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4 MBCHB > MSK 1 > Flashcards

MSK 1 Flashcards

1
Q

risk factors for prostethic joint infection

A

RA, DM, malnutrition, obesity

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2
Q

0-3 months early post op PJI caused by what and symptoms

A

SA, strep, enterococci

fever, warmth, effusion, drainage

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3
Q

3-12 months causes and symptoms

A

coag neg staph

persistent pain, device loosening, fistula

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4
Q

> 24 months spread how and what

A

blood spread

SA, E Coli

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5
Q

investigations for PJI

A

3 sets of culture, ECHO, ESR, CRP, FBC, U&Es, inflam markers

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6
Q

DAIR

how long course of antibiotics

A

debridement, antibiotics, implant retention

4-6weeks

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7
Q

2 stage how long

A

6 weeks of antibiotics then break for surgery

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8
Q

ABs given proph

PA

A

1.2g Co-amox peri op within 60 mins of op and then 2 doses post op within 72 hours of op
PA - cotrimoxazole

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9
Q

ABs in theatre

A

Cipro 400mg IV

Vancomycin IV

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10
Q

ABs on ward

A

Cipro 500mg BD
continue vanc
PO rifampicin if rifampicin sensitive staph

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11
Q

when should ciprof be stopped

A

if no GN bacteria on culture results

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12
Q

osteomyelitis is what

A

inflammation of bone and medullary cavity

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13
Q

Acute osteo

where

A

few days to 2w

shoulder, ankle, hip, elbow

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14
Q

chronic osteo

A

2w over
SIRS usually absent
delay in treatment of acute
No ABs till culture results

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15
Q

ix important to do and why

A

joint washout/aspirate for microscopy and culture in case septic joint

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16
Q

treatment of osteomyelitis

PA

A

Fluclox IV 2g QDS 2 w then ORAL total 4-6w

IV Clindamycin 600mg QDS

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17
Q

treatment of chronic osteo

A

PO fluclox 1g QDS

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18
Q

MRSA osteo

A

IV vanc

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19
Q

investigations for septic arhtiris

A

cultures, CRP, FBC, U&Es, ERP, lactate, fluid washout/aspirate, USS, MRI, XR, CT

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20
Q

symptoms of septic arhtritis

A

single joint
decreased ROM, pain, swelling, red, hot
systemic upset

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21
Q

treatment septic

A

IV fluclox 2g QDS for 2w then oral

PA IV clindamycin 600mg QDS

22
Q

if under 5 for septic

A

add ceftriaxone for HI and king ella cover

23
Q

SIRS is 2 or more of what

A

temp >38 or <36
HR >90
RR>20 or PaCO2 <4.3
WBC>12000 or <4000

24
Q

cellulitis treatment mild

A

oral fluclox 1g WDS for 7days

25
Q

if not resolving cellulitis

A

doxy 100mg BD for 7d

26
Q

septic cellulitis

A

fluclox 1g QDS IV 2g if BMI>30

27
Q

symptoms of abscess

A

defined and fluctuating, red, pain

history of trauma

28
Q

treatment of abscess

A

surgical incision and drainage
analgesia
splint
ABs

29
Q

gas ganagrene caused by what which is what

A

clostridium perfringes

GN strictly anaerobic rods

30
Q

how does gas gangrene happen and what are the predisposing factors

A

spores into tissue
PDF - dead tissue, anaerobic conditions
spores germinal creating gab bubbles which leads to crepitus

31
Q

treatment of gas gangrene

A

urgen debridement
penicillin or metro or both
+/- hyperbaric oxygen if severe

32
Q

tetanus causes by what which is what

A

clostridium tetanus

gram positive anaerobic rods

33
Q

where are tetanus spores found

incubation periods

A

soil, gardens, animal bites

4d-several weeks

34
Q

what does tetanus do

A

neuroxin - spastic paralysis - locked jaw - muscles spasm

35
Q

treatment of tetanus

A

surgical debridement
antitoxins
penicillin/metro
booster vaccination

36
Q

how long is tip toeing common

any action

A

<3s

wil resolve

37
Q

cavus feet causes

any action

A

can be inherited

if assymetrical investigate

38
Q

flat feet normal?
any action
causes

A

normal
resolves at ages 4-8
flexible ligamentous laxity
rigid - tarsal coalition

39
Q

intoeing causes

A

femoral neck anteverions
internal tibial torsion
metatarsal adductus

40
Q

femoral neck anteversion
check what
any action

A

hip rotational angle

resolves

41
Q

internal tibial torsion check what

any action

A

check foot shape. thigh-foot angle

resolves

42
Q

metatarsal adducts is what

any action

A

banana feet

resolves spontaneously if persists - cast

43
Q

out toeing normal

action

A

resolves by age 2

interfere if does not resolve as risk of patellofemoral pain

44
Q

bow legs are what
resolves?
when to investigate

A

genu varum
resolves by age 4-5
decreased height - skeletal dysplasia
assym - pathology

45
Q

knock knees another name for what
peak at when
what should the intermaleolar distance be at age 11

A

genu valgus

  1. 5 yo
    8cm. if >8 -> refer
46
Q

club foot is what

A

deformation of cavus

adducts varus equinos

47
Q

causes of clubfoot

associations

A

idiopathic

associated with CP, spina bifida, edwards, oligohydraminos, arthrogryoposis

48
Q

treatment of clubfoot

A

Ponseti method - cast and maniupalation from birth till 10-12 weeks
night brace till child is 4yo

49
Q

relapse rate of clubfoot

A

15%

50
Q

opposite of clubfoot

A

rocker bottom feet

4 MBCHB (80 decks)

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