Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MICBI - Clinical MICBI > L49 Bone and Joint infections > Flashcards

L49 Bone and Joint infections Flashcards

1
Q

What are the 3 classification of osteomyelitis?

A
  1. Hematogenous osteomyelitis
  2. Contiguous osteomyelitis
  3. Chronic osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hematogenous osteomyelitis occurs in children. Which anatomical site is MC?

A

Long bones near metaphysis
e.g. femur, tibia, humerus

(blood stream bacteremia > get stuck at the growth plate, Haversian canals can be seen)

Male:Female= 2:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hematogenous osteomyelitis occurs in adults with?

A
  1. Malignancies

2. IV drug abusers (vertebrae)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the clinical presentations of hematogenous osteomyelitis? (5)

A

Local

  1. Pain, erythema, swelling
  2. Pseudoparalysis (in children, avoid using one limb)
  3. Soft tissue abscess, sinus tract

Systemic

  1. Fever
  2. Sepsis? low BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In Xray, able to see irregular cortical lucency at the proximal tibia with periosteal reaction. Dx?

A

Hematogenous osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name the causative organisms of hematogenous osteomyelitis

  1. MC
  2. In neonates
  3. Elderly/debilitated
  4. In Hong Kong, need to consider
A
  1. Staph. aureus
  2. E.coli, Group B streptococci
  3. Coliforms (E.coli), Pseudomonas aeruginosa
  4. Mycobacterium tuberculosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How would you investigate to confirm diagnosis for hematogenous osteomyelitis? (3)

A
  1. Microbiological culture
    - Bone tissue
    - Blood
    - Needle aspiration
    - Sinus tract swab (not recommended, skin flora like S.epidermidis, bacillus may be tested)
  2. Imaging
  3. Inflammatory markers - ESR, WBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How to treat hematogenous osteomyelitis?

A
  1. IV cloxacillin for 2 weeks
  2. Oral cloxacillin for 2 weeks later

Generally 4 weeks of Abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Contiguous focus osteomyelitis can be due to direct inoculation of bacteria in trauma/surgical procedure.
What are the MC causative organism? (4)
What is the empirical treatment?

A

Causative organisms

  • Polymicrobial
    1. Staph. aureus
    2. Staph. epidermidis
    3. GN bacillus
    4. Anaerobes

Empirical Abx
- Amoxicillin-clavulanate (Augmentin) with GP, GP and a bit of anaerobe coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following about contiguous focus osteomyelitis with vascular insufficiency?

A. Diabetes mellutis is an example
B. Atherosclerosis is an example
C. Vasculitis is an example
D. It affects extremities 
E. Polymicrobial organisms is expected to be found
A

all of the above

DM: foot ulcers: vascular/neuropathy (not painful, patient may not be aware)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Time course of chronic osteomyelitis?

A

months to years

  • progress from hematogenous or contiguous osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is expected to be found in X ray of chronic osteomyelitis?

A
  1. Dead bone formation (sequestrum)
  2. Reactive new bone formation (involucrum)
  • may have sinus tract formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment to chronic osteomyelitis?

A
  1. Surgical debridement

2. 6 weeks of antibiotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is septic arthritis? (3)

A

Invasion of 1. synovial membrane by micro-organism, usually with 2. extension into joint, causing 3. close space infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risk factors of septic arthritis in
A. Children
B. Adults

A

A

  • none
  • sometimes a/w adjacent osteomyeltiis

B

  • bacteremia
  • IVDA
  • co-existing joint disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which of the following is correct about septic arthritis?
A. It is usually monoarticular
B. Knee, hip joints are commonly involved
C. Pain, swelling, hotness and erythema is common
D. Patient will have fever and systemic toxicity
E. Staph. aureus is the MC causative organism

A

All of the above

17
Q 
Staph. aureus is the MC organisms to septic arthritis.
What are the common organisms in:
1. Neonates
2. Pre-school children
3. Adult ***
4. Elderly
A
  1. E.coli, Group B streptococci
  2. Strep. pyogenes (Group A - cellulitis too)
  3. Neisseria gonorrhoea
    * *(PP! - Disseminated gonococcal infection)
  4. Pneumococci, GN bacilli
18
Q

How would you investigate for septic arthritis? (4)

A
  1. Joint fluid analysis
    - Gram stain
    - Culture + susceptibility testing
    - Crystals (gout)
  2. Blood culture
  3. Imaging
  4. WBC, ESR, Rheumatoid factor
19
Q

How would you treat septic arthritis?

A
  1. Surgical drainage/lavage of joint
  2. Cloxacillin (because mostly S.aureus)
    for 2-4 weeks

MICBI - Clinical MICBI (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions