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Microbiology > Wound, Bone and Joint Infections > Flashcards

Wound, Bone and Joint Infections Flashcards

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1
Q

What is the most likely organism to cause a surgical site infection?

A

Staphylococcus aureus

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2
Q

At what concentration of microorganisms in tissue is the risk of a surgical site infection increased?

A

10^5 microorganisms per gram of tissue

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3
Q

What levels exist in surgical site infections?

A

Superficial: skin and subcutaneous tissue
Deep: fascia and muscle
Organ/Space: any part outside of the incision

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4
Q

Which of these is a gram positive coccus?

  • E. Coli
  • Enterobacter
  • Neisseria meningitides
  • MRSA
A

MRSA
E. coli is a gram negative rod
Enterobacter is a gram negative rod
Neisseria meningitides is a gram negative coccus

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5
Q

Which of the following is not a factor to consider in preoperative management of surgical site infections?

  • diabetes
  • weight
  • hair
  • showering
  • food intake
A

Food intake.

The rest have all been shown to affect the risk of surgical site infections

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6
Q

At what ASA score does the risk of surgical site infections increase?

A

3

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7
Q

How should one manage the drugs in rheumatoid arthritis before an operation?

A

Stop them 4 weeks before, and up to 8 weeks post op

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8
Q

At what BMI does risk of surgical site infection increase, and by how much?

A

35, 2-7 food increase

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9
Q

True or false, using razors to remove hair will reduce the risk of surgical site infections

A

False. Microabrasions can lead to multiplication of bacteria

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10
Q

When should antibiotic prophylaxis be given to prevent surgical site infections, and at what concentration?

A

At the time of anaesthesia, and a bactericides concentration must be maintained.

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11
Q

What are the guidelines to prepare the skin in operations, to prevent surgical site infections?

A

Chlorhexidine in 70% alcohol

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12
Q

At what level should the oxygen saturations of a patient be kept in theatre to prevent surgical site infections?

A

95%

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13
Q

What bacterial factors can contribute to septic arthritis?

A

Having protein receptors (fibronectin binding receptor) or cytokines production

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14
Q

Which of the following is a host factor which contributes to septic arthritis?

  • leukocyte derived proteases
  • reduced intrarticular pressure
  • interleukin 10
A

Leukocyte derived proteases

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15
Q

What is the most likely organism to have caused septic arthritis?

A

Staphylococcus aureus

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16
Q

What is the most likely joint to be affected in septic arthritis?

A

Knee

17
Q

What synovial WCC is indicative of septic arthritis?

A

> 50,000 cells per mm^3

18
Q

What part of the spine is most likely to be affected by vertebral osteomyelitis?

A

Lumbar spine

19
Q

What is the investigation of choice for vertebral osteomyelitis?

A

MRI

20
Q

A culture shows silvery growths of cocci. What is the most likely diagnosis?

A

Brucella

21
Q

In what technique to treat chronic osteomyelitis involves the introduction of a double lumen irrigation system?

A

Lautenbach Technique

22
Q

In what technique to treat osteomyelitis is a skin graft used to close the wound?

A

Papineau

23
Q

What is the most likely causative organism in a prosthetic joint infection?

A

Coagulase negative cocci

24
Q

A patient complains of hip pain after a hip replacement. At what CRP level is a prosthetic joint infection indicated?

A

> 5

25
Q

A patient complains of knee pain after a knee operation, at what WCC is a prosthetic joint infection indicated?

A

> 1700 cells per mm^3

26
Q

A patient complains of pain the knee after a knee replacement. At what CRP level is a prosthetic joint infection likely?

A

> 13.5

27
Q

A patient complains of hip pain after a recent hip replacement. At what WCC is the diagnosis of a prosthetic joint infection likely?

A

> 4200 cells per mm^3

28
Q

True or false, in two stage remission management of prosthetic joint infections, the infected joint is removed and replaced together, and the patient is brought back for a second stage of cultures.

A

False. The joint is removed, IV antibiotic course succeeds, and then a new joint is replaced.

Microbiology (22 decks)

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