Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Infectious disease > Osteomyelitis > Flashcards

Osteomyelitis Flashcards

1
Q

Origin of infections in bone

A

Haematogenous spread ()
Direct ioculation
Contiguous spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Haemotogenous spread in osteomyelitis

A

staph aureus, slamonells in children w sickle cell
TB
Brucellosis - ulcers in diabetic foot - deep enough to get to bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of bacteria form biofilms on prosthetics

A

Negative staphylococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why are biofilms esp dangerous

A

Resistant to immune defenses and antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What diseases and devices are biofilms implicated in

A

Infective endocarditis
Ventilator ass pneumonia
Central line infection
Cystic fibrosis lung infections
Chronic oseteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are biofilms

A

Structured community microorganisms adhering to surface and producing extra cellular matrix of polysaccharides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bacteria free vs biofiml

A

Planktonic = free
sessile = biofilm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why are most antibiotics not effective against sessile bacteria/biofilms

A

Bacteria are quiescent - not dividing, and antibiotics target beta lactamase within the cell wall
Difficulty penetrating thrugh ECM biofilm also phagocytes struggle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Epidemiology of osteomyelitis

A

Diabetes increasing
Arthroplasty surgery increSING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prosthetic joint infection presentation

A

Joont pain
Evidence inflammation surgical site - sometimes looks asbolutely clean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vertebral osteomyelitis presentation

A

Back pain - localised, weeks/months
Nerve roots - reticular, landscape pain
May -> neuro signs if vertebral column unstable, weakness arms and legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Presentaton of chronic osteomyelitis

A

Sinus tracts
>2cm3 ulcer in DM
Non healing fractures
loosening prosthesis #

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Investigation tests in osteomyelitis

A

No fever
Bloods - FBC, U+Es, CRP, blood cultures (ACUTE)
Joint aspiration, bone biopsy, tissue biopsy, sonication of excised prosthetic material
Plain X ryas, CT scans, MRI scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What see on xray osteomyelitis

A

Has to be severe
Bone loss - lucency and bone deposition - sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why are antibiotic courses for osteomyelitis prolonged and how long for

A

Infected bone loses blood supply - antibiotics wont reach - need time for bone to revascularise
6 week course for vertebral and prosthetic koint infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How long course antibiotics for septic arthritis

A

Four weeks

16
Q

How are antibiotics delivered

A

Recent research - IV and oral antibiotics just as affective
OVIVA trial - v similar, shorter stay in hospital with oral+ therefore less complications

17
Q

What is main component of treatmnet

A

Debridement of area - orthopaedics and plastics (soft tissue), vascular if diabetic
May need to replace joint

18
Q

What bacteria are polymorphs and gram negative intracellular diplococci consistent with

A

Neisseria species

19
Q

What is DAIR

A

Debridemnet
Antibiotics
Implant retention

20
Q

What antibiotic use to treat skin staph aureus infection

A

Flucloxacillin

21
Q

Manamgeent immediate of chronic prosthetic joint infection presentaiton

A

The best course of action would be to take a swab of the discharge and send for bacterial culture and organise plain x ray of the knee and discuss with senior member of orthopaedic team (patient is stable so need to commence antibiotic immediately)

22
Q

Gram positive cocci on Gram stain, catalase positive, coagulase negative

A

Likely organisms coagulase negative
Staphylococcus

23
Q

Management of chronic prosthetic infection

A

Removal and bone cmeent w generous debridement to remove all infected and necrotic tissues
Implant cement spacer containing vancomycin
Minimum 6 weeks teicoplanin therapy
Reimplantation new prosthesis after

24
Q

Causative organisms of prosthetic joint infection 0-3 months post op

A

S.aureus
Strp pyogenes
Enterococcus sp
Gram negative bacilli

25
Q

Causative oragnisms of delayed presentation prosthetic infection (4-24 months post op)

A

Coag negative staph
Propionibacterium acnes
Other skin commensals

26
Q

Causative oragnisms of late infection (>24 months post op)

A

Coag negative staph
S.aurues
Viridans streptococci
Gram negative rods, esp E coli
Anaerobes

27
Q

Gram positive cocci species causing native joint infection

A

Staph aureues
Step - pyogenes, pneumoniae, group B, viridans group

28
Q

Gram negative bacilli species causing native joint infection

A

Enteric gram negative bacilli eg eschericia coli
Pseudomonas aeruginosa
Eikenella corodens (human bite)
Pasteurella multicoda (animal bite)

In paeds esp:
Kingella kingae
H. influenzae

29
Q

Gram + bacilli and gram - cocci causes of native joint infection

A

Gram + bacilli - clostridium sp
Gram - cocci - n.gonorrhea

30
Q

Clinical presentation of chronic perprosthetic joint infection

A

Chronic pain
Loosening of prosthesis
Sinus tract - fistula - to surface, may be discharging

31
Q

What causative organsims of acute prosthesis are most common and why

A

Highly virulent
S.aureus
Gram -
e.coli
Klebsiella
Pseudomonas

32
Q

Causes of chronic prosthetic infection and why common

A

Coag negative staph
Cultibacterium acnes
Low virulence - dormant

33
Q

Surgical management acute prosthesis infection vs chronic

A

Acute - DAIR
chronic - Remove prosthesis, exchange in 1 stage, 2 stage or 3 stage eg bone cement and antibitoic placement and oral antibitoics

34
Q

Antibiotic management osteomyelitis

A

IV or oral
flucloxacillin (clindamycin if allergic)
MRSA/some chronic -> vancomycin (implant), teicoplanin
6 weeks minimum treatment
+/- fusidic acid and rifampacin

35
Q

Ass conditions osteomelitis

A

DM
PAD
Venous insufficiency
IVDU -> haematogenous spread
Peripheral neuropathy -> non haem spread
Sickle cell- infracted bone

Infectious disease (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions