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MSK > Infections > Flashcards

Infections Flashcards

1
Q

Which bugs can cause MSK infections?

A 
Staph aureus 
Staph epidermidis
Strep pyogenes
Gram -ve 
Anaerobes
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2
Q

Define adult osteomyelitis

A

Inflammation of bone and medullary cavity, usually located in one of the long bones

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3
Q

What happens to the periosteum in infection?

A

Elevated due to infected pus filled abscess

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4
Q

What happens in chronic osteomyelitis?

A

Bone responds to injury by producing bone - the infected bone becomes enveloped in a shell of new bone

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5
Q

What is the gold standard investigation for osteomyelitis?

A

Bone biopsy

MRI/CT also useful

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6
Q

When would you be suspicious of an ulcer?

A

> 2cm >2 months

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7
Q

How are infections of bone treated?

A

Debridement and 6 weeks of antibiotics

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8
Q

What are the virulence factors of staph aureus?

A

Coagulase

Toxins - PVL, SSS, TSS

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9
Q

How are open fractures characterised?

A

Non-union and poor wound healing

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10
Q

What characterises a diabetic infection?

A

Probe to bone

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11
Q

Which drug is used for a true penicillin allergy?

A

Vancomycin

Doxycycline

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12
Q

Who is at risk of haematogenous infection?

A

Prepubertal children
PWID
Central lines/dialysis
Elderly

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13
Q

Where can haematogenous infection spread from?

A 
Throat 
Skin 
UTI 
GI 
Lung
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14
Q

What are the characteristics of PWID bone infection?

A

Unusual sites - staph and strep
Sacroiliac and sternal joints
Unusual PWID - candida, pseudomonas, mycobacterium tuberculosis

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15
Q

Which bug are dialysis patients susceptible to?

A

Staph

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16
Q

Name four unusual patient groups

A
  • sickle cell
  • gauchers
  • synovitis acne pustolosis hyper-stasis
  • chronic recurrent multifocal osteomyelitis
17
Q

How are vertebral infections usually acquired?

A

Haematogenous associated with epidural/psoas abscess

18
Q

How does vertebral osteomyelitis present?

A

Insidious pain
Tenderness
Inflammatory markers increased

19
Q

How is vertebral osteomyelitis treated?

A

Drainage of abscess

6 weeks antibiotics

20
Q

What is the name for vertebral TB?

A

Pott’s disease

21
Q

What are the risk factors for prosthetic joint infection?

A
  • rheumatoid arthritis
  • diabetes
  • malnutrition
  • obesity
22
Q

Describe the mechanism of prosthetic joint infection

A

Direct innoculation, manipulation at time of surgery or seeding of joint at later time

23
Q

Which pathogens cause prosthetic joint infection?

A 
Staph aureus 
Staph epidermidis 
Propionibacterium acnes 
Strep/enterococcus 
E.coli
24
Q

How is prosthetic joint infection diagnosed?

A

Culture preoperative tissue
Blood culture
CRP
Radiology

25
Q

How is prosthetic joint infection treated?

A

Remove prosthesis for at least 6 weeks
Aggressive antibiotic therapy
Re-implant

26
Q

What are the risk factors for arthroplasty?

A
  • preoperative adjustment
  • antibiotic prophylaxis
  • laminar flow theatre
  • doctors scrubbing technique
  • anti-infective implant
  • hydrogels
  • antibiotic impregnated cement
  • aftercare
  • wound dressing
27
Q

Which organisms cause septic arthritis?

A 
Staph aureus 
Streptococci 
Coagulase -ve (prosthetic joint)
Neisseria gonorrhoea (sexually active)
H influenza (children)
28
Q

How is septic arthritis investigated?

A

Aspirate joint fluid for microscopy

Blood culture if pyrexial

29
Q

How is septic arthritis treated?

A

Flucloxacillin

<5 years old ceftriaxone

30
Q

What can cause viral arthritis?

A

HBV
Paravirus B19
Rubella
Alphavirus

31
Q

What is pyomyositis?

A

Muscle inflammation caused infection

32
Q

What organism causes pyomyositis?

A

Staph

33
Q

Describe tetanus

A

Clostridium tetani, spores in soil

Related to muscle spasm and paralysis

34
Q

How is tetanus treated?

A

Antibiotics
Surgical debridement
Supportive measures

MSK (22 decks)

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