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MSK Block > Micro & Infections > Flashcards

Micro & Infections Flashcards

1
Q

What are the 4 G- rods with animal reservoirs?

A

brucella
francisella
pasteurella
bartonella

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2
Q

Features of Brucella

A

facultative intracellular

granuloma forming

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3
Q

How is Brucella transmitted?

A

transmitted through drinking contaminated milk or skin during butchering

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4
Q

How does Brucella present?

A 
joint/back pain
flu-like symptoms
depression
travel/unpasteurized milk history
blood cx negative because it has a long incubation period
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5
Q

How is Brucella treated?

A

6 wk combo:
doxycycline
streptomycin or rifampin

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6
Q

How is tularemia transmitted?

A

transmitted by ticks/flies from rabbits or cutaneous exposure to an infected animal

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7
Q

What is the disease caused by Francisella?

A

Tularemia

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8
Q

Features of Francisella

A

G- rod

found in central US

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9
Q

How does tularemia present?

A

ulcerations
fevers/muscle aches
painful axillary lymph nodes
exposure to rabbits or ticks

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10
Q

How is tularemia diagnosed?

A

serology

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11
Q

How is tularemia treated?

A

2 wks of 1:
streptomycin
gentamycin
doxycycline

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12
Q

What does Pasteurella look like under methylene blue?

A

bipolar staining

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13
Q

How is Pasteurella transmitted?

A

dog or cat bites

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14
Q

What infections does pasteurella cause?

A

osteomyelitis
endocarditis
meningitis

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15
Q

What is cat scratch disease?

A

Bartonella

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16
Q

How does Bartonella present?

A

fever
lymph nodes
bacillary angiomatosis in immunocompromised pts

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17
Q

What disease does Bacillus anthracis cause?

A

anthrax

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18
Q

How does anthrax present?

A 
cutaneous:
pigmented eschar
edema
Inhalation (wool-sorter's disease):
hemorrhagic mediastinitis
sepsis
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19
Q

What dz does Borrelia burgdorferi cause?

A

Lyme

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20
Q

Where does Lyme occur?

A

New England

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21
Q

How long does it take a tick to transmit Borrelia?

A

36-72 hrs

22
Q

What rash is ass’d with Lyme?

A

erythema migrans

23
Q

What are early signs of Lyme? (within 1 month)

A 
fever/chills
headache
muscle/joint pain
lymph nodes
erythema migrans
24
Q

What are the late signs of Lyme? (over 1 month)

A

severe headache/neck stiffness
facial palsy
more erythema migrans rashes
arthritis w/ severe pain/swelling

25
Q

How is Dengue virus transmitted?

A

Aedes mosquitoes

26
Q

How does Dengue fever present?

A

severe fever
rash
leukopenia
severe muscle/joint pain

27
Q

How does Dengue hemorrhagic fever present?

A

dengue fever

progresses to hemorrhagic shock

28
Q

How many serotypes exist of Dengue?

A

4

29
Q

What is antibody-enhanced disease?

A

antibodies recognize but don’t destroy new serotype
antibody-coated virus is taken up more quickly by cells
complement fixation leads to more vascular permeability

30
Q

What most commonly infects joint replacements?

A

staph epi

31
Q

What most commonly infects native joints?

A

staph aureus most common overall

Neisseria gonorrhoeae common in sexually active individuals

32
Q

How is septic arthritis diagnosed?

A

cloudy fluid with >20,000 PMN/ul and low glc compared to BG

33
Q

What is Pott’s disease?

A

spinal TB from hematologic spread

34
Q

Who gets bone/joint infections with nontyphoid Salmonella?

A

sickle cell pts

expanded bone marrow with low blood flow

35
Q

Where does osteomyelitis infect in kids and adults?

A

kids: metaphysis of long bones (doesn’t spread to joint)
adults: vertebral bodies, metaphysis spreading to joint

36
Q

Why are metaphyses more likely to be infected?

A

vessels make hairpin turns and have slow blood flow

37
Q

What osteomyelitis changes are seen on x-ray?

A

lytic lesions at the abscess

38
Q

Which joints have a physis within the joint capsule? Why is this important?

A 
allows direct spread on infection to joint
distal fibula
radial head/neck
proximal humerus
proximal femur
39
Q

How does osteomyelitis present?

A

local pain
fever
tenderness
elevated ESR, CRP

40
Q

How long does it take for osteomyelitis to show up on x-ray?

A

1-2 wks

41
Q

How is osteomyelitis treated?

A

antibiotics (oral/IV/local)

I&D or debriedment

42
Q

What are osteomyelitis complications?

A

infectious arthritis
chronic infection
recurrent infections

43
Q

How does chronic osteomyelitis appear on x-ray?

A 
"bone within a bone"
new bone (involucrum) growing around the dead bone (sequestrum)
44
Q

What is a Marjolin ulcer?

A

squamous cell carcinoma in a sinus tract or burn

45
Q

How is chronic osteomyelitis treated?

A

antibiotics
remove sequestra or implants
establish blood supply

46
Q

What is a commonly infected joints in IV drug users?

A

SC joint

47
Q

What are the most commonly infected joints?

A

hips

knees

48
Q

What are complications of septic arthritis?

A

synovial cell death
chondrolysis
condrocyte death
All begin within 24 hrs

49
Q

How does septic arthritis present? Diagnosed?

A

inflammation and effusion
ID effusion with ultrasound/MRI
Diagnosed with joint aspiration

50
Q

What is a potential cause of an infected shoulder replacement?

A

P acnes

MSK Block (19 decks)

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