Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Senior - ID 3 > 20 - Osteopres > Flashcards

20 - Osteopres Flashcards

1
Q

MC joint infection?

A

Knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Warning sings for joint infection?

A 
Sudden onset pain
Decreased motion
Fever >102.2
Selling 
Effusion
Warmth
Monoarticular infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Common labs with joint infections?

A 
ESR
Synovial cell count 
WBCs >50,000-100,000ml (septic)
PML 90%
Glucose - low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
#1 joint infection
?
A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Other common joint bacteria?

A

Prostetic joint - MRSA/S. Pyogenes

Neisseria gonorrhea

Mycobacterial/fungal

Viral: rubella, parvo, hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Warning sign for joint infection being n. Gonorrhea?

A

The associated rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

X ray for joint infection?

A

Initial = negative

Later:

  • soft tissue swelling
  • distention
  • narrow joint space
  • capsule
  • bony erosions
  • fat pad
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tx for joint infection?

A

Abx
- empiric/specific
Drain/aspirate
Synovectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common abx for joint infection?

A

Nafcillin or oxacillin
- MSSA IV

Vancomycin + rifmpin IV
- MRSA

Ceftazidime (fortaz) IV
- P. Aeroginosa

Ceftriaxone (rocephin)
- N. Gonorrhoeae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Septic bursitis locations and types?

A

Superficial bursa
- infectious bursitis

Patellar/olecranon

  • older adults
  • trauma
  • repetitive activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

S/s of septic bursitis?

A 
Fever
Cellulitis
Swelling
TTP
Erythema
Decreased motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fever and cellulitis require?

A

Immediate aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MC septic bursitis?

A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Septic bursitis may be the 1st sign of?

A

Septic arthritis in pts with RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MC bursas to get septic bursitis?

A

Olecranon

Prepatellar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of osteomyelitis?

A

Acute and chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute osteomyelitis?

A

Presents W/in 2 weeks

- bacteria penetrates the bone causing abscess formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why does bacteria cause osteomyelitis?

A

Penetrates the bone causing abscess formation

  • derives bone of blood supply
  • leads to necrosis of bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Chronic osteomyelitis?

A

Occurs after 1+ months of bone infection

  • recurrent infections
  • non-healing wounds
  • draining wounds/sinuses

Often have a hx of acute osteomyelitis

20
Q

Why are abx ineffective for osteomyelitis?

A

Cycle of infection and bone destruction w/o an efficient blood supply prevents penetration of abx

21
Q

Types of infection of osteomyelitis?

A

Trauma to periosteum
Contiguous spread
Hematogenous seeding

22
Q

What is contiguous spread (in reference to osteomyelitis)

A

Often polymicrobial

  • abscess
  • diabetic foot ulcer
  • decubitus ulcer
  • post-op wound infection
23
Q

WTF is hematogenous seeding of bone?

A

Spread through blood

Often monomicrobial

  • endocarditis
  • sepsis
  • UTI
  • IVDU
  • Pulmonary TB
  • Sickle cell
24
Q

Osteomyelitis and ulcers?

A

15% of osteomyelitis pts get ulcers

85% (of the 15%) end in amputation
- 60% 5 yr mortality on amputations

60% have DM

25
Q

Pressure injury staging (national pressure ulcer advisory panel NPUAP)

Pics on 19-24

A 
Stage 1: 
- intact skin
-  non blanchable 
Stage 2: 
- partial thickness
- loss of dermis
- shallow ulcer 
- w/o sloughing
Stage 3: 
- full thickness
- subC fat
- slough
- necrotic tissue 
Stage 4: 
- full thickness
- loss of bone/tendon/muscle
- slough/eschar
- exposed muscle
- bone/tendon visible/palpable
26
Q

What is unstageable osteomyelitis?

A

Full thickness tissue loss that is obscured by slough in the wound bed
- Must be explored/derided to determine stage

27
Q

STDI in osteomyelitis?

A

Suspected deep tissue injury

  • purplish area due to damage of underlying tissue-evolution
  • may include thin blister over dark wound bed
28
Q

Areas that medical device pressure injuries can occur

A

Nasal cannula - ears
Foley cath
IV tube

Mucosal membrane pressure injury
- ET tube or tape Around mouth,nasal cannula in nares

29
Q

Wagner grading system?

A

System for diabetic (neuropathic) foot ulcers

30
Q

Wagner grading system stages

A

Grade 0: fully epithelialized
- redness, callous, bony deformity
Grade 1: superficial
- partial thickness foot ulcer limited to dermis
- not extending to subcutaneous tissue
Grade 2: deep ulcer -> sub C tissue to tendon, joint, bone
- w/o osteomyelitis,abscess, or joint sepsis
Grade 3: deep ulcer
- w osteomyelitis, abscess joint sepsis
Grade 4: gangrene - toes/forefoot
Grade 5: gangrene - extensive/foot

31
Q

Presentation of osteomyelitis?

A 
Pain
Muscle spasm
Draining sinus
Fever/chills
Erythemia
32
Q

Labs for osteomyelitis?

A

ESR
CRP
Culture (diagnostic)

33
Q

Standard technique for culturing osteomyelitis?

A

Bone and needle aspirate
- not from superficial site (i.e. draining sinuses)

Bx must be done 48hrs post abx or before starting them

34
Q

Usual part of bone affected by osteomyelitis?

A

Metaphases of long bones is most freq

35
Q

Common bugs for osteomyelitis?

A 
Staph aureus - MC
Coag neg staph
Enterococci
Gram neg rods 
- pseudomonas
- serratia
- e-coli
- salmonella
Anaerobes (diabetic foot infections)
MRSA in joint associated infections
36
Q

Less common pathogens for osteomyelitis?

A 
TB
Brucellosis
Coccidiomycosis
Blastomycosis
Histoplasmosis
37
Q

Radiology studies for osteomyelitis

A

X ray - (may not be pos for 2-6 weeks)
Bone scan - pos in 2 days
MRI/CT - pos in 2 days

38
Q

X ray findings for osteomyelitis?

A

lytic lesions
periostitis
endosteal scalloping
- focal or diffuse

39
Q

Why is debridement important?

A

Necrotic tissue acts as a physical barrier

- debride devitalized tissue

40
Q

What must be done with osteomyelitis

A

Must resect infected bone

- it will recur

41
Q

Poor outcomes with osteo are associated w?

A

DM
SCD
Vascular disease

42
Q

Meds for osteomyelitis?

A

Pathogen specific
4-6 wks PO therapy
Can do abx impregnated beads
Hyperbaric oxygenation

43
Q

Prosthetic joint infections come from?

A

Contamination during surgery

  • 1-9% risk
  • elbows are highest risk
44
Q

Diagnosis of prosthetic joint infections?

A

Onset w/in 6 mo of surgery
Looks like septic arthritis
Labs: look like osteo

45
Q

Radiologic findings for prosthetic joint infection?

A

Endosteal scalloping
- focal or diffuse
Osteomyelitis

46
Q

Tx for prosthetic joint infection

A

Two fold

  • eradicate infectious agent
  • maintenance of function of joint

Can do: re-implant, arthrodesis, amputate or implant salvage

47
Q

What did the stoner ask his doctor for?

A

A joint replacement

Senior - ID 3 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions