Micro - wound bone + joint infections

Question 1

Rheumatoid arthritis patients are at risk of surgical site infections. What steps are taken to prevent SSIs in these patients?

Answer 1

stop DMARDs for 4 weeks pre-op –> 8 weeks post-op

Question 2

How does hair removal increase risk of SSI?

Answer 2

Razor –> micro abrasions of the skin

Question 3

Biggest RF for SSI after cardiothoracic surgery

Answer 3

Staph aureus colonisation in nasal mucosa

Question 4

How does temperature in surgery affect risk of acquiring SSI?

Answer 4

Hypothermia –> vasoconstriction –> less oxygenation –> risk of SSI

Question 5

Number 1 organism in SSI?

Answer 5

Staph aureus

Question 6

top 2 organisms in septic arthritis?

Answer 6

Staph aureus

Strep

Question 7

How does S aureus cause septic arthritis? i.e. how does it do its damage

Answer 7

has fibronectin binding protein + PVL toxin

Question 8

Number 1 organism in chronic osteomyelitis

Answer 8

S aureus

Question 9

best imaging for chronic osteomyelitis?

Answer 9

MRI

Question 10

Vertebral osteomyelitis - which part is most commonly affected?

Answer 10

Lumbar spine

Question 11

Management of chronic osteomyelitis?

Answer 11

Abx + debridement

Question 12

Radiology of prosthetic joint infection shows…?

Answer 12

“loosening” of joint

Question 13

2 causative organisms of prosthetic joint infection?

Answer 13

Staph + enterobacteriaceae

Question 14

Management of prosthetic joint infection?

Answer 14

Removal of prosthesis + replacement with Abx cement

Question 15

How to confirm diagnosis of prosthetic joint infection?

Answer 15

5 tissue specimens from around implant for microscopy