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Ortho-Rheum > Orthopaedic Infections > Flashcards

Orthopaedic Infections Flashcards

1
Q

soft tissue infection of the proximal or lateral nail folds; the most common hand infection

A

paronychia

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2
Q

what organism causes acute paronychia?

A

staph aureus

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3
Q

what pathogen causes paronychia in diabetic patients?

A

candida albicans

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4
Q

a patient presents with pain over the nail fold with erythema and swelling. Dx?

A

paronychia

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5
Q

what will be seen on physical exam of an acute paronychia? (3)

A

fluctuance
nail plate discoloration
nail fold tenderness + erythema

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6
Q

what pathogen should we think of when a patient’s physical exam shows green nail plates?

A

pseudomonas

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7
Q

what is the no-op treatment for an acute paronychia? (2)

A

warm soaks
oral antibiotics: augmentin or clindamycin

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8
Q

what is the operative treatment for an acute paronychia? (3)

A

I&D
partial/total nail bed removal
oral antibiotics: augmentin or clindamycin

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9
Q

what is the non-op treatment for a chronic paronychia? (2)

A

warm soaks
topical antifungal: miconazole

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10
Q

what is the op treatment for a chronic paronychia?

A

nail plate removal

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11
Q

subcutaneous abscesses of the fingertip pulp

A

felon

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12
Q

what is the common cause of a felon? organism?

A

trauma
staph aureus

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13
Q

a patient presents with severe throbbing over tip of finger with erythema and pain +/- fluctuance. PE has tenderness over finger tip and localized swelling over distal phalanx. Dx?

A

felon

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14
Q

when is an xray indicated for a felon? (2)

A

hx of trauma
r/o fracture or foreign body

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15
Q

what is the treatment for a felon without an abscess? (2)

A

oral antibiotics
f/u within 2 days

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16
Q

what is the treatment for a felon with an abscess? (3)

A

I&D
antibiotics
+/- hospital admission

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17
Q

infection along the flexor tendon sheath, caused either by penetrating trauma over the volar side of the finger or spread from a felon, septic joint, or deep infection

A

pyogenic flexor tenosynovitis

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18
Q

what are the 2 most common organisms that cause pyogenic flexor tenosynovitis?

A

staph aureus (#1)
MRSA (#2)

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19
Q

a patient presents with pain and swelling over flexor side of finger. Dx?

A

pyogenic flexor tenosynovitis

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20
Q

what are the 4 Kanavel’s signs for pyogenic flexor tenosynovitis?

A

pain with passive extension of finger
finger held in flexion for comfort
swelling of entire finger
TTP along flexor tendon sheath

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21
Q

what is the treatment for a pyogenic flexor tenosynovitis?

A

I&D by ortho

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22
Q

what is a diabetic wound infection that is a complication of peripheral neuropathy?

A

charcot neuro osteoarthropathy

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23
Q

what is the most common cause of charcot neuro osteoarthropathy?

A

diabetes mellitus

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24
Q

diabetic foot infections begin as soft tissue infections but can lead to what?

A

bone infections

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25
Q

what is the most common cause of nontraumatic LE amputation?

A

diabetic wound infections

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26
Q

what are the most common pathogens of diabetic wound infections? (3)

A

staph aureus
MSSA/MRSA

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27
Q

a patient presents with plantar wound ulcers, redness, warmth, induration, swelling, painless malodor, and purulence. Dx?

A

diabetic wound infection

28
Q

what is the gold standard to evaluate for wound healing potential of diabetic wound infections?

A

transcutaneous oxygen pressures

29
Q

a serum albumin level of > 3 in diabetic wound infections indicates what?

A

increased healing potential

30
Q

what imaging helps identify abscess formation or osteomyelitis from diabetic wound infections?

A

MRI

31
Q

what is the management for mild diabetic wound infections? (4)

A

outpatient
oral antibiotics
wound care
pressure off-loading

32
Q

what is the management for moderate-severe diabetic wound infections? (3)

A

IV antibiotics
wound care
+/- surgical intervention

33
Q

what is the most common complication following orthopaedic trauma surgery?

