Infections

Question 1

if you can see bone and there is signs of infection what is it?

Answer 1

Osteomyelitis

Question 2

What is osteomyelitis?

Answer 2

inflammation of bone and medullary cavity, usually located in one of the long bones

Question 3

Treatment of infection

Answer 3

Debridement

Antimicrobial

Question 4

if chronic symptoms

Answer 4

Wait till you have had biopsy, blood and then treat

Question 5

Retroscective data

Answer 5

group of people and gather data now in terms of what has happened to them in terms of treatment

Question 6

What organisms are diabetic foot ulcers caused by?

Answer 6

Staph aureus
Streptococcus spp
Enterococcus spp

Question 7

What should you avoid (unless your patient is septic)

Answer 7

EMPIRIC ANTIMICROBIAL

Question 8

What do coat negative staph love

Answer 8

plastic/metal

Question 9

Staphlococcus

Answer 9

aerobic
prodcuces enzyme inc coagulase
some strains produce toxins inc enterotoxin, SSST, PVL

Question 10

If true penicillin allergy ( therefore can’t give fluclox) then what do you give?

Answer 10

Vancomycin

Question 11

What is key with open fractures?

Answer 11

Early management is key (aggressive debridement, fixation and soft tissue cover)

Question 12

A swab is not helpful unless..

Answer 12

you are asking a specific clinical question

Question 13

What is the classic infection that causes sinuses of the bone

Answer 13

TB

Question 14

What is the GOLD standard in haematogenous osteomyelitis

Answer 14

Bone biopsy

Question 15

Who is haematogenous osteomyelitis common in?

Answer 15

Prepubertal children
PWID
Central lines/ dialysis, elderly

Question 16

What is the epidermiology of PWID haematogenous osteomyelitis

Answer 16

Contiguous
Haematogenous
Direct innoculation

Question 17

What is the cause of osteomyelitis pubis

Answer 17

urogynae procedures

Question 18

What organisms - sickle cell osteomyelitis

Answer 18

Stpahlococcus aureus

salmonella

Question 19

What is Gaucher’s disease

Answer 19

lysosomal storage disease

Question 20

SAPHO and CRMO

Answer 20

Synovitis
Acne
Pustulosis
Hyperostosis
Ostteitis

Chronic
Recurrent
Multifocal
Osteomyelitis

Question 21

What is the risk factors for clavicle osteomyelitis

Answer 21

Neck surgery

subclavian vein catheterisation an

Question 22

Vertebral osteomyelitis

Answer 22

Staph aureus

can be TB

Question 23

How can you be sure of verebral osteomyelitis

Answer 23

MRI

Question 24

What is the treatment of vertebral osteomyelitis

Answer 24

Drainage of large paravertebral/epidural accesses
Antimicrobials for 6 weeks minimum
MRI increased if inc pain, increase in inflammatory markers or new anatomical signs

Question 25

``` Skeletal tuberculosis (Pott's disease) Who gets it and what are the symptoms? ```

Answer 25

Often systemic symptoms Vets people who drink unpasteurised milk

Question 26

Planktonic bacteria

Answer 26

Bacteraemia

Question 27

Sessile bacteria

Answer 27

Phenotypic transformation of planktonic bacteria Biofilm Extracellular matrix

Question 28

What does rifampicin do?

Answer 28

Helps to penetrate the biofilm ( only used alongside another treatment as risk of mutation too high)

Question 29

in diagnosis of prosthetic joints

Answer 29

Culture-perioperative tissues Blood culture CRP Rdiology

Question 30

What is the ideal treatment of prosthesis infection

Answer 30

Remove prosthesis and cement

Question 31

In people who are sexually active remember the organism

Answer 31

Neisseria