bone infections Flashcards

1
Q

what should be assumed for an acute monoarthritis

A

assume it is septic arthritis and then aspirate to test

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2
Q

how does the infection usually get to the joint

A

haematogenous spread

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3
Q

risk factor for bone infection

A
age
pre-existing joint disease
diabetes mellitus
immunosuppression
ivdu
sti
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4
Q

clinical features of septic arthritis

A

acute monoarthritis
fever
swollen hot and red joint
usually knee and hip

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5
Q

most common pathogen of septic arthritis

A

is staph aureus

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6
Q

a common pathogen of septic arthritis in sexually active adults

A

disseminated gonococcal infection from untreated gonorrhoea

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7
Q

pathogens that can cause septic arthritis in elderly and IVDU

A

gram negative bacilli or strep

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8
Q

pathogens that can cause septic arthritis in neonates

A

strep and staph

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9
Q

investigation for septic arthtiris

A

-aspirate joint and culture synovial fluids
-fbc
-blood cultures
-lft
u and e
esr and crp

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10
Q

management of septic arthritis

A
  1. aspirate the joint
  2. blood culture and other swabs
  3. empirical antibiotics=flucoxacillin or in elderly add cephalosporin or gentamicin
  4. analgesia
  5. aspirate the joint one or twice daily
  6. consult for a wash out
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11
Q

what other disease can septic arthritis prevent in

A

lyme disease by borrelia

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12
Q

how does viral arthritis present

A

polyarthritis following a febrile illness and may have a rash

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13
Q

most common cause of viral arthritis in the UK

A

parvovirus=slapped cheek

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14
Q

dx of parvovirus

A

IgM antibodies

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15
Q

musculoskeletal manifestation of HIV

A
  • sjorgen like disease
  • vasculitis
  • reactive arthritis
  • psoriatic arthritis
  • non specific arthralgia
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16
Q

what is osteomyelitis

A

infection in the bone and bone marrow often at the juxta epiphyseal region of long bones

17
Q

usual pathogens causing osteomyelitis

A

staph
pseudomonas
tb

18
Q

risk factor for osteomyelitis

A
  • childhood
  • immunodeficiency
  • diabetes mellitus
  • sickle cell disease-salmonella
19
Q

sequestrum of osteomyeltisi

A

osteonecrosis and eventual perforation of the cortex by pus stimulating new bone formation in the periosteum leading to sinus and skin discharge

20
Q

how long do empirical antibiotics for an SAB have to be given

A

2 WEEKS!!

21
Q

Complications of osteomyelitis

A

chronic osteomyelitis

secondary amyloidosis and skin malignancy

22
Q

where does tb infection usually target

A
  • spine Pott’s disease or large joint

- pain swelling and fever