Infection - bone infection Flashcards by Jenna Dymond

infection spread to bone from other parts of body via blood stream then colonising and infecting blood marrow. what type of spread is this?

a. haemotogenous
b. contiguous

a.haemotogenous

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TB causing lung infection, neisseria gonorrhoea causing uretheral infection , staph aureus from venous catheter spread to bone via which type of spread?

a. haemotogenous
b. contiguous

a.haemotogenous

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what is contiguous spread?

a. by blood
b. directly to bone by superficial skin lesion
c. from bone to other bone
d. from bone to soft tissue

b.directly to the bone by superficial skin lesion

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trauma or chronic ulceration of the skin lead to bone infection via which type of spread?

a. haemotogenous
b. contiguous

b.contiguous

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osteomyelitis

infection of the bone

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what is a typical presentation of acute osteomyelitis in children ?

a. infectionn at epiphyeseal growth plates following contiguous spread
b. infection at epiphyseal growth plate following heamotogenous spread
c. infection at diaphysis following haematogenous spread
d. infection at diaphysis following contiguous spread

b. infection at epiphyseal growth plate following heamotogenous spread

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who is chronic osteomyelitis most prevalent in?

a. patients with ischamia / limb neuropathy especially lower limbs with diabetes
b. elderly patients with hypertension
c. patients with coronary heart disease and diabetes

a, patients with limb neuropathy/ischameia in lower limbs due to diabetes

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patient with diabetes leading to lower limb ischaemia and neuropathy. diagnosed with osteomyelitis. which type most likely?

a. acute
b. chronic

b. chronic

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which of these is a risk factor for chronic osteomyelitis ?

a. hypertension
b. marfans
c. diabetes
d. elderly

c.diabetes

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patient has pain localised at bone, fever, swelling, redness and tenderness what is likely diagnosis?

a. osteoperosis
b. osteromyelitis
c. isteosarcoma

b.osteomyelitis

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which of these is not a sign of osteomyelitis?

a. swelling
b. pain
c. fever
d. redness and tenderness
e. easy fractures

e.easy fractures

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where is chronic osteomyelitis most commonly found?

a. foot
b. arm
c. back
d. chest

a.foot (diabetic ulcers)

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why is chronic osteomyelitis increased in diabetics?

a. more bacteria present
b. neuropathy in lower limb means they can’t feel pain of inflammation
c. bones weaker

b. neuropathy in lower limb means they can’t feel pain of inflammation

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what is the gold standard to diagnose bone infection?

a. bone biopsy
b. blood culture

a. bone biopsy

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what type of spread is associated with acute osteomyelitis ?

a. haemotogenous
b. contiguous

a. haemotogenous

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what type of spread is associated with chronic osteomyelitis ?

a. haemotogenous
b. contiguous

b.contiguous

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blood culture taken from patient with suspected osteomyelitis .which bacteria most likely responsible for causing bone infection?

a. stretococcus progenies
b. neisseria gonorrhoea
c. staph aureus
d. TB

c.staph aureus

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in which type of osteomyelitis is staph aureus more likely the cause?

a. acute
b. chronic

a.acute

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patient with skin and soft tissue infection which bacteria most likely seen on culture?

aa. stretococcus pyogenes
b. neisseria gonorrhoea
c. staph aureus
d. TB

a. strep pyogenes

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patient has Potts disease. this is associated with which bacterial infecting the vertebral bodies?

a. stretococcus progenies
b. neisseria gonorrhoea
c. staph aureus
d. TB

d.TB

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which bacteria most likely found on culture of chronic osteomyelitis ?

a. stretococcus progenies
b. neisseria gonorrhoea
c. staph aureus
d. TB

c.staph aureus

but greater variety due to polymicrobial colonisation of ulcers

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how is septic arthritis spread?

a. contiguous
b. haemotogenous

b.haematogenous

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which pathogen most common in septic arthritis

a. stretococcus progenies
b. neisseria gonorrhoea
c. staph aureus
d. TB

c. staph aureus

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patient with metastatic joint infection which pathogen most likely on culture?

a. stretococcus progenies
b. neisseria gonorrhoea
c. staph aureus
d. TB

b. neisseria gonorrhoea

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what type of bacteria is salmonella? a. aerobic gram negative b. anaerobic gram negative c. aerobic gram positive d. anaerobic gram positive

a. aerobic gram negative

baby with septic arthritis which pathogen most likely responsible? a. stretococcus progenies b. neisseria gonorrhoea c. staph aureus d. TB e. salmonella

e.salmonella

osteomyelitis often coexists with what other condition? a. osteoporosis b. rheumatoid arthritis c. septic arthritis d. salmonella

c.septic arthritis

patient has discitis (infection of intervertebral disc) this is associated with osteomyelitis in which bones? a. associated ribs b. adjacent vertebral bodies c. lumbar bodies

b.adjacent vertebral bodies

patient with arthritis. tests show organisms present in the joint space. which type of arthritis is most likely? a. rhumatoid b. septic c. reactive

b.septic

patient has infection, this leads to associated arthritis.tests show non organisms in the joint spaces of bones affected. how would this be classified? a. rheumatoid b. septic c. reactive

c.reactive

what type of arthritis is reactive arthritis? a. infective b. inflammatory

b.inflammatory associated with immune reponse to infection at other site

patient has reactive arthritis following GI infection which bacteria most likely seen on culture? a. c diff b. staph aureus c. campylobacter d. e coli

c.campylobacter

patient has reactive arthritis and slapped cheek syndrome following glandular fever which organism most likely caused this? a. c diff b. staph aureus c. campylobacter d. e coli e. epstein barr

e.epstein barr

patient has reactive arthritis following sexually transmitted infection which bacteria most likely seen on culture? a. c diff b. staph aureus c. campylobacter d. e coli e. chlamydia

e.chlamydia

patient has osteomyelitis following prosthetic knee replacement. how would this infection be classified? a. SSSI m. clean contaminated c. DSSI d. clean

c.DSSI

patient has rely onset osteomyelitis following prosthetic knee replacement what bacteria most likely present? a. c diff b. staph aureus c. campylobacter d. e coli

b. staph aureus

patient has late onset prosthetic joint infection. which bacteria most likely seen on culture? a. c diff b. staph aureus c. campylobacter d. e coli e. staph epidermis

e. staph epidermis | b. staph aureus

first stage of approaching the treatment osteomyelitis a. consider if acute or chronic b. likely organisms involved c. is there. primary source of infection that has spread haemotogenously

b.likely organisms involves and pathophysiology

patient has dead bone sequestrum following osteomyelitis. what best describes the pathophysiology of this? a. bone dissolving b. pieces of dead bone detaching c. bone being unable to regenerate

pieces of dead bone detaching acts like foreign body providing four of infection

first consideration of treatment for osteomyelitis a. removal of de vitalised tissue/foreign bodies b. aspirating infected fluid collection c. long course of antibiotics d. high dose antibiotics via IV

a.a.removal of de vitalised tissue/foreign bodies

how are antibiotics prescribed for osteomyelitis? a. short course, high dose b. long course, high dose c. long course, low dose d. short course, low dose

b.long course high dose

why is healing following debridement impaired in patients with peripheral vascular disease/ diabetes? a. less oxygen reaching bones and antibiotics not reaching therapeutic window at site b. less nutrients reaching bones c. more bacteria present due to ulcers d. lack of control of motor fibres makes it hard to immobilise area

a.less oxygen reaching bones and antibiotics not reaching therapeutic window at site

patient with diabetic foot infection then followed by chronic osteomyelitis what would eb the ,most likely management cosideration? a. antibiotics b. pain killers c. debridement

c.debridement

patient with diabetic foot infection and osteomyelitis referred for amputation. what is the most likely amputation? a. toes b. foot c. lower leg d. whole leg e. upper leg

a. toes

why is a long dose of antibiotics given in osteomyelitis? a. to make sure antibiotic penetrates bone b. slow pace of osteoblast and osteoclast activity c. slow pace of osteoblast and osteocyte activity

b. slow pace of osteoblast and osteoclast activity

why is it important t use targeted rather than empirical antibiotics when treating osteomyelitis? a. resistance b. venous access and side effect risk c. limited resources for such a long course

b.venous access and side effect risk

what must be done prior to treatment of chronic osteomyelitis a. empirical given b. risk assessment c. sample taken for culture

c.sample taken for culture

which one of these is not an approach to treatment of osteomyelitis? a. suppressive b. curative c. surgical d. reconstructive

d. reconstructive

patient with osteomyelitis has multiple comorbidities and no symptoms due to neuropathy. surgery and antibiotics are high risk what treatment pathway would be most appropriate? a. surpressive b. surgical c. antibiotics

a.surpressive

what is the aim of surpressive treatment? a. reduce symtoms b. treta infection c. prevent deterioration or spread

c.prevent detonation or spread

what is given in surpressive treatment? a. long course high dose antibiotics IV a. long course high dose oral c. short course low dose oral d. long course oral antibiotics

d.long course oral antibiotics

for surpressive treatment which antibiotic is most appropriate ? a. amxicillin b. doxycycline c. vancomycin d. flucloxacillin

b.doxycycline

most common treatment for septic arthritis? a. antibiotic treatment b. drainage of infected fluid from joint space then antibiotics c. surgery

b.drainage of infected fluid from joint space then antibiotics

approx duration of antibiotics for septic arthiritis? a. 4 weeks b. 6 weeks d. lifelong

