HIGH YIELD Flashcards
T/F, infectious agent in SA is a bacterial pathogen?
F
bacteria
virus
fungus
spirochetes
SA often results from?
occult bacteremia
describe the infectious pathogenesis route?
direct damage to joint leading to auto digestion of cartilage(cytokines released) leading to cartilage anoxia as a result of purulence
what are the types of infection?
hematogenous spread
direct inoculation
contiguous spread
major RF for hematogenous spread?
prosthetic joints
major RF for direct inoculation?
infection seeded into the joint
recent surgery
recent intra articular injection
prosthetic joint
major RF for hematogenous spread?
ulcerations
skin infections
trauma
eczema
in the physical exam, what is the most common presentation?
monoarticular or polyarticular
monoarticular
if polyarticular: asymmetric, 4+ joints, involves knee
-gonococcal
most common gonococcal pathogen responsible for SA?
nongonococcal?
N. gonorrhea
Staph (MRSA) and strep
DDx?
OA inflammatory arthriditis crystal induced arthriditis systemic infection AVN foreign body hemarthrosis trauma/fracture
major labs?
blood culture
CBC, CRP, ESR
renal and hepatic function
*synovial fluid analysis s/p arthrocentesis
SA tx?
abx
cephalosporin
vancomycin
*for bites, consider ampicillan/sulbactam
I&D of joint, decompress, improve blood flow and removes bacteria
repeat arthrocentesis
immobilize then mobilize
major concern in delayed or unsuccessful tx?
systemic progression
two of the following SIRS criteria?
temp>38 degrees celsius
HR>90 bpm
RR>20 breaths/min or PaCO2<32 mmHg
WBC<4000 cells/microliter or >12,000 or >10% bands
sepsis tx, other alternatives?
fluid resuscitation
antibiotics
vasoactive agents
intubation
