MSK Microbiology Flashcards

Dr B Mooka

1
Q

what drug is used to treat staph aureus?

A

Flucloxacillin

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2
Q

what is the side effect in the use of clindamycin?

A

C. diff

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3
Q

where is adult osteomyelitis likely to occur?

A

long bone medullary cavity

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4
Q

how do you class osteomyelitis?

A

by time

acute vs. chronic

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5
Q

name the treatment approach to infection

A

debridement

antimicrobials

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6
Q

if you can see bone, see tendon and infection, what is the diagnosis?

A

osteomyelitis

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7
Q

osteomyelitis is a medical emergency.

true or false?

A

false

only if sepsis too

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8
Q

you must start empiric antibiotics immediately in chronic osteomyelitis.

true or false?

A

false*

you can afford to wait a few days

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9
Q

how long does debrided tissue take to be covered by soft tissue?

A

6 weeks

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10
Q

how long is the treatment in osteomyelitis?

A

6 weeks

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11
Q

coagulase negative staph only really cause problems in those with prosthetics

true or false?

A

true

coagulase negative staph only virulent in presence of plastic and metal

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12
Q

name examples of osteomyelitis

A
open fractures
diabetes/vascular insufficiency
haematogeneous osteomyelitis
vertebral osteomyelitis
***
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13
Q

describe staph aureus

A
common
coagulase positive
gram positive
clusters
produce enzymes
***
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14
Q

what is the clue in open fracture infection?

A

poor wound healing

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15
Q

in diabetes/venous insufficiency, what is the common pathogen?

A

often polymicrobial but staph aureus is most common

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16
Q

in diabetes/venous insufficiency, what is the treatment?

A

debridement and antimicrobials

17
Q

what is the way to tell you what the infection is? best test?

A

bone biopsy

18
Q

what drugs do you use for gram negatives?

A

gentamycin*

19
Q

what is the alternative to flucloxacillin for people with a penicillin allergy?

A

vancomycin

20
Q

name the duration of treatment in diabetic foot infection.

A

mild - 7days*
moderate - 7days*
severe - 7days*
osteomyelitis - 6 weeks*

21
Q

what drugs do you use for anaerobes?

A

metronidazole*

22
Q

name the drug and allergy alternative and oral switch for gram positive cover.

A

Flucloxacillin IV
vancomycin if allergic
oral switch - doxycycline

23
Q

what drug is no use systemically?

A

vancomycin

topical treatment for bowel i.e. gastroenteritis

24
Q

who are the likely people to have haematogenous osteomyelitis?

A

prepubertal children
PWID
elderly

25
what bone is most commonly affected in haematogenous osteomyelitis?
femur
26
most common pathogen in endocarditis in PWID?
strep. viridians
27
in vertebral osteomyelitis, what percentage have fever and what percentage have insidious pain?
50% - fever | 90% - insidious pain
28
what should you avoid in vertebral osteomyelitis initially?
empiric antibiotics
29
how long should you be on antimicrobials for?
6 weeks minimum
30
do you need to have pulmonary TB to have vertebral TB?
no - approx 50% do not
31
what are the risk factors in prosthetic joint infection?
rheumatoidarthritis diabetes malnutrition obesity
32
what is time scale for early prosthetic infection?
less than a month | later is more than a month
33
what is a biofilm?
extracellular matrix making a strong barrier to pathogen making it difficult for antimicrobials to work
34
when is there re-implantation of the joint after infection?
after aggressive antibiotic therapy
35
what is the classic tetanus - toxin mediated illness?
clostridium tetani
36
describe clostridium tetani
Gm +ve
37
what does tetanus cause?
spastic paralysis due to neurotoxin
38
are survivors immune to tetanus?
NO