a. 4 weeks

approx duration of antibiotics for septic arthiritis if osteomyelitis in adajacent bone? a. 4 weeks b. 6 weeks d. lifelong

b.6 weeks

what is a two stage revision surgery

remove prosthetic give antibiotic containing granules into space for 6 weeks IV antibiotics given at same time remove granules and replace joint

what type of antibiotic is ceftriaxone ? a. penicillin b. cephalosporin

b.cephalosporin

beta lactic drug with a 6 membered ring adjacent to the beta lactam ring a. peniciilin b. amoxicillin c. flucloxacillin d. ceftriaxone

d.ceftriaxone

what generation of cephalosporin is ceftriaxone classified as? a. first b. second c. third d. fourth

c.third

what differs between generations of cephalosporin? a. side chains b. beta lactam ring c. shape

a.side chains

patient with past history of non life threatening allergy to penicillin is ceftriaxone appropriate for use? a. yes b. no

a.yes

how ais ceftriaxone given? a. IV b. orally c. IM d. topical

a.IV

what is the correct dosage for ceftriaxone given IV a. 1-2 x daily b. 4x daily c. 3x daily d. 6x daily

a.1-2 x daily

patient with osteomyelitis. culture shows saphylococci (a gram positive). what antibiotic most appropriate? a. penicillin b. ceftriaxone c. doxyxycline d. co amoxiclav

b.ceftriaxone

patient with osteomyelitis. culture shows streptococci (a gram positive). what antibiotic most appropriate? a. penicillin b. ceftriaxone c. doxyxycline d. co amoxiclav

b.ceftriaxone

first line treatment for suspected bacterial meningitis in adults? a. flucloxacillin b. doxycycline c. co amoxiclav d. ceftriaxone

d.cefttriaxone

strep pneumonia, haemophilus influenzae and neis. meningitis are the triad of common causes for what bacterial infection? a. meningitis c. salmonella d. chlamydia e. pneumonia

a.meningitis

principle adverse effect of ceftriaxone? a.nausea b.headaches c,diarrhoea d.confusion

c.diarrhoea

ceftriaxone use limited to what two purposes ?

OPAT and bacterial meningitis

what is the normal dose for ceftriaxone? a. 10g 12 hourly b. 1g 12 hourly c. 2g 12 hourly

b.1g 12 hourly

what type of antibiotic is doxycycline? a. cephalosporin b. tetracycline c. penicillin d. beta lactam

b.tetracycline

mechanism of action of doxycycline a. act on cell wall b. inhibit bacterial protein synthesis by acting on ribosomes c. insert into cell membrane stooping transport of peptidoglycan out of cytoplasm

b. inhibit bacterial protein synthesis by acting on ribosomes

how is doxycline administered? a. IV b. IM c. orally

c.orally

patient with stained teeth due to antibiotics. what antibiotic has this adverse effect? a. doxycycline b. ceftriaxone c. co amoxiclav d. vancomycin

a.doxycycline

what metal ions does doxycycline attract? a. Mg Na b. Mg Ca c. Na K d. Fe Mg

b. Mg Ca

patient on drugs containing calcium which antibiotic should be avoided? a. ceftriaxone b. doxycycline c. flucloxacillin

b.doxycycline

pregnancy, under 14 yrs and breast-feeding are contraindications for which antibiotic? a. doxycycline b. amoxicillin c. ceftriaxone

a.doxycyline

patient taking antibiotic for osteomyelitis has experienced photosensitivity and presents with a rash. which antibiotic is this linked to? a. ceftriaxone b. doxycycline c. vancomycin

b.doxycycline

antibiotic active against MRSA, strep pneumonia and staph aureus a. ceftriaxone b. doxycline

b.doxycycline

penicillin allergic patient with resp tract infection. culture shows MRSA. what antibiotic should be given? a. flucloxacillin b. doxyxycline c. ceftriaxone

b.doxyxycline

which antibiotic used as a suppressive treatment? a. doxyxycline b. ceftriaxone c. vancomycin

a.doxycycline

following 6 weeks IV antibiotic to cure osteomyelitis which antibiotic would be given for 6 weeks orally? a. amoxicillin b. co amoxiclav c. ceftriaxone d. doxycycline

d.doxycycline

What is OPAT?

out patient parenteral antibiotic therapy

what would be considered if the sole reason patient is in hospital is to receive IV antibiotics? a. oral antibiotics c. surgery d. OPAT

d.OPAT

risk of infection by which bacteria is decreased by OPAT? a. staph aureus b. c diff c. strep pneumonia d. e coli

b.c diff

what drug is used most often in OPAT? a. doxycycline b. ceftriaxone c. flucloxacillin

b.ceftriaxone