125 - Infective Arthritis

Question 1

Acute infectious arthritis usually affect a __ joint. In patients with __ the infection can spread to __ joints

Answer 1

single
RA
multiple

Question 2

What are the main pathogens that cause infectious arthritis?

Answer 2

staph aureus
neisseria gonorrhea
mycobacteria

Question 3

subacute or chronic monoarticular arthritis main pathogens are usually 2

Answer 3

fungal

mycobacteria

Question 4

Episodic infectious arthritis main pathogens:

Answer 4

syphilis
Lyme disease
reactive arthritis

Question 5

Normal synovial fluid may contain up to __ cells/ microliter, mostly __. A definitive diagnosis should be after identifying the pathogen in __,__

Answer 5

180
mononuclear
culture
PCR

Question 6

In acute infectious arthritis the synovial fluid will contain - cells/microliter with >_% neutrophils

Answer 6

25k-250k

90

Question 7

The most common joints get infected is the __ pathway

Answer 7

hematogenic

Question 8

Cartilage will start to degenerate __ hours after the bacteria infiltration to the synovium

Answer 8

48

Question 9

Different age groups are affected from different pathogens:
infants-
children-
adolescence-

Answer 9

GBS, SA, G(-) enteric bacilli
like infants + Kingella kingae
neisseria gonorrhea, SA

Question 10

Most often, nongonococcal bacterial infection affects patients with risk factors, mostly __. Other risk factors include: 5

Answer 10

RA
diabetes
dialysis
malignancy
steroids
vasculitis

Question 11

Most patients suffering from infective arthritis have monoarthritis (%). The most common joints are:>>>_

Answer 11

knee
hip
shoulder
wrist/elbow

Question 12

IVDU with infective arthritis usually suffer from infected __ and __ joints

Answer 12

sacroiliac

sternoclavicular

Question 13

Blood culture will be positive in -% of cases with SA, but much less with other pathogens

Answer 13

50-70

Question 14

When treating infectious arthritis __ treatment should be administrated immediately after __ together with __ the joint

Answer 14

empiric
cultures
draining

Question 15

How should you treat an adult with community acquired infectious arthritis with no organism on blood film?
What if G(+) is found?
if pseudomonas/IVDU are suspected?

Answer 15

3rd gen cephalosporine IV
add- vancomycin or oxacillin/nafcillin/cefazolin
aminoglycoside / 3rd gen cephalosporine IV

Question 16

Gonococcal arthritis is the most common type (_%) for people < _. More in __

Answer 16

70
40
women 1

Question 17

What is DGI?

Answer 17

Disseminated gonococcal infection

Question 18

What are the symptoms for DGI? 4

Answer 18

fever
shivering
rash (papular->pustular)
joint symptoms (migratory arthritis)

Question 19

DGI blood cultures are positive in _%, and __ cultures usually come back negative

Answer 19

45

synovial

Question 20

What is the recommended treatment for DGI?

Answer 20

ceftriaxone IM/IV -> after symptoms relieve ->fluoroquinolone PO

Question 21

Spirochetal arthritis are caused by __ and __. Treatment will be __ and __ respectively

Answer 21

Lyme disease
Syphilitic arthritis
ceftriaxone/amoxicillin/doxycycline
penicillin

Question 22

What is Poncet’s syndrome?

Answer 22

polyarthritis that occurs during acute tuberculosis infection

Question 23

What is Reiter’s syndrome?

Answer 23

reactive arthritis that produces pain swelling redness and heat in the joints several weeks after nongonococcal urethritis or enteric infections

Question 24

Reiter’s syndrome is usually __, affecting the __or __

Answer 24

asymmetric
lower limb
sacroiliitis