery 
       المرحلة الثانية
 
3 
 
Cinical Feature  
➢ a smooth swelling under your skin that can feel hard or firm. 
➢ pain and tenderness in the affected area. 
➢ warmth and redness in the affected area. 
➢ a visible build-up of white or yellow  
➢ fever 
➢ chills. 
Investigation  
❖ ↑ C-reactive protein  
❖ ↑ erythrocyte sedimentation rate 
❖ leukocytosis 
❖ Ultrasound, CT scan , MRI, may be necessary to confirm the diagnosis. 
 
Treatment 
➢ Drain the pus, e.g. incision and drainage (Abscesses need drainage) 
➢ IV antibiotics . 
➢ Modern imaging techniques may allow guided needle aspiration. 
➢ An open abscess cavity heals by secondary intention. 
➢ secondary healing, is the healing that occurs when a wound is left open to heal by 
granulation, contraction, and epithelialization. 
 
 
Ultrasound guided needle aspiration 


            Quiz: