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Musculoskeletal System > Infections > Flashcards

Infections Flashcards

1
Q

MC cause of infectious arthritis

A

S. Aureus

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2
Q

Infectious arthritis in a pt with sickle cell

A

Salmonella

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3
Q

Osteomyelitis

A

usually hematogenous spread of bacteria, S. Aureus MC cause, bone pain with systemic signs of infection, lytic focus (sequestrum) surrounded by sclerosis (involucrum).

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4
Q

Risk Factors for septic arthritis

A

PREEXISTING ABNORMAL JOINT (RA, gout, etc.), advanced age, DM, IVDU, endocarditis, immunosupp

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5
Q

Septic Arthritis in IVDU and iatrogenic cause

A

P. Aeruginosa

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6
Q

Cat or dog bite (septic arth)

A

Pasteurella Multocida

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7
Q

Unpasteurized milk (septic arth)

A

Brucella - SI joint arthritis

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8
Q

MC joint affected by septic arthritis in children

A

Hip

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9
Q

Clinical presentation of septic arth

A

intense pain and loss of fxn over 1-2 week period, swelling, redness, warmth of joint, fever and malaise common. Not usually high fever or chills

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10
Q

Dx of septic arthritis

A

leukocytosis, elevated CRP and ESR, must get arthrocentesis of joint - >50,000 leukocytes usually

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11
Q

Tx septic arthritis

A

call ortho ASAP! to drain it, Vancomycin for GPC, cephalosporins or zosyn for GNR, Use both for negative stain result

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12
Q

Gonococcal Arth is more common in

A

Women, pts <40, lower SE status, MSM, illicit drug use, complement deficiencies (C5-C8) and SLE

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13
Q

Clinical Presentation of Gonococcal Arth

A

triad of dermatitis, tenosynovitis, migratory polyarthralgia/itis. Joint sx often severe and ASYMM Cultures not commonly positive

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14
Q

Lyme Disease Arth

A

late infection/Stage III - joint swelling and pain in large joints esp knee lasting a few weeks - months. Tx with doxy or ceftriaxone

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15
Q

Causes of Viral Arthritis

A

Rubella, parvo B19, HCV, HBV

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16
Q

Viral Arth

A

immune complex mediated, short duration arthralgia usually small joints of hands, often resolves spontaneously

17
Q

Prosthetic Joint Infections

A

S. Aureus > S. Epi or S. Sapro (coag neg) > Strep Species > GNB > Enterococci

18
Q

Clinical Presentation of Osteomyelitis

A

non specific pain, draining sinus tract - subacute to chronic presentation

19
Q

Stepped on a nail osteomy

A

Pseudomonas

20
Q

Tx of osteomyelitis

A

surgical + antibiotics; beta lactams and vanc MC used, linezolid against strep, staph, VRE; daptomycin against gram pos pathogens ~4-6 weeks IV therapy

21
Q

osteomyelitis in DM or vasc insufficiency

A

MRI very valuable, surgical tx + broad spec antibiotics, develop under ulcer

22
Q

Group B strep

A

Streptococcus agalactiae - cause of hematogenous osteomy in neonates. Also E. Coli

23
Q

Osteomyelitis in Sickle Cell patient

A

Salmonella and S. Aureus

24
Q

Osteomy in IVDU

A

S. Aureus, Pseudomonas, Candida, Serratia

25
Q

MTB osteomyelitis often affects

A

the spine - Potts disease

26
Q

Clostridium Perfringens

A

large gram pos rods, spore former, double zone of hemolysis on blood agar. Causes gas gangrene and food poisoning, alpha toxin (lecithinase) causes hemolysis, high mortality, tx with Penicillin G

27
Q

Covers pseudomonas

A

cefepime

28
Q

increases risk of Neisseria infection

A

terminal complement deficiencies

29
Q

cell type seen in chronic osteomyelitis

A

Polymorphonuclear cells - neutrophils

30
Q

fibroblasts mixed with osteoclasts at the edge of trabecula

A

brown tumor (osteitis fibrosa cystica) due to hperparathyroidism

31
Q

alpha toxin of Clostridium Perfringens

A

hemolytic toxin with phospholipase & sphingomyelinase action, causes platelet aggregation and adherence of neutrophils to endothelium, also a negative inotrope, inhibiting cardiac pump function

32
Q

theta toxin

A

(also known as perfringolysin O, PFO), a member of the cholesterol dependent cytolysin family that includes pneumolysin, streptolysin O, listeriolysin, septicolysin and others

33
Q

Neutrophils in gas gangrene

A

arriving at the site of infection adhere
to & accumulate along endothelium of arterioles,
capillaries and venules, but do not cross
the endothelium into infected tissue.

34
Q

arborizing pattern of cutaneous blood vessels + bullae

A

clostridial myonecrosis

Musculoskeletal System (9 decks)

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