Wound, bone, & joint infection Flashcards
A 74 year old patient presents with a 3 hour history of sudden onset, intense pain in the right knee and a fever. Rank the following diagnoses given this information, with the most likely diagnosis given first.
Reactive arthritis
Rheumatoid arthritis
Septic arthritis
Osteoarthritis
Patellar tendonitis
Septic arthritis Reactive arthritis Rheumatoid arthritis Patellar tendonitis Osteoarthritis
Choose the most appropriate answer from the list
- Septic Arthritis
- Acute osteomyelitis
- Prosthetic Joint Infection
- Chronic osteomyelitis
- Haematogenous osteomyelitis
- Brodie’s abscess
- Vertebral osteomyelitis
- Cellulitis
- Spinal cord neoplasm
- Gout
60 year old diabetic patient presents with localized back pain, fever, malaise and swelling at the site of pain. Rasised CRP.
Vertebral osteomyelitis
Choose the most appropriate answer from the list
- Septic Arthritis
- Acute osteomyelitis
- Prosthetic Joint Infection
- Chronic osteomyelitis
- Haematogenous osteomyelitis
- Brodie’s abscess
- Vertebral osteomyelitis
- Cellulitis
- Spinal cord neoplasm
- Gout
29 year old patient presents with 1 week history of painful, red, swollen restricted knee joint. Raised CRP. High WCC (>50,000 WCC cells/mm3). Causative agent is Staphyloccus aureus. Patient is an i.v. drug abuser.
Septic Arthritis
Choose the most appropriate answer from the list
- Septic Arthritis
- Acute osteomyelitis
- Prosthetic Joint Infection
- Chronic osteomyelitis
- Haematogenous osteomyelitis
- Brodie’s abscess
- Vertebral osteomyelitis
- Cellulitis
- Spinal cord neoplasm
- Gout
Young patient presents with sudden fever, bone pain, swelling, restricted movement in elbow joint 3 weeks after injury.
Acute osteomyelitis
Choose the most appropriate answer from the list
- Septic Arthritis
- Acute osteomyelitis
- Prosthetic Joint Infection
- Chronic osteomyelitis
- Haematogenous osteomyelitis
- Brodie’s abscess
- Vertebral osteomyelitis
- Cellulitis
- Spinal cord neoplasm
- Gout
Patient presents 1 month after bilateral arthoplasty. Claims the joints haven’t “felt right”. Fever, leaking wounds, pain. Staphyloccus aureus was isolated.
Prosthetic Joint Infection
Choose the most appropriate answer from the list
- Septic Arthritis
- Acute osteomyelitis
- Prosthetic Joint Infection
- Chronic osteomyelitis
- Haematogenous osteomyelitis
- Brodie’s abscess
- Vertebral osteomyelitis
- Cellulitis
- Spinal cord neoplasm
- Gout
Sudden onset of excruciating pain in left MTP joint. Swelling and inflammation. High uric acid.
Gout
Choose the most appropriate answer from the list
- Blood culture and synovial fluid aspirate
- Open biopsy of the joint
- Chronic Osteomyelitis
- Plain X-Ray
- CT
- PO Flucloxacillin
- Enterobacter
- Prosthetic Joint Infection
- Infected Baker’s cyst
- Septic Arthritis
- IV Gentamycin
- Staph. Aureus
- MRI
- Strep Pyogenes
- Neisseria Meningitides
- Vertebral Osteomyelitis
A 48yo lady with a BMI of 28 presents to your rapid access clinic with a 3 week history of a painful L knee. On examination, you note the joint is oedematous and hot. She is pyrexial, has a reduced range of movement and feels generally lethargic. Upon further questioning, she reports having intra-articular steroid injections for her Rheumatoid Arthritis a month previously but otherwise she has no medical problems. What is your working diagnosis?
What should you do nex?
Septic Arthritis
Blood culture and synovial fluid aspirate
Choose the most appropriate answer from the list
- Blood culture and synovial fluid aspirate
- Open biopsy of the joint
- Chronic Osteomyelitis
- Plain X-Ray
- CT
- PO Flucloxacillin
- Enterobacter
- Prosthetic Joint Infection
- Infected Baker’s cyst
- Septic Arthritis
- IV Gentamycin
- Staph. Aureus
- MRI
- Strep Pyogenes
- Neisseria Meningitides
- Vertebral Osteomyelitis
A 69yo man is recovering on the surgical ward after surgery for L2/3 vertebral disc herniation and spinal canal compression. The operation went well but now he has spiked a temperature and is complaining of a ‘bad back’ and a pain in his leg. What diagnostic test is most sensitive in helping your diagnosis?
What causative organism do you suspect?
MRI
Staph. Aureus
Choose the most appropriate answer from the list
- Blood culture and synovial fluid aspirate
- Open biopsy of the joint
- Chronic Osteomyelitis
- Plain X-Ray
- CT
- PO Flucloxacillin
- Enterobacter
- Prosthetic Joint Infection
- Infected Baker’s cyst
- Septic Arthritis
- IV Gentamycin
- Staph. Aureus
- MRI
- Strep Pyogenes
- Neisseria Meningitides
- Vertebral Osteomyelitis
An 81yo Lady with Type 1 DM and a BMI of 26 presents to you in A&E, four weeks post bilateral hip replacement surgery. She is in pain, is not yet mobilising and is complaining that her hips have ‘never felt right’ since the surgery. Initial blood tests show Hb 140g/L, WCC 20x109/L, CRP 156, Plt 267, Na 134mmol/L, K 4.8mmol/L. Pelvic x-ray shows areas of lysis around the acetabular component of both joints and joint aspirate reveals 6700 WCC/ml. What do you suspect in this lady?
Prosthetic Joint Infection
Choose the most appropriate answer from the list
- Staphylococcus aureus
- Borrelia burgdorferi
- Escherichia coli
- Brucella abortus
- Pseudomonas aeruginosa
- Mycobacterium tuberculosis
- Kingella kingae
- Streptococcus pyogenes
- Coagulase negative staph
- Proteus mirabilis
- Haemophilus influenza
- Candida albicans
- Neisseria gonorrhoeae
- Bartonella henselae
- Salmonella
- Toxoplasma gondii
Most common causative organism in septic arthritis
Staphylococcus aureus
Choose the most appropriate answer from the list
- Staphylococcus aureus
- Borrelia burgdorferi
- Escherichia coli
- Brucella abortus
- Pseudomonas aeruginosa
- Mycobacterium tuberculosis
- Kingella kingae
- Streptococcus pyogenes
- Coagulase negative staph
- Proteus mirabilis
- Haemophilus influenza
- Candida albicans
- Neisseria gonorrhoeae
- Bartonella henselae
- Salmonella
- Toxoplasma gondii
Causes arthritis mainly in young children
Haemophilus influenza
Choose the most appropriate answer from the list
- Staphylococcus aureus
- Borrelia burgdorferi
- Escherichia coli
- Brucella abortus
- Pseudomonas aeruginosa
- Mycobacterium tuberculosis
- Kingella kingae
- Streptococcus pyogenes
- Coagulase negative staph
- Proteus mirabilis
- Haemophilus influenza
- Candida albicans
- Neisseria gonorrhoeae
- Bartonella henselae
- Salmonella
- Toxoplasma gondii
Most common cause of infective arthritis in teenagers and young adults
Neisseria gonorrhoeae
Choose the most appropriate answer from the list
- Staphylococcus aureus
- Borrelia burgdorferi
- Escherichia coli
- Brucella abortus
- Pseudomonas aeruginosa
- Mycobacterium tuberculosis
- Kingella kingae
- Streptococcus pyogenes
- Coagulase negative staph
- Proteus mirabilis
- Haemophilus influenza
- Candida albicans
- Neisseria gonorrhoeae
- Bartonella henselae
- Salmonella
- Toxoplasma gondii
Most commonly involves the vertebral column in adults and associated with wedging and/or collapse of vertebrae
Mycobacterium tuberculosis
Choose the most appropriate answer from the list
- Staphylococcus aureus
- Borrelia burgdorferi
- Escherichia coli
- Brucella abortus
- Pseudomonas aeruginosa
- Mycobacterium tuberculosis
- Kingella kingae
- Streptococcus pyogenes
- Coagulase negative staph
- Proteus mirabilis
- Haemophilus influenza
- Candida albicans
- Neisseria gonorrhoeae
- Bartonella henselae
- Salmonella
- Toxoplasma gondii
Most common cause of prosthetic joint infection
Coagulase negative staph
A 28 year old IV drug user presents to A&E with fever and back pain. He prepares his drugs using tap water and does not clean his skin prior to injecting. On examination, he was pyrexial at 40 degree Celsius, pan-systolic murmur on auscultation and tenderness over his thoracic spine on percussion.
Rank the following causative organisms given the above information, putting the MOST LIKELY organism first, and the least likely organism last.
A) Streptococcus pyogenes
B) Candida albicans
C) Escherichia coli
D) Staphylococcus aureus
E) Pseudomonas aeruginosa
Staphylococcus aureus Streptococcus pyogenes Pseudomonas aeruginosa Escherichia coli Candida albicans Pseudomonas aeruginosa
