Lecture 20 (0_0) Septic Arthritis

Question 1

inflammation of joint: infiltration of ____ and ____ causing a swollen, _____, and ______ joint

Answer 1

PMNs, phagocytes;

warm, painful

Question 2

previous joint ____ or compromised ____ ____ are predisposing factors for septic arthrits

Answer 2

damage (ie RA, OA)
host defenses (ie corticosteroid use)

Question 3

most common gram + cocci that cause septic arthritis

Answer 3

staph aureus > streptococcus

Question 4

_____ are more common causes of septic arthritis in the young, chronically ill, or IV drug users

Answer 4

gram neg bacilli

Question 5

most gram - bacilliary septic arthritis are secondary to ____ or ____ infections

Answer 5

UTI, skin

Question 6

____ is common in elderly patients. ____ and ____ are common in IV drug users. _____ can occur following animal bites

Answer 6

e. coli,
serratia, pseudomonas;
pasteurella multicoda

Question 7

foul smelling fluid or air seen on joint x-rays should clue you to _____ bacterial infections

Answer 7

anaerobic

Question 8

Vertebral ___ (_____ ____) accounts of skeletal septic arthritis

Answer 8

TB (pott’s disease)

Question 9

PMN infiltrate causes a ____ synovial fluid. There is also neovascularization, synovial proliferations, ____ tissue, and cartilage ______

Answer 9

purulent;
granulation;
destruction

Question 10

what causes the synovial/bone/cartilage necrosis in septic arthritis?

Answer 10

proteolytic enzymes released from PMNS in response to phagocytosed bacteria

Question 11

classic presentation:
poly or monoarticular?
sudden or gradual pain?
____ and ____

Answer 11

monoarticular, suddenly painful, swollen and warm

Question 12

What conditions most resemble septic arthritis>?

Answer 12

gout or pseudogout

Question 13

when acutely hot, what should be done to the joint?

Answer 13

aspiration/drainage of joint asap

Question 14

if gram positive cocci, use _____
if gram negative cocci, use ____
if gram negative rod, use ____

Answer 14

nafcillin or vanco if MRSA;
ceftriaxone;
aminoglycoside

Question 15

____ deficiency is associated with with increased risk of Neisseria bacteremia

Answer 15

C5-C9 complement

Question 16

presentation of gonococcal arthritis:

STD

Answer 16

S=synovitis of several joints
T=tenosynovitis
D=dermatitis

+ fever

Question 17

What kind of arthritis is seen with gonococcal infections?

Answer 17

migratory polyarticular, asymmetric

Question 18

treatment of gonoccocal arthritis

Answer 18

penicillin or ceftriaxone

Question 19

Cells that can be seen on wright strain of synovial fluid:

1. large transformed _____
2. synoival lining cell
3. reiter’s cell: ____ phagocytosing a ____
4. LE cell: ____ phagocytosing a _____ ____

Answer 19

lymphocyte;

monocyte, PMN;
monocyte, PMN nucleus