A

post-op wound infection

34
Q

infection of the surgical site within 30 days, or 90 days if implant was used

A

post-op wound infection

35
Q

what is the most common post-op wound infection organism?

A

staph aureus (half of those are MRSA)

36
Q

a patient presents with cellulitis appearance on their leg, pain over surgical site, and erythema +/- drainage, +/- fever, chills, and night sweats. Dx?

A

post-op wound infection

37
Q

what on physical exam of a patient with a post-op wound infection requires an urgent surgery consult?

A

hardware exposure

38
Q

what is the most accurate diagnostic used for post-op wound infections?

A

deep cultures intra-operatively

39
Q

what is the most predictive lab for post-op wound infections?

A

CRP

40
Q

what should we do for all post-op wound infections?

A

refer to orthopaedic surgeon

41
Q

what is the non-op treatment for post-op wound infections? (2)

A

oral antibiotics
wound care

42
Q

what is the operative treatment for post-op wound infections? (3)

A

surgical debridement
oral antibiotics
+/- wound care

43
Q

flesh-eating disease that is a life-threatening bacterial deep soft tissue infection that spreads along fascial planes rapidly

A

necrotizing fasciitis

44
Q

post-surgery patients with which 2 co-morbidities have an increased risk for necrotizing fasciitis?

A

peripheral vascular disease
diabetes mellitus

45
Q

what are the 3 common bacterial causes of necrotizing fasciitis? (3)

A

strep pyogenes
clostridium perfringens
vibrio

46
Q

a patient presents with rapidly progressing erythema with tense edema, fever, tissue tenderness, and pain out of proportion to appearance of skin. Dx?

A

necrotizing fasciitis

47
Q

what are 3 clinical features of necrotizing fasciitis that occur in the later stages?

A

tachycardia
hypotension
AMS

48
Q

what is the scoring system used for necrotizing fasciitis?

A

Lrinec scoring system

49
Q

what is the treatment for necrotizing fasciitis? (3)

A

emergency radial debridement
IV broad spectrum antibiotics
+/- extremity amputation

50
Q

infection of the bone caused via bloodstream, cellulitis, or penetrating trauma

A

osteomyelitis

51
Q

what is the most common organism that causes osteomyelitis?

A

staph aureus

52
Q

what organism do sickle cell patients suffer from if they have osteomyelitis?

A

salmonella

53
Q

what organism do infants suffer from if they have osteomyelitis? (2)

A

group A and B strep

54
Q

what organism do DM patients suffer from if they have osteomyelitis?

A

pseudomonas

55
Q

what is the most sensitive lab for osteomyelitis?

A

CRP

56
Q

what imaging is best for diagnosing early osteomyelitis?

A

MRI - shows bone and soft tissue edema

57
Q

what should we do for any patient with osteomyelitis?

A

refer to ortho for treatment

58
Q

inflammation of the joint due to infection

A

septic joint infection

59
Q

where in the body does septic joint infection most commonly occur? (3)

A

shoulder
hip
knee

60
Q

what organism should we suspect to be the cause of septic joint infection in a healthy sexually active young adult?

A

neisseria gonorrhea

61
Q

what is the most common organism that causes septic joint infection in all patients?

A

staph aureus

62
Q

what is the most classic sign of septic joint infection?

A

inability to bear weight + pain with axial load

63
Q

what is the gold standard for diagnosis and treatment of a septic joint infection?

A

joint aspiration

64
Q

what lab level is diagnostic for septic arthritis?

A

WBC > 50,000

65
Q

what is septic joint infection considered?

A

orthopaedic emergency

66
Q

what is the treatment for septic joint infection? (2)

A

irrigation + debridement + intraoperative cultures
empiric broad spectrum IV antibiotics

67
Q

what can delayed diagnosis of septic joint infection lead to?

A

cartilage damage within 8 hours

Ortho-Rheum (27 decks)

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