Osteomyelitis and Septic Arthritis Flashcards

1
Q

What is osteomyeltis? What are the 3 different pathways that it can happen?

A

Infection of the bone

  1. Hematogenic dissemination of bacteria
  2. Invasion (surgical hardware or open fractures)
  3. Vascular deficiency (ulcers)
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2
Q

Where does hematogenic dissemination of bacteria occur in children vs adults

A

Children = long bones

Adults= vertabrae

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3
Q

What pathogens are responsible for osteomyelitis and which pathways do they occur in?

A

Staph aureus = hetamogenic + vascular insufficiency

Staph epidermis = invasion

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4
Q

Describe the pathophysiology behind osteomyelits?

A

Infection of the bone
Acute inflammation
Bone necrosis

Then bone abscess and finally rupture that leads to sinus drainage

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5
Q

What is the best diagnostic test to diagnose osteomyelitis?

A

MRI with gadolinium

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6
Q

What findings will you see for osteomyelitis?

A

Early demineralization

Hypercalcemia and alkaline phosphotemia

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7
Q

What is the treatment for Osteomyelitis caused by MRSA

What is the treatment for Osteomyelitis caused by MSSA?

A

Vanco + Fluoroquinolone

Nafcillin + Fluoroquinolone

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8
Q

What is the pathogen that causes Infectious Arthritis - Non-gonococcal?

A

Staph aureus - MC

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9
Q

What is the MC etiology that causes Infectious arthritis?

A

Hematogenous

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10
Q

What is the clinical presentation of infectious arthritis - non-gonococcal?

Where is the most common site for this to happen at

A

Erythema, warmth, pain

MC is the knee

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11
Q

What is the best diagnostic test for infectious arthritis?

A

Synovial fluid analysis

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12
Q

What findings in a synovial fluid analysis depic infectious arthritis?

A

Leukocytosis
Low glucose
Positive culture

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13
Q

What 4 areas does a Polyarthritis infection happen at?

A

Knees
Elbow
Shoulder
Hips

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14
Q

What unusual joints will become infected in a IVDU with infectious arthritis

A

Sternoclavicular
costochondral
pubic symphysis

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15
Q

What are the 2 treatments for infectious arthritis- non gonococcal

A

Joint aspiration and irrigation

Vanco + Cephlosporin (MRSA)
Nafcillin + Cephlosporin (MSSA)

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16
Q

What is infectious arthritis - gonococcal

Who is the most common in

A

infection with neisseria gonorrhea

Young, healthy, sexually active women

17
Q

When does infectious arthritis most commonly occur?

A

During pregnancy and menses

18
Q

Clinical signs of infectious arthritis gonococcal

A

Polyarthritis in the wrists, elbows, knees and ankles

Necrotis pustures on palms and soles

Tenosynovitis (swelling on tendons; usually at the wrist)

19
Q

Treatment for infectious arthritis gonococcal?

A

Azithromycin + Cephlasporin

20
Q

After initial treatment what must be done 24-48 hours after in someone with Infectious arthritis gonococcal?

A

7-14 days course of IM Ceftriaxone