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MSK 2.0 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

define osteomyelitis

A

inflammation of bone and medullary cavity, usually located in one of the long bones, unusual sites include pubic symphysis and clavicle

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2
Q

presentation of osteomyelitis

A

five features of inflammation

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3
Q

diagnosis of osteomyelitis

A
  • bone biopsy (GOLD standard)
  • wound swabs/blood cultures are not always diagnostic
  • cross sectional imaging may be helpful e.g. CT, MRI
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4
Q

management of osteomyelitis

A

await lab results, do not treat empirically (UNLESS SEPSIS)

surgery to remove infected tissue, drain and debride (takes 6 weeks to be covered by vascularised tissue)

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5
Q

causes of osteomyelitis

A 
open fractures
diabetes
vascular insufficiency
haematogenous spread
prosthetic join infection
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6
Q

common organism in open fracture osteomyelitis

A

staph aureus

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7
Q

organisms in PWID osteomyelitis

A

staph
strep
unusual pathogens e.g. pseudomonas, candida

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8
Q

why is dialysis a cause of osteomyelitis?

A

line high risk of staph colonisation

often co-morbidities including peripheral vascular disease and diabetes

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9
Q

what is vertebral osteomyelitis associated with?

A

epidural or psoas abscess

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10
Q

presentation fo vertebral osteomyelitis

A

insidious pain

tenderness

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11
Q

management of vertebral osteomyelitis

A

drainage

anti-microbial for 6 weeks minimum

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12
Q

risk factors for prosthetic joint infection include

A

RA
diabetes
malnutrition
obesity

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13
Q

how can prosthetic joint infections occur?

A

direct inoculation at surgery

seeding of joint at a later time

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14
Q

diagnosis of prosthetic joint infection

A

multiple perioperative tissues and if the same organism grows from multiple samples this increases significance
blood culture
CRP
radiology

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15
Q

what is frequently picked up in perioperative tissue samples in prosthetic joint infection?

A

staph epidermidis (coagulase negative staph) but are low virulence so are not causative

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16
Q

management of prosthetic joint infection

A

removal of prosthesis

re-implantation after aggressive antibiotic therapy

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17
Q

unusual patient groups

A
  • sickle cell osteomyelitis
  • Gaucher’s disease
  • SAPHO (adults) and CRMO (kids)
18
Q

causative organisms in sickle cell osteomyelitis

A

staph aureus

salmonella

19
Q

drug of choice for staph aureus

A

flucloxacillin IV (oral has poor bone penetration- when switching to oral use doxycycline)

20
Q

what to use against staph aureus if penicillin allergic

A

vancomycin

21
Q

drug of choice for staph epidermidis

A

vancomycin

22
Q

drug of choice for strep pyogenes

A

doxycycline

23
Q

drug of choice for gram negatives

A

clindamycin

24
Q

drug of choice for anaerobes

A

metronidazole

25
Q

how can septic arthritis be caused?

A

spread by direct invasion through penetrating wound, other infections e.g. cellulitis), spread from osteomyelitis or haematogenous spread

26
Q

define septic arthritis

A

inflammation of a joint space caused by infection

27
Q

bacterial causes of septic arthritis

A 
staph aureus
strep
coagulase negative staph (prosthetic joints)
neisseria gonorrhoea in sexually active
haemophilus influenza in pre-school
28
Q

diagnosis of septic arthritis

A

joint fluid for microscopy, culture and sensitivity
blood culture if pyrexial
exclude crystals

29
Q

management of septic arthritis

A

antibodies

surgery

30
Q

viral arthritis causes

A

alphavirus
hep B
parvovirus B19
rubella virus

31
Q

define pyomyositis

A

bacterial infection of skeletal muscle

32
Q

causative organisms of pyomyositis

A

staph
immunocompromised= pseudomonas, beta haemolytic strep and enterococcus
clostridial infection possible in contaminated wounds

33
Q

define myositis

A

diffuse viral infection of muscles

34
Q

causes of myositis

A 
HIV,
HTLV
CMV
rabies
chikungunya
other arboviruses
can also be fungal and parasites
35
Q

define tetanus

A

neurotoxin causes spastic paralysis (binds to inhibitory neurones, preventing release of neurotransmitters)

36
Q

cause of tetanus

A

clostridium tetani (gram +ve anaerobic rods that produce spores- found in soil and gardens)

37
Q

incubation of tetanus

A

4 days-several weeks

38
Q

presentation of tetanus

A

locked jaw

muscle spasms

39
Q

diagnosis of tetanus

A

culture (anaerobic gram +ve and spore is drumstick shaped)

serum and urine toxin assay

40
Q

management of tetanus

A

surgical debridement
antitoxin (preventative vaccine at 2, 3 and 4 months)
antibiotics (penicillin and metronidazole)
booster vaccine

MSK 2.0 (10 decks)

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