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Urgent Care Guide > MS 3 > Flashcards

MS 3 Flashcards

1
Q

infectious tenosynovitis

A

infection of a tendon and surrounding sheath, causing inflammation and pain

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2
Q

infection of a tendon and surrounding sheath, causing inflammation and pain

A

infectious tenosynovitis

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3
Q

infectious tenosynovitis - usually involves what part of your body, symptoms, infection, typically the result of
3

A
  1. usually involves upper extremities - hands, fingers
  2. +/- systemic symptoms
  3. infection typically a result of direct inoculation from trauma or IV drug use
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4
Q

infectious tenosynovitis - ____ signs are suggestive of infectious tenosynovitis

A

Kanavel signs

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5
Q

infectious tenosynovitis - Kanavel signs include
4

A
  1. pain w/ passive extension - earliest sx
  2. fusiform swelling of the digit
  3. digit held in slight flexion at rest
  4. tenderness along tendon sheath - late finding
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6
Q

infectious tenosynovitis - img/testing

A

consider x ray to evaluate for bony involvement or subcutaneous emphysema

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7
Q

infectious tenosynovitis - infectious flexor tx

A

emergency - needs ortho, go to ER

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8
Q

non infectious tenosynovitis - tx

A

may be referred to Ortho or hand specialist

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9
Q

tenosynovitis - when to refer to ER

A

all suspected cases of infectious tenosynovitis

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10
Q

septic arthritis

A

infection in a joint, usually d/t bacteria

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11
Q

infection in a joint, usually d/t bacteria

A

septic arthritis

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12
Q

septic arthritis - clinical pres
2

A
  1. erythematous, warm, painful, edematous joint
  2. may have systemic sx - fever in <50%
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13
Q

septic arthritis - infection spreads how

A

through direct inoculation or hematogenous route (trauma to area, drug IV use, surgery, UTI, skin infection)

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14
Q

septic arthritis - risk factors
4

A
  1. skin infection
  2. recent procedure
  3. immunosuppression meds
  4. DM
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15
Q

septic arthritis - physical exam findings
2

A
  1. limited ROM - pain w/ passive and active ROM
  2. erythema, edema, effusion, warmth
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16
Q

septic arthritis - img/testing
2

A
  1. consider plain films to assess bony involvement, foreign body, subcutaneous emphysema
  2. US can help evaluate for fluid collection or abscess and assist w/ aspiration
17
Q

septic arthritis - gold std for dx
1

A
  1. joint aspiration (prior to starting abx) for fluid analysis including gram stain, cell count, culture, and crystal analysis - if available in ER, otherwise send to ER
18
Q

septic arthritis - tx

A

refer all suspected cases to ED for joint aspiration before abx start

19
Q

bursitis

A

inflammation of the bursa

20
Q

inflammation of the bursa

A

bursitis

21
Q

acute traumatic/hemorrhagic bursitis occurs from

A

direct trauma causing bleeding into the bursa

22
Q

chronic bursitis occurs from

A

microtrauma from repetitive friction (kneeling) or inflammatory conditions (gout, RA)

23
Q

septic bursitis occurs from

A

local infection or direct inoculation

24
Q

chronic inflammatory bursitis - presents as
4

A
  1. pain
  2. erythema
  3. limited ROM
  4. often r/t occupation (flooring, plumbing, janitorial industries)
25
Q

traumatic/hemorrhagic bursitis - presents as
3

A
  1. acute pain
  2. edema
  3. limited ROM
26
Q

septic bursitis - presents as
6

A
  1. acute pain
  2. edema
  3. erythema
  4. limited ROM
  5. hx of trauma
  6. immunocompromised
27
Q

chronic inflammatory bursitis - physical exam findings
4

A
  1. mild tenderness
  2. +/- erythema
  3. edema
  4. ROM usually preserved
28
Q

traumatic/hemorrhagic bursitis - physical exam findings
4

A
  1. edema
  2. acute pain
  3. +/- ecchymosis
  4. limited ROM
29
Q

septic bursitis - PE findings
6

A
  1. pain
  2. erythema
  3. warmth
  4. edema
  5. +/- fever
  6. +/- lymphadenopathy
30
Q

bursitis - img/testing, consider ordering
3

A
  1. plain film
  2. US
  3. aspiration
31
Q

bursitis - order plain film to check for
3

A
  1. bony involvement
  2. foreign body
  3. subcutaneous emphysema
32
Q

bursitis - US can assist w/

A

determining bursal involvement in the setting of significant edema from cellulitis as well as assist w/ aspiration

33
Q

bursitis - consider dx aspiration and evaluation what

A

fluid for gram stain, cell count, culture, and crystal analysis

34
Q

bursitis - DD
5

A
  1. joint effusion
  2. RA/OA
  3. septic arthritis
  4. cellulitis
  5. gout
35
Q

chronic inflammatory bursitis - tx
3

A

conservative - RICE, NSAIDs, avoid aggriv. factors

36
Q

chronic inflammatory bursitis - tx, what is rarely needed

A

aspiration and steroid injections

37
Q

traumatic bursitis - tx
2

A
  1. conservative - RICE
  2. consider therapeutic aspiration
38
Q

septic bursitis - tx
2

A
  1. consider aspiration prior to abx
  2. mild - cephalexin 500 mg PO q6H or bactrim DS 1-2 tabs PO q12h for 10 days
39
Q

septic bursitis - disposition

A

need aspiration prior to abx tx - send to ER if unable to do aspiration

Urgent Care Guide (38 decks)

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