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My2 MSK > orthopaedics: osteomyelitis and MSK infections > Flashcards

orthopaedics: osteomyelitis and MSK infections Flashcards

1
Q

what is osteomyelitis

A

infection of bone including compact bone, spongy bone and bone marrow

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2
Q

what infective organisms normally cause osteomyelitis

A

occasionally fungal, usually bacterial: staph A (90%), H influenza, salmonella

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3
Q

how does osteomyelitis spread

A

haematological

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4
Q

what are the symptoms of osteomyelitis

A

fever, localised pain and tenderness over bone, erythema

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5
Q

what is an involucrum

A

new bone forming around dead, necrotic bone

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6
Q

what investigations are done in osteomyelitis

A

MRI>xray, blood cultures, biopsy and culture

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7
Q

who normally gets acute osteomyelitis

A

children (boys) and immunocompromised

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8
Q

why are children more likely to get osteomyelitis

A

metaphysis has torturous vessels with slow flow that can accumulate bacteria

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9
Q

what can subacute osteomyelitis lead to

A

brodies abscess

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10
Q

how do you treat acute osteomyelitis

A

IV AB, surgical drain of abscess, if AB fails then cultures and washout of infected bone

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11
Q

how do you get chronic osteomyelitis

A

untreated acute,

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12
Q

where does chronic where does it commonly affect commonly affect

A

axial skeleton (spine/ pelvis)

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13
Q

how do you manage chronic axial skeleton (spine/ pelvis)

A

surgical debridement and biopsy, bone grafting, long hospital recovery and IV AB’s

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14
Q

what should be avoided in osteomyelitis

A

emperic AB’s

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15
Q

who can get Haematogenous vertebral osteomyelitis

A

children, post trauma, IV drugs, diabetics, central lines

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16
Q

what is gold standard diagnosis in osteomyelitis

A

bone biopsy

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17
Q

what is Haematogenous vertebral osteomyelitis

A

infection of bone from blood spread elsewhere in body

18
Q

how do you manage Haematogenous vertebral osteomyelitis

A

drain and debride, avoid emperic AB’s unless sepsis, antimicrobials for 6 weeks

19
Q

name 3 unusual osteomyelitis

A

sickle cell, Gaucher’s disease, SAPHO, CRMO

20
Q

what causes TB osteomyelitis

A

blood spread from reactivated TB, usually affects spine

21
Q

what disease is common in TB osteomyelitis and what are the symptoms

A

Pott’s disease, asymptomatic

22
Q

who is at risk of prosthetic joint infections

A

RA, diabetes

23
Q

what are symptoms of prosthetic joint infections

A

haemotoma, puss,, tender, pain, loss of function

24
Q

what organisms cause prosthetic joint infections

A

normally staph epidermis, staph A, e.coli, pseudomonas, fungal

25
Q

how do you manage prosthetic joint infections

A

remove joint, vancomycin and replace

26
Q

how do you get septic arthritis

A

direct invasion from penetration which then spreads through blood

27
Q

what organisms commonly cause septic arthritis

A

staph A, strep, N gonnorhea, H influ (kids), e.coli (elderly, IV drug users)

28
Q

what are symptoms of septic arthritis

A

red, hot, swollen, sore, not working, fever, systemically V unwell

29
Q

what viral causes can cause arthritic sepsis

A

hep B, parovirus

30
Q

how do you treat septic arthritis

A

presumed staph A –> fluclox, under 5 ceftriaxone (h influ), surgical wash out (avoid empiric ABs)

31
Q

what organisms cause pyomyositis

A

90% staph, pseudomonas, B haemolystic strep, enterocoous

32
Q

what causes tetanus and what type of bacteria is it

A

clostridium tetani, gram +ive anaerobic rod

33
Q

what do toxins of tetanus do

A

cause spastic paralysis eg lockjaw

34
Q

how do you treat tetanus

A

penicillin and metro, vaccines

35
Q

what antibiotic should be given to staph and strep

A

fluclox

36
Q

what antibiotic should be given to staph and strep if penicillin allergy

A

vancomycin

37
Q

what AB is given to staph epi

A

vanco

38
Q

what AB is given to strep pyogens

A

doxy

39
Q

what is given to gram -ive

A

clindamycin

40
Q

what is given to anaerobes

A

metro

My2 MSK (29 decks)

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