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MSK > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Treatments of choice for osteomyelitis (2)

A
  • Aggressive debridement

- Antimicrobials (IV)

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2
Q

Which % of all open fractures become infected?

A

Between 3-25%

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3
Q

Non-union and poor wound healing can indicate which condition?

A

Osteomyelitis

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4
Q

Common isolate in osteomyelitis

A

S. aureus

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5
Q

Osteomyelitis is only ever spread by direct inoculation. True/false?

A

False - can be haematogenous.

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6
Q

Needle-licking PWID are likely to develop which isolate?

A

Eikenella corrodens

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7
Q

Which % of dialysis patients develop infection?

A

7%

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8
Q

Most common pathogen in dialysis patients’ osteomyelitis?

A

S. aureus

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9
Q

Sickle Cell disease can predispose to osteomyelitis. True/false?

A

True

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10
Q

“A lysosomal storage disorder which can mimic bone crisis” is likely to describe which disease?

A

Gaucher’s Disease

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11
Q

Gaucher’s disease often affects which bone?

A

Tibia

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12
Q

Diabetic / vascular osteomyelitis is often polymicrobial. True/false?

A

True

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13
Q

The first-line investigation for a deep ulcer you suspect to cause osteomyelitis?

A

Probe-to-bone test + inflammatory markers

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14
Q

If there’s a positive probe to bone test in a deep ulcer, what is the next step in diagnosis of osteomyelitis?

A

Plain radiograph

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15
Q

In a deep ulcer which is an osteomyelitis concern, you check radiographs (2nd stage investigation) to find there’s no evidence of osteomyelitis. What’s the next step?

A

Osteomyelitis unlikely, consider soft tissue infection (2 weeks treatment)

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16
Q

If a radiograph is consistent with osteomyelitis, BUT not characteristic, what’s the next line of studies?

A

MRI

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17
Q

What is the definitive/ final investigation for diagnosis of osteomyelitis?

A

Bone biopsy

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18
Q

Haematogenous osteomyelitis presents in which 3 groups?

A
  • Prepubertal children
  • PWID
  • Central lines/ dialysis patients
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19
Q

Urogynae procedures can predispose to which form of osteomyelitis?

A

Osteitis pubis

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20
Q

Neck surgery can predispose to which form of osteomyelitis?

A

Clavicle osteo

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21
Q

Which pathogens are common in sickle cell osteomyelitis? (2)

A
  • Salmonella

- S. aureus

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22
Q

Gaucher’s disease is always infectious.

A

False

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23
Q

Plain X-rays are useful in diagnosing bone infection. True/false?

A

False

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24
Q

Which imaging modality could be useful in diagnosing bone infection?

A

Technetium bone scan (detects osteoblast activity)

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25
Q

Most common cause of acute osteomyelitis (1)

A

-Post trauma or open ounds

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26
Q

Most common organism causing acute osteomyelitis (2)

A

1) S. aureus

2) May also be haemophillus in children

27
Q

Does vertebral OM always present with fever?

A

No, only 50% of cases do

28
Q

What makes SAPHO/CRMO different from regular OM?

A

They are multifocal

29
Q

SAPHO is adults/kids?

A

Adults

30
Q

In OM, empiric antibiotics should be used ASAP. T/F?

A

False, wait until suggestive results

31
Q

How is vertebral OM treated? (4)

A

1) Drain abscess
2) Antibiotics for 6 weeks
3) Monitor ESR (should decrease by >50%)
4) Repeat MRI if ESR raises, pain increases or new symptom

32
Q

Skeletal TB is AKA

A

Pott’s Disease

33
Q

Skeletal TB is often symptomatic, T/F?

A

False - often asymptomatic

34
Q

Do skeletal TB / Pott’s Disease patients commonly have pulmonary TB?

A

Less than 50% have pulmonary TB

35
Q

If prosthetic OM develops <1 month from insertion of prosthesis, what was the likely source?

A

Wound sepsis

36
Q

If prosthetic OM develops >1 month from insertion of prothesis, what is the likely source?

A

Intraoperative

37
Q

PVL treatment

A

Fluclox

38
Q

What is a S. epidermidis virulence factor in OM?

A

Slime

39
Q

Pyomyositis describes what kind of infection

A

Pus-forming muscle infection

40
Q

Septic arthritis common cause

A

S. aureus

41
Q

How is septic arthritis diagnosed? (3)

A

1) Joint aspirate
2) C&S
3) Blood cultures if pyrexial (30-60% sensitive)

42
Q

What’s the standard treatment choices & route for acute OM or septic arthritis?

A

Flucloxacillin IV 2g QDS for 2 weeks, PO antibiotics for maximum 4 weeks

43
Q

What’s the antibiotic treatment & route for chronic OM?

A

PO flucloxacillin

44
Q

What’s the antibiotic treatment & route for MRSA-OM?

A

IV vancomycin

45
Q

Tetanus gram stain profile & growth condition

A

Gram positive rod, strict anaerobe

46
Q

“Drumstick shaped bacteria” is code for

A

C. tetani

47
Q

Treatment of tetanus (4)

A

1) Antitoxin
2) Surgical debridement
3) Supportive antibiotics (penicillin, metronidazole)
4) Booster toxoid vaccine

48
Q

Is the tetanus vaccine live?

A

No, it’s a toxoid

49
Q

Which book is recommended for vaccine advice in children?

A

The Green Book

50
Q

Children with skeletal TB should be offered which test? What should adults be offered?

A

Children -> IFNgamma assay

Adults -> HIV test

51
Q

What are the cardinal signs of inflammation?

A 
Rubor (redness)
Calor (heat)
Dolor (pain)
Tumour (swelling)
Functio lasea (loss of function)
52
Q

What bloods are useful in OM diagnosis?

A

CRP, PV, WBC count, blood cultures, ESR

53
Q

Technetium bone scan shows what kind of activity?

A

Osteoblastic

54
Q

What organism causes OM in children?

A

Haemophillus

55
Q

How is pus in OM treated?

A

Lancing, drainage

56
Q

What is a Brodie’s abscess?

A

An abscess that develops within bone due to a deep OM. The outer bone dies and acts as sequestrum, protecting the infection.

57
Q

What is a complication of Brodie’s abscess?

A

Involucrum formation.

58
Q

What is involucrum?

A

A layer of bone which forms external to the periosteum of a bone with a deep OM

59
Q

Are blood tests useful in diagnosis of COM?

A

No

60
Q

Cellulitis common causative organisms?

A

Staphs & streps

61
Q

How is cellulitis treated? (NHST antibiotic man)

A

Flucloxacillin 1g QDS, IV/PO for 7 days

62
Q

“Bony sinus” is a keyword for what

A

A DEEP bone infection

63
Q

2-step surgery is how successful in controlling infection in OM?

A

80-90%

MSK (21 decks)

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