orthopaedic infections Flashcards

1
Q

what are the risk factors for osteomyelitis?

A

diabetes
immunosuppression
surgical contamination
penetrating injury

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2
Q

what can cause the infection of the bone to develop?

A

haematogenous spread
peripheral vascular disease
prosthesis

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3
Q

what organisms can cause acute osteomyelitis?

A

staph aureus
streptococci
h.influenze

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4
Q

what organisms can cause chronic osteomyelitis?

A

TB
pseudomonas aeroigenosa
salmonella
ecoli

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5
Q

what is Potts disease?

A

TB infective spine disease that causes crush fracture of thoracic spine

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6
Q

what is salmonella osteomyelitis a complication of?

A

sick cell anaemia

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7
Q

what investigation is crucial for osteomyelitis ?

A

MRI

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8
Q

what is the treatment for acute osteomyelitis?

A

flucloxacillin (6 weeks) IV
clindamycin if allergic
vancomycin IV is MRSA

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9
Q

what is the treatment for chronic osteomyelitis?

A

antibiotics and debridement
flucloxicillin
MRSA or penicillin allergy:
co-trimoxazole or doxycycline

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10
Q

in prosthetic join infections, what causative organisms form early post operative?

A

staph aureus

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11
Q

in prosthetic join infections, what causative organisms form delayed post operative?

A

staph epidermis

propionbacterium acnes

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12
Q

in prosthetic join infections, what causative organisms form late?

A

staph aureus or E.coli

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13
Q

in early post operative infection, what is the time/route/presentation?

A

time: 0-3 months
route: perioperative
presentation: sepsis, warm joint with signs of effusion

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14
Q

in delayed post operative infection, what is the time/route/presentation?

A

time: 2-24 months
route: preoperative
presentation: persistent joint pain, loosening of prosthetic

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15
Q

in late operative infection, what is the time/route/presentation?

A

time: >24 months
route: haematogenous
presentation: acute or sub acute

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16
Q

what is prophylaxis for prosthetic joint infection?

A

co-amoxiclav (co-trimoxazole if allergic)

17
Q

what is the therapy for prosthetic joint infection?

A
dependent on culture results/if implant retained or replaced
given for approx 12 weeks
gram postive: flucloxacillin/vancomycin 
gram negative: ciprofloxaxin
if staph sensitive: rifampicin
18
Q

what are the most common causes of septic arthritis?

A

1st: staph aureus
2nd: streptococci

19
Q

what is the most common cause of septic arthritis in children?

A

h.influenza

20
Q

what is the most common cause of septic arthritis in adolescents?

A

gonorrhoea

21
Q

what it the most common cause of septic arthritis in the old/IVDU?

A

e.coli

22
Q

what should you think if multiple septic arthritis?

A

endocarditis

23
Q

what is the management of septic arthritis?

A

antibiotics +/- surgical wash out

fluxcloxacillin (clindamycin if penicillin allergic)

24
Q

what antibiotic should be added if children to cover h.influenza?

A

ceftriaxone

25
Q

what is and where does necrotising fasciitis happen?

A

severe subcutaneous tissue infection

most commonly abdominal wall, limbs and groin

26
Q

what are the two types of causative organisms of NF?

A

type 1: mixed anaerobes and aerobes

type 2: group A strep

27
Q

what is the management for NF?

A

start treatment before result obtained
debridement + antibiotics
IV penicillin + clindamycin

28
Q

what causes gas gangrene?

A

cholstridium perfingens (sporm forming, gram positive bacillus that is a strict aerobe)

29
Q

how does gas gangrene present?

A

usually following penetrative wound
skin discolouration
bubbling of the skin

30
Q

what is the management of gas gangrene?

A

urgent debridement and antibiotics:

penecillin and metronidazole

31
Q

what is the causative organisms of tetanus?

A

cholstridium tetani:
spore forming, gram positive bacillus that is a stoic anaerobe
drumstick shaped in culture
from rusty nails

32
Q

how does tetanus present?

A
following penetrative trauma 
spastic paralysis
lock jaw 
can affect breathing 
can be triggered by loud noises and bright lights
33
Q

what is the management of tetanus?

A

surgical debridement
antibiotics - penicillin and metronidazole
anti-toxin
vaccine