Microbiology Flashcards

1
Q

most common organisms in MSK infections

A

Staph aureus
Streptococci
Coliforms

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2
Q

Common organisms in prosthetic joint infections

A

CoNS, proprionobacteria (diphtheroids)

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3
Q

less common but severe bugs

A

pseudomonas aeruginosa

kingella in under 5s

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4
Q

features of kingella

A

gram -ve

usually sensitive to amoxicillin

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5
Q

features of SIRS

A

2+ of

  • temp >38
  • HR>90
  • Resp rate >20 or PaCO2 12000 or
  • WCC >12000 or
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6
Q

what is septic arthritis

A

infection of the joint space

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7
Q

main organisms in septic arthritis

A

MSSA and Strep

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8
Q

Diagnosis in septic arthritis

A

arthroscopic washout/joint aspirate

Blood cultures

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9
Q

Treatment of septic arthritis

A

IV flucloxacillin

if

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10
Q

What is osteomyelitis

A

inflammation of bone and medullary cavity

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11
Q

what method of spread is most likely in acute osteomyelitis

A

haematogenous

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12
Q

Where is CoNS usually found

A

skin flora

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13
Q

what feature of CoNS infection makes it difficult to treat with antibiotics alone

A

biofilm

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14
Q

treatment of PJI

A

remove prosthesis and cement

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15
Q

what is necrotising fasciitis

A

acute and severe infection of the subcutaneous soft tissues

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16
Q

what is the clinical picture in necrotising fasciitis

A

pain disproportionately high to superficial inflammation

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17
Q

what causes Type 1 Necrotising fasciitis

A

anaerobes plus multiple other bacteria

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18
Q

what causes type 2 necrotising fasciitis

A

flesh eating bacteria

group A strep

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19
Q

treatment of necrotising fasciitis

A

surgical debridement

penicillin and clindamycin

20
Q

what does penicillin do

A

kills actively multiplying bacteria in their exponential growth phase

21
Q

what does clindamycin do

A

stops bacterial protein production

22
Q

what bug causes gas gangrene

A

clostridium perfringens

23
Q

features of clostridium perfringens

A

part of normal bowel flora

gram +ve strictly anaerobic rods

24
Q

what causes gangrene crepitus

A

spore germination and accumulation of gas bubbles in tissue space

25
Q

treatment of gas gangrene

A

urgent theatre debridement

high dose antibiotics - penicillin, metronidazole, hyperbaric oxygen

26
Q

what bug causes tetanus

A

clostridium tetani

27
Q

features of clostridium tetani

A

gram +ve strictly anaerobic rods

28
Q

where is clostridium tetani found

A

spores found in soil, gardens, animal bites etc

29
Q

features of tetanus

A

spastic paralysis

lock jaw

30
Q

treatment of tetanus

A

anti-toxin (immunoglobulin), penicillin, metronidazole, surgical debridement, booster vaccine

31
Q

What/When is the tetanus booster vaccine given

A

toxoid at 2/3/4m

32
Q

antibiotics used for staphs and streps

A

flucloxacillin, vancomycin, clindamycin

33
Q

antibiotics used for coliforms

A

gentamicin
cephalosporin like ceftriaxone
sometimes ciprofloxacin

34
Q

which bacteria are phenotypically resistant to antibiotics

A

bacteria in abscesses and biofilm

35
Q

what is the protocol for surgical prophylaxis

A

first dose given within 60mins of start of surgery, it should not be continued >24hr after surgery

36
Q

prophylaxis in orthopaedics

A

co-amoxiclav 1.2g peri-op and 2 post-op doses

37
Q

when do most cases of acute osteomyelitis occur

A

post-traumatic or in open fractures

may also occur in children or the immunosuppressed

38
Q

common organism to infect kids

A

haemophilus

39
Q

what causes osteomyelitis

A

trauma causing blood vessel wall damage which acts as a petri dish for passing bacteria

40
Q

what is an involucrum

A

new bone which forms around central dead bone

41
Q

most common site for chronic osteomyelitis

A

tibia

42
Q

how is gas seen on xray

A

little dark spots

43
Q

what does necrotising fasciitis cause?

A

surgical emphysema

44
Q

what bug usually causes discitis

A

staph

45
Q

common bugs which infect arthroplasty

A

staph aureus, staph epidermidis