MSK Microbiology

Question 1

what drug is used to treat staph aureus?

Answer 1

Flucloxacillin

Question 2

what is the side effect in the use of clindamycin?

Answer 2

C. diff

Question 3

where is adult osteomyelitis likely to occur?

Answer 3

long bone medullary cavity

Question 4

how do you class osteomyelitis?

Answer 4

by time

acute vs. chronic

Question 5

name the treatment approach to infection

Answer 5

debridement

antimicrobials

Question 6

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

Answer 6

osteomyelitis

Question 7

osteomyelitis is a medical emergency.

true or false?

Answer 7

false

only if sepsis too

Question 8

you must start empiric antibiotics immediately in chronic osteomyelitis.

true or false?

Answer 8

false*

you can afford to wait a few days

Question 9

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

Answer 9

6 weeks

Question 10

how long is the treatment in osteomyelitis?

Answer 10

6 weeks

Question 11

coagulase negative staph only really cause problems in those with prosthetics

true or false?

Answer 11

true

coagulase negative staph only virulent in presence of plastic and metal

Question 12

name examples of osteomyelitis

Answer 12

open fractures
diabetes/vascular insufficiency
haematogeneous osteomyelitis
vertebral osteomyelitis
***

Question 13

describe staph aureus

Answer 13

common
coagulase positive
gram positive
clusters
produce enzymes
***

Question 14

what is the clue in open fracture infection?

Answer 14

poor wound healing

Question 15

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

Answer 15

often polymicrobial but staph aureus is most common

Question 16

in diabetes/venous insufficiency, what is the treatment?

Answer 16

debridement and antimicrobials

Question 17

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

Answer 17

bone biopsy

Question 18

what drugs do you use for gram negatives?

Answer 18

gentamycin*

Question 19

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

Answer 19

vancomycin

Question 20

name the duration of treatment in diabetic foot infection.

Answer 20

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

Question 21

what drugs do you use for anaerobes?

Answer 21

metronidazole*

Question 22

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

Answer 22

Flucloxacillin IV
vancomycin if allergic
oral switch - doxycycline

Question 23

what drug is no use systemically?

Answer 23

vancomycin

topical treatment for bowel i.e. gastroenteritis

Question 24

who are the likely people to have haematogenous osteomyelitis?

Answer 24

prepubertal children
PWID
elderly

Question 25

what bone is most commonly affected in haematogenous osteomyelitis?

Answer 25

femur

Question 26

most common pathogen in endocarditis in PWID?

Answer 26

strep. viridians

Question 27

in vertebral osteomyelitis, what percentage have fever and what percentage have insidious pain?

Answer 27

50% - fever

90% - insidious pain

Question 28

what should you avoid in vertebral osteomyelitis initially?

Answer 28

empiric antibiotics

Question 29

how long should you be on antimicrobials for?

Answer 29

6 weeks minimum

Question 30

do you need to have pulmonary TB to have vertebral TB?

Answer 30

no - approx 50% do not

Question 31

what are the risk factors in prosthetic joint infection?

Answer 31

rheumatoidarthritis
diabetes
malnutrition
obesity

Question 32

what is time scale for early prosthetic infection?

Answer 32

less than a month

later is more than a month

Question 33

what is a biofilm?

Answer 33

extracellular matrix making a strong barrier to pathogen making it difficult for antimicrobials to work

Question 34

when is there re-implantation of the joint after infection?

Answer 34

after aggressive antibiotic therapy

Question 35

what is the classic tetanus - toxin mediated illness?

Answer 35

clostridium tetani

Question 36

describe clostridium tetani

Answer 36

Gm +ve

Question 37

what does tetanus cause?

Answer 37

spastic paralysis due to neurotoxin

Question 38

are survivors immune to tetanus?

Answer 38

NO