Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2 MSK > Microbiology > Flashcards

Microbiology Flashcards

1
Q

which antibiotic has a high CDIF risk

A

clindomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is adult osteomyelitis

A

inflammation of bone and medially cavity

usually in long bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how can osteomyelitis be classified

A

acute vs chronic (by time) -most common
contiguous vs haematogeneous (by spread)
host status eg. presence of vascular insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how is osteomyelitis confirmed

A

direct biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

diagnostic factor for osteomyelitis

A

if you can see tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is osteomyelitis treated

A

await microbiological diagnosis
treat with the appropriate antibiotics
EXAM Q
no empiric antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

investigations for osteomyelitis

A

good standard- bone biopsy

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

5 features of infection seen in osteomyelitis

A 
calor
rubor 
tumor 
dolor 
functino laesa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

why does bone infection occur

A

due to necrosis

or a bacteria with high inoculum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the aims of surgery for osteomyelitis

A

remove infected tissue

drain and debride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how long does debrided bone take to be covered by vascularised soft tissue

A

6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most common sites of bone infection

A 
prosthetic joint infection 
diabetic foot infection (vascular insufficiency) 
post-traumatic infection (open fracture)
vertebral osteomyelitis 
haemotogeneous osteomyelitis (IVDU)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when do coagulase negative staph cause problems

A

mainly in people who have prosthetics, however usually just a commensal

coagulase positive staph are much much more virulent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

is fever a reason to start empiric antibiotics for osteomyelitis before getting results back

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

is sepsis a reason to start empiric antibiotics in osteomyelitis

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does coagulase do

A

clots plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

antibiotic for staph aures

A

flucloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

coag negative staph is golden true/false

A

false
coag positive staph aures is gold
coag negative staph is white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what bacterial infection open fractures

A

staph areas

gram negative bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how to treat open fractures osteomyelitis

A

aggressive debridement
fixation
soft tissue cover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

clinical signs of open fracture osteomyelitis

A

non-union and poor wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when are diabetic ulcers likely to get infected

A

when ulcer is >2cm for >2months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what microbes infect diabetic ulcers

A

polymicrobial however often staph aures

treat staph aures first and if no improvement treat gram negative too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

treatment for infected diabetic ulcers

A

probe to bone (diagnostic)

debridement and antimicrobials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the best diagnostic test for osteomyelitis

A

bone biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

best imaging for osteomyelitis

A

MRI

rely on MRI if patient cant go to theatre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how do u treat a mild diabetic ulcer infection

A

flucloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how to treat moderate diabetic foot ulcer infection

A

flucloxacillin (oral) + metronidazole (oral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how to treat severe diabetic foot ulcer infection

A

flucloxacillin (IV)
Gentomycin
metronidazole
7 days (14 if blood infection, 6 weeks if osteomyelitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

does fluclox cover MRSA

A

no but covered MSSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what does metronidazole cover

A

anaerobes

32
Q

what does gentamicin cover

A

gram negatives

33
Q

what antibiotics cover gram positives

A

fluclox/vancomycin if allergic

oral switch is doxycycline (to help get patient out of hospital quicker)

34
Q

what antibiotics cover gram -ve

A

gentamicin/aztreonam IV if severe

oral cotrimoxazole/doxycyxline

35
Q

can you switch IV vancomycin to oral

A

no because it isn’t absorbed

used as topical treatment for bowel in cdiff

36
Q

when is pseudomonas likely to be an infection

A

if its in bone or blood but not on skin

37
Q

significant organisms to not be ignored

A

staph aures
group A, B C or G strep
miller group
anaerobes

38
Q

what is haemotogenous osteomyelitis

A

bone infection from bacteria in blood

39
Q

who tends to get haemitogenous osteomyelitis

A

IVDUs (PWID)
prepubertal children
people with central lines/dialysis
elderly

40
Q

sources of infection in haemitogeneous osteomyelitis

A 
tonsils
throat 
teeth
skin infection 
GI
UTI 
mostly staph aures
41
Q

if person has staph aures in blood what do you do

A

remove all lines
treat with IV minimum 14 days
look for endocarditis
if endocarditis 4-6 weeks

42
Q

organisms found in blood of PWID

A

staph aures
strep viridians

unusual:
eikenella corrodes (needle lickers)
candida (heroin, or lemon juice)

43
Q

causes of haemotogenous osteomyelitis in PWID

A

continuous
haemotogenous
direct inoculation

44
Q

what organisms do people with sickle cell myelitis have

A

staph aures

salmonella

45
Q

SAPHO (adults) and CRMO (kids)

A

chronic lytic regions on X-ray that look like osteomyelitis

46
Q

how does vertebral osteomyelitis occur

A

mostly haematogenous
may be associated with epidural access or psoas access
may be associated with PWID, IV site infections, GU infections, SSTI, post op

47
Q

everyone with vertebral osteomyelitis have fever true/false

A

false 5%

48
Q

investigations for vertebral osteomyelitis

A 
MRI, Ga-67 scan 
vertebral biopsy (before antibiotics)
49
Q

treatment for vertebral osteomyelitis

A

drainage of large abscess
antimicrobials for 6 weeks minimum
expect >50% decrease in ESR
duration extended in complicated cases

50
Q

why would you repeat MRI in vertebral osteomyelitis

A

unexplained increase in inflammatory markers
increased pain
new anatomical signs

51
Q

those with vertebral tb also have pulmonary tb true/false

A

false

<50%

52
Q

risk factors for infection of prosthetic joints

A

rheumatoid arthritis
diabetes
malnutrition
obesity

53
Q

what are the mechanisms of infection in prosthetic joints

A

direct inoculation at time of surgery
manipulation of joint at time of surgery
seeding of joint at later time

54
Q

what is a biofilm

A

a layer of bacteria which is really close to the prosthetic and grows really slowly, difficult to treat with antibiotics

55
Q

where do you get biofilms

A

cystic fibrosis

anywhere you have metals or plastic

56
Q

pathogens which infect prosthetic joints

A 
staph aures
staph epidermis 
propionibacterium acnes (upper limb prosthesis) 
rarely strep 
e.coli, pseudomonas 
fungi 
mycobacteria
57
Q

how to diagnose prosthetic joint osteomyelitis

A

culture preoperative tissues
blood culture
CRP
radiology

58
Q

treatment for prosthetic joint osteomyelitis

A

removal of prosthesis and cement
antimicrobial therapy for at least 6 weeks
re-implantation of joint after aggressive antibiotic therapy

59
Q

how does septic arthritis occur

A

direct invasion through wound
ematogenous spread
spread from focus osteomyelitis in adjacent bone
spread from infection focus in adjacent soft tissues

60
Q

symptoms of PVL producing staph aures

A 
skin infection 
necrotising fascitis 
invasive infections 
bacteraemia 
septic arthritis
61
Q

what is septic arthritis

A

inflammation of the joint space caused by infection
can be blood born organisms
can be extension of local infection
can be introduced directly following injection or trauma

62
Q

bacterial causes of septic arthritis

A 
staph aures 
streotococci 
coag neg staph - prosthetics 
neisseria gonorrhoea -sexually active 
haemophilia influenzae- less common now bc of vaccination
63
Q

how to diagnose septic arthritis

A

clinical picture
joint fluid microscopy
blood culture
exclude crystals

64
Q

treatment for septic arthritis

A

high dose flucloxacillin
if <5 years old add ceftriaxone
adjust when organism confirmed

65
Q

what is pyomyositis

A

bacterial infection of the skeletal muscle

66
Q

who gets pyomyosititis

A

immunosuppressed

67
Q

What else can cause psyomyositis

A

viral - diffuse
fungal -v rare
parasites (Taenia- tape worm, trichenella (rare meat)

68
Q

what is myonecrosis

A

flesh eating bugs causing necrosis of muscle tissue

69
Q

what causes tetanus

A

clostridium tetani
gram +ve strictly anaerobic rods
spores
spores found in soil, gardens ect

70
Q

what happens in tetanus

A

neurotoxin causes spastic paralysis

71
Q

clinical signs of tetanus

A

extreme muscle spasm

spastic paralysis

72
Q

what is the incubation period for tetanus

A

4 days - several weeks

73
Q

tetanus treatment

A 
surgical debridement 
antitoxin 
supportive measures 
antibiotics... penicillin/metonidazole 
booster vaccination
74
Q

how to prevent tetanus

A

vaccination at 2,3,4 months

check green book

75
Q

how is tetanus diagnosed

A

clinically

culture v difficult

2 MSK (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions