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MSK (mine) > infections > Flashcards

infections Flashcards

1
Q

what is acute osteomyelitis

A

inflammation of bone and medullary cavity usually located in a long bone

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2
Q

what is the common cause of acute osteomyelitis

A

staph aureus

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3
Q

what are the investigations of acute osteomyelitis

A

MRI
bone biopsy = gold standard
stick a probe in and see if it touches bone
look and see if bone is visible

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4
Q

what is the treatment of acute osteomyelitis, when should it be carried out

A

treatment should take place once the organism is identified

debridement
specific antibiotics for 6 weeks

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5
Q

what are the two ways chronic osteomyelitis can occur

A

pus can enter into the joint cavity

pus can enter into the periosteum

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6
Q

what does chronic osteomyelitis result in

A

involucrum

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7
Q

what is involucrum, what causes it

A

new layer if bone growth outside the existing bone

this is due to the stripping off of the periosteum by the accumulation of pus within the bone, the new bone then grows from this periosteum

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8
Q

what are the investigations of chronic osteomyelitis

A

X-ray

MRI

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9
Q

what is the treatment of chronic osteomyelitis

A

not all require surgery: possible to live with it and just treat the flare ups

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10
Q

what is the spread of vertebral osteomyelitis

A

haematogenous

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11
Q

what is vertebral osteomyelitis associated with

A

epidural

psoas abscess

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12
Q

what are the causes of vertebral osteomyelitis

A

IVDU
IV
GU infection
post-op

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13
Q

what are the symptoms of vertebral osteomyelitis

A

fever in 50%
insidious pain/tenderness
raised inflammatory markers

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14
Q

what are the investigations of vertebral osteomyelitis, when would they be done

A

MRI
biopsy: repeat if fail to get info
open biopsy = if 2 x biopsy have failed

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15
Q

what is the treatment of vertebral osteomyelitis

A

drain abscesses
specific antibiotics for 6 weeks
repeat MRI

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16
Q

when would a repeat MRI be used in the treatment of vertebral osteomyelitis

A

unexplained increase in inflammatory markers
increasing pain
new anatomically related symptoms

17
Q

who is affected by haematogenous osteomyelitis

A 
children
elderly
IVDU
dialysis patients
patients with central lines
18
Q

what is septic arthritis

A

pus in the joint

19
Q

what is the spread of septic arthritis

A

haematogenous

metaphyseal

20
Q

what are the investigations of septic arthritis

A

microscopy
blood culture if pyrexial
exclude gout

21
Q

what is the treatment of septic arthritis

A

high dose flucloxacillin = presumptive to treat staph aureus + ceftriaxone if <5

adjust antibiotics when organism is confirmed

22
Q

what is pyomyositis

A

bacterial infection of skeletal muscles

23
Q

what is the cause of pyomyositis

A

90% = staph

24
Q

what is Synovitis Acne Pustolosis Hyperostosis Osteitis (SAPHO) known as in children

A

chronic recurrent multifocal osteomyelitis (CRMO)

25
Q

what are the symptoms of SAPHO/CRMO

A

exacerbations and remissions
fever
weight loss
generalised malaise

26
Q

what are the investigations of SAPHO/CRMO

A

samples = exclude osteomyelitis
raised inflammatory markers
X-ray = lytic lesions

27
Q

what investigations should be done if an infected arthroplasty is suspected

A

CRP
joint aspiration
bone scan
X-ray

28
Q

what is the history of an infected arthroplasty

A

problem with the wound

never been pain free

29
Q

what is the treatment of an infected arthroplasty

A

two stage revision

30
Q

what is tetanus

A

gram positive, anaerobic rods

31
Q

what does tetanus release

A

neurotoxin which causes spastic paralysis due to binding to inhibitory neurones preventing the release of neurotransmitters

32
Q

what is the incubation period of tetanus

A

4 days - several weeks

33
Q

what are the symptoms of tetanus

A

lockjaw

muscle spasms

34
Q

what is the treatment of tetanus

A

surgical debridement
anti-toxin
antibiotics
booster vaccination

35
Q

what antibiotics are used in the treatment of tetanus

A

penicillin or metronidazole

MSK (mine) (17 decks)

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