Infectious Syndromes: Infectious Arthritis

Question 1

Which of the following are the most common cause of infectious arthritis
A. Neisseria gonorrhoeae and Streptococcus pneumonia’s
B. Staphylococcus aureus and Neisseria gonorrhoeae
C. Mycobacterium tuberculosis and Neisseria meningitis is
D. Streptococcus pneumoniae and Mycobacterium tuberculosis

Answer 1

Staphylococcus aureus and Neisseria gonorrhoeae

Question 2

Which of the following is true:
A. Synovial cell counts averaging 100, 000 /uL are characteristic of acute bacterial infections
B. Synovial cell counts with <90% neutrophils are characteristic of acute bacterial infections
C. Crystal induced arthritides are associated with cell counts of 100,000 / uL
D. Normal synovial fluid contains <200 cells/uL

Answer 2

A

Which of the following is true:
A. Synovial cell counts averaging 100, 000 /uL are characteristic of acute bacterial infections
B. Synovial cell counts with >90% neutrophils are characteristic of acute bacterial infections
C. Crystal induced arthritides are associated with cell counts of 10,000- 30,000 / uL
D. Normal synovial fluid contains <180 cells/uL

Question 3

Acute bacterial arthritis after surgical procedures or penetrating injuries are usually due to
A. S. aureus 
B. Pseudomonas aeruginosa
C. N. gonorrhoeae 
C. Eikenella corrodens

Answer 3

A

A. S. aureus
B. S. Pseudomonas aeruginosa- penetration of sharp object through a shoe
C. N. gonorrhoeae - young adults
C. Eikenella corrodens- human bite

Question 4

Treament of Nongonococcal Bacterial arthritis when smears are negative for an organism:

A. 3rd generation cephalosporin
B. Vancomycin
C. Cefazolin
D. Oxacillin

Answer 4

A

Question 5

Treatment for Nongonococcal Bacterial arthritis if there are gram positive cocci in smear

A. 3rd generation cephalosporin
B. Vancomycin
C. Cefazolin
D. Oxacillin

Answer 5

B

A. 3rd generation cephalosporin
B. Vancomycin
C. Cefazolin- When MRSA is unlikely
D. Oxacillin- When MRSA is unlikely

Question 6

Which of the following is true regarding the Manifestations of Gonococcal arthritis:
A. Cutaneous lesions and articular findings are consequences of an immune reaction to circulating gonoccoci
B. Cultures of synovial fluids are consistently positive
C. Migratory arthritis and tenosynovitis is rare
D. Small number of papules that progress to hemorrhagic pustules develop on the trunk and extensor surfaces

Answer 6

A.

A. Cutaneous lesions and articular findings are consequences of an immune reaction to circulating gonoccoci
B. Cultures of synovial fluids are consistently negative
C. Migratory arthritis and tenosynovitis is prominent
D. Small number of papules that progress to hemorrhagic pustules develop on the trunk and flexor *surfaces

Question 7

Initial treatment for Gonococcal Arthritis 
A. Azithromycin
B. Cefazolin 
C. Ciprofloxacin
D. Ceftriaxone

Answer 7

D

Question 8

Reactive polyarthritis may develop several weeks after an enteric infection due to the ff except 
A. E. Coli
B. Shigella flexneri
C. Campylobacter jejuni
D. Yersinia enterocoltica

Answer 8

A

Due to:
A. Salmonella
B. Shigella flexneri
C. Campylobacter jejuni
D. Yersinia enterocoltica

Question 9

Which of the following drugs is always included in treatment of prosthetics joint infections due to high cure rates and retention of the prosthesis 
A. Quinolone 
B. Vancomycin 
C. Rifampin
D. Anti staphylococcal penicillin

Answer 9

Rifampin

Plus any of the other choices

Question 10

Osteomyelitis in adults most commonly occurs where?
A. Femur
B. Patella
C. Humerus
D. Vertebral column

Answer 10

D. Vertebral column

Question 11

Most common cause of acute vertebral osteomyelitis 
A. E. coli
B. Pseudomonas aeruginosa
C. Mycobacterium tuberculosis
D. Staphylococcus aureus

Answer 11

D

A. E. coli- gram negative*
B. Pseudomonas aeruginosa
C. Mycobacterium tuberculosis- subacute*
D. Staphylococcus aureus

Question 12

Typical infecting agent in late onset implant associated spinal osteomyelitis 
A. P. Acnes
B. Coagulase- positive staphylococci
C. Viridians streptococci
D. Candida

Answer 12

A

P. Acnes or Coagulase- negative staphylococci

Question 13

Leading initial symptom of patients with vertebral osteomyelitis:
A. Fever
B. Paraplegia 
C. Back pain
D. Parenthesis

Answer 13

C. Back pain

Question 14

Gold standard is diagnosing vertebral osteomyelitis
A. CT scan
B. Spinal X-rays
C. MRI
D. PET

Answer 14

C. MRI

Question 15

Drug of choice for treatment of vertebral osteomyelitis caused by anaerobes 
A. Metronidazole 
B. Clindamycin
C. Imipinem
D. Methicillin

Answer 15

Clindamycin

Question 16

Drug of choice for treatment of vertebral osteomyelitis caused by Methicillin susceptible Staphylococcus spp

A. Penicillin G
B. Ciprofloxacin
C. Nafcillin
D. Ceftazidime

Answer 16

Nafcillin

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Question 17

Widely used staging system that classifies osteomyelitis accordingly to a atomic site , comorbidity and radiographic findings 
A. Williams 
B. Cierny-Mader
C. Waldvogel
D. Cobb’s

Answer 17

B

Question 18

Which of the following is true when diagnosing vertebral osteomyelitis:
A. Leukocytosis and neutrophilia have high diagnostic sensitivity
B. Increased CRP is found in 100% of cases
C. Increased ESR is found in 75% of cases
D. Blood cultures are positive in 90% of cases

Answer 18

B

A. Leukocytosis and neutrophilia have *low diagnostic sensitivity
B. Increased CRP is found in 100% of cases
C. Increased ESR is found in 98% of cases
D. Blood cultures are positive in 30 to 78% of cases

Question 19

Test used in diagnosing Foot osteomyelitis 
A. Spatula
B. Probe to Bone
C. Fork test
D. Semmes Weinstein monofilament test

Answer 19

B

Question 20

Most common pathogenisis of Sternal Osteomyelitis
A. Hematogenous spread
B. Entry of exogenous organisms after sternal surgery
C. Contiguous extension from adjacent sites of sternocostal arthritis
D. Exogenous infection following minor sternal trauma

Answer 20

B