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Pod Exam 2 > 37: Infectious Disease - Smith > Flashcards

37: Infectious Disease - Smith Flashcards

1
Q

clinical s/s of infection

A
  • Fever, Chills, Night Sweats
  • Lump
  • Red streaks
  • Duration of symptoms
  • Prior therapy
  • Medical history
  • Allergies
  • Social history
  • Pets
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2
Q

PE infection

A
  • Overall patient appearance (appear sick, lethargic, diaphoretic, disheveled)
  • Temperature
  • Cellulitis
  • Lymphadenopathy
  • Lymphangitis
  • Open lesions
  • Drainage/ Fluctuance/ Crepitus
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3
Q

define cellulitis and its most common pathogen

A

Inflammation of the skin and connective tissues - Streptococcus (usually a gram + organism)

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4
Q

five cardinal signs of celsus ***

A 
Rubor (Redness)
Tumor (Edema)
Dolor (Pain)
Calor (Heat)
Functio Lasea (Loss of function)

“red, hot, painful, swollen “

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5
Q

Red streaking caused by inflammation of the lymphatic channels draining the of infection

A

lymphangitis

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6
Q

what do you have to record about open lesions? ***

A

depth
size
shape
tissue or debris within lesion

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7
Q

how do you describe drainage?

A

How much
Type
Color
Odor

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8
Q

Fluid beneath surface of skin which may be an abscess or hematoma

A

fluctuance (like palpating a water balloon)

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9
Q

yellow/gold drainage

A

staphAUREUS

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10
Q

white drainage

A

staphEPI

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11
Q

brown dishwater drainage

A

anaerobic bacteria life-threatening severe

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12
Q

crepitus w/ signs and symptoms of infection =

A

surgical emergency

- feeling of crepitus is created by subcutaneous air or gas

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13
Q

what is a normal WBC

A

under 11,000

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14
Q

left shift WBC

A

fighting off infection and putting immature into circulation

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15
Q

do platelets increase or decrease with infection

A

increase

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16
Q

describe ESR erythrocyte sedimentation rate

A
    • Measures the distance (mm) that a column of erythrocytes falls in one hour
    • Erythrocytes fall in a rouleaux formation in the presence of acute phase reactants
    • INCREASED in infection, malignancy or inflammation
    • Used to monitor therapy
    • normal sed rate is 15 or less male, 20 or less female
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17
Q

more sensitive but not specific in comparison to sed rate

A

CRP c-reative prtn

- acute phase reactant

18
Q

infection does what to blood glucose

A

increase

19
Q

where should a wound culture be taken from first?

A
  • Wound culture taken from the deepest part of the wound (anaerobic culture first)
  • Culture should be taken prior to antibiotic therapy
20
Q

3 types of blood cultures

A

Transient Bacteremia - Happens on daily basis
Intermittent

Bacteremia - Septic foci seeding the blood

Continuous Bacteremia - Bacterial endocarditis

21
Q

*** hospitalization guidelines

A
    • High fever > 101º F
    • High WBC > 13,000
    • Systemic infection or sepsis
    • Failure to respond to outpatient therapy
    • Organism only susceptible to parenteral agent
    • Debridement requiring general anesthesia
    • Systemic disease
22
Q

infected ingrown nail

A

paronychia

  • nail spicule must come out
  • five cardinal signs of infection along nail with purulent drainage
23
Q

interdigital maceration and pruritus, with possible cellulitis

A

gram negative interspace infection

24
Q

wood’s lamp (UV) reveals…

A

green fluorescence = gram neg pseudomonas

coral red = gram pos = Erythrasma (Corynebacterium)

25
Q

*** coral red wood’s lamp UV

A

erythrasma

gram pos corynebacterium infection

26
Q

describe the pathophysiology of osteomyelitis

A
    • Destruction of trabeculae and bone matrix at site of infection resulting in radiolucency radiographically
    • Spreads from original site through medullary bone and haversian canals of cortical bone
    • Ischemic necrosis of bone
27
Q

sequestrum in osteomyelitis

A

As infection progresses within the bone, segments of necrotic bone are isolated from viable bone - Sequestrum (Dense sclerosis)

28
Q

involucrum in osteomyelitis

A

The outer cortex of bone violated with elevation of periosteum and stimulation of new bone to wall off infection - Involucrum

29
Q

cloaca in osteomyelitis

A

New bone formation violated releasing infection into soft tissue - Cloaca

30
Q

Most common cause of acute OM in body, but rare in foot

A

hematogenous osteomyelitis

31
Q 
*** hematogenous osteomyelitis in ...
neonates
children under 2
IV drug user
sickle cell anemia
A

most common = s. aureus

neonates= groub B
under 2 = h. influenzae
IVDA = pseudomonas
sickle cell = sallmonella

32
Q

gold standard osteomyelitis diagnosis

A

bone biopsy and bone culture

Bone Biopsy
- Presence of necrotic bone with new bone formation

Bone Culture

  • Definitive
  • Discontinue antibiotics for 48 hours
  • Take culture through clean site
  • Jamshidi needle
33
Q

chronic OM with sinus tracts associated with …

A

squamous cell CA

34
Q

tx osteomyelitis

A
    • IV antibiotics 6-8 weeks
    • Surgical debridement
    • PMMA Beads
    • Closed suction irrigation
35
Q

acute monoarticular arthritis is assumed…

A

infection until proven otherwise

36
Q

best tx for adequate drainage of septic arthritis

A

arthrotomy

- open it up and drain it

37
Q

98% of puncture wounds

A

nails

puncture wounds are 5-7% of ER visits

38
Q

treatment puncture wounds ***

A

open and clean it - even in office

debridement and irrigation is gold standard

  • antibiotics can not overcome inadequate treatment
39
Q

OM from puncture wound - what is the organism?

A

pseudomonas 93%

b/c sole of shoe get wet - pseudomonas likes water

40
Q

patzakis classification

A

used to predict osteomyelitis from puncture wounds in zone 1/ forefoot
zone 3/ rearfoot is the next common
- b/c the bone is closer to skin here

Pod Exam 2 (16 decks)

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