Brainscape's Knowledge GenomeTM

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


See full index

Block 7 Week 5 Colt > Bone and Joint Infections - Hall > Flashcards

Bone and Joint Infections - Hall Flashcards

1
Q

Which is more likely to cause a bone infx, strep or S aureus

A

staph aureus

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

Do you need to do a needle biopsy if you have a positive blood culture?

A

nope

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

What is the sensitivity of a needle biopsy?

A

80%

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

Can you rely on cultures taken from fistulas or sinus tract?

A

only if they culture a single organism or staph aureus

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

what is the gold standard for bone infection diagnosis?

A

open bone biopsy

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

If cultures are sterile after three days but you know there is an infection, what should you do?

A

grow cultures for 15 days

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

What are the situations in which a prosthetic may be retained after debridement?

A

symptoms <3 weeks
stable implant
easy to treat organism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the conditions for a single-stage prosthesis replacement?

A

symptoms >3 weeks
soft tissue in good shape
no co-morbidities
easy to treat organism

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

what is the first sign of an epidural abcess?

A

spinal ache

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

What are the indications for debridement of vertebral osteomyelitis?

A 
Instability
Abcess
Cord compression
Cervical infection
Medical failure
Neurological signs or symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

t/F: imaging within four weeks of osteomyelities Tx usually look worse

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you diagnose osteomyelitis?

A

histopathologic evidence with supporting microbiological data

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

describe how the following findings will predict bone involvement:
size of lesion
probe depth
ESR

A

> 2cm large and >3mm deep
if probe goes to bone
ESR >70

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

What are the best imaging studies for a diabetic foot?

A

plain film
Ct
MRI
nuke med

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

T/F: plain films are insensitive to actue osteomyelitis in a diabetic foot

A

true

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

What would you see on a plain film in a chronic infection of a diabetic foot?

A

sclerosis, periosteal elevation, and sequestra

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

What is the best method for detecting small areas of necrossi, gas, and foreign bodies?

A

CT

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

WHat is the best single test for a diabetic foot infection>?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In the TC-99 bone scan, when will soft tissue infections be positive and when will osteomyelitis be present?

A

soft tissue: immediate and at 15 mins

osteomyelitis: delay greater than 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What organisms can cause an infected ulcer?

A

S. aureus, B-streptococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What organisms cause a chronically infected ulcer?

A

S. aureus, ß streptococci, enterococci, Enterobacteriaceae, Pseudomonas species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What species cause a necrotic, malordorous, fetid foot?

A

S. aureus, ß streptococci, enterococci, Enterobacteriaceae, Pseudomonas species and anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment for a diabetic foot?

A

Surgical debridement (with bone cultures)
Re-vascularization if needed
Long-term antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T/F: abx alone may be sufficient to treat a diabetic foot

A

true

25
Q

T/F: you should always include gram pos coverage for staph aureus when giving Abx for a diabetic foot infection

A

true

26
Q

When should you add gram neg coverage for a DM foot?

A

for chronic wounds or pts previously treated with abx

27
Q

When do you inlcude anaerobic coverage for a DM foot?

A

necrotic foot with odor

28
Q

When do you narrow your abx coverage for a dM foot?

A

upon pos cultures

29
Q

WHere should you take your culture from in a DM foot?

A

bone

30
Q

T/F: coverage of enterococci is not necessary but MRSA is in DM feet

A

true

31
Q

What is the indication for pseudomonas coverage when treating a dM foot?

A

after the wound has been treated with hydrotherapy

32
Q

When do avirulent bugs like coag negative staph or corynebacterium become a problem?

A

when the host is immunocompromised with sig. soft tissue necrosis

33
Q

Mild DM foot infx should be treated for how long?

A

1-2 weeks

34
Q

Moderate to severe DM foot infx should be treated for how long?

A

2-4 weeks

35
Q

osteomyelitis in a DM foot should be treated for how long?

A

4-6 weeks or longer

36
Q

Acute angle deformities of the thoracic spine with granulomas on biopsy, with possibly septic joints makes you think of what bug?

A

TB

37
Q

What are indications for surgery in Pott’s disease?

A

Neurological deficits
Instability
Cervical disease
Medical failure including non-adherence

38
Q

In DEVELOPED countries, what does skeletal TB represent?

A

reactivation of old focus of infection; Dz of adults

39
Q

In the DEVELOPING world, skeletal TB presents in pts who….

A

recently acquired TB; Dz of children

40
Q

What is the average length of symptoms of skeletal TB prior to Dx?

A

16-19 months

41
Q

T/F: Local swelling, pain, fluctuance; systemic symptoms (fever, sweats, etc) are often absent in skeletal TB

A

true

42
Q

Pulmonary disease is present in what portion of skeletal TB?

A

30%

43
Q

Pott’s disease, aka (blank)

A

tuberculosis spondylitis

44
Q

Describe the progression of Pott’s disease

A

Infection begins in the anterior aspect of the vertebral body leading to anterior collapse and spread of the infection along the anterior ligament

45
Q

Most cases of Pott’s disease have what regions of vertebrae affected?

A

thoracic and lumbar

46
Q

1/2 pts with Pott’s disease also have (blank), which if calcified are diagnostic for TB

A

abcesses

47
Q

What is the common presentation of Pott’s disease?

A

50% have weakness or paralysis at the time of presentation or during Rx
50% associated with disc involvement
50% without disc involvement are younger and more likely to have other skeletal lesions
77% have epidural involvement by MRI (Pertuiset, 1999)

48
Q

T/F: gonorrheal infections will show up most of the time in the CSF

A

true

49
Q

What is the abx for reactive arthritis?

A

ceftriaxone

50
Q

SAUSAGE DIGITS makes you think:

A

about sausages, aka penises, aka GC infection

51
Q

What are the risk factors for reactive arthritis?

A

enteric infection, IBD

52
Q

What causes pyogenic arthritis in the newborn?

A

Staphylococcus aureus
Enterobacteriaceae
Group B streptococcus

53
Q

How do you treat pyogenic arthritis in the newborn?

A

PRSP + third generation cephalosporin

54
Q

What bugs cause pyogenic arthritis in a child 3-6 months old?

A

Staphylococcus aureus
H. influenzae
Streptococci
Enterobacteriaceae

55
Q

How do you treat pyogenic arthritis in a kid 3-6 months old?

A

(PRSP or first generation cephalosporin) + third generation cephalosporin

56
Q

What bugs cause septic arthritis in an adult?

A

Staphylococcus aureus
Group A streptococci
Enterobacteriaceae

57
Q

What do you use to treat septic arthritis in an adult?

A

[(PRSP or first gen cephalosporin) + (APAG or Ciprofloxacin)] or Timentin or Piperacillin Tazobactam or Unasyn

58
Q

what caues infection of a joint replacement?

A

Staphylococcus epidermidis
Staphylococcus aureus
Enterobacteriaceae
Pseudomonas

59
Q

How do you treat infections of joint replacements?

A

Vancomycin + ciprofloxacin or aztreonam or APAG

Block 7 Week 5 Colt (7 decks)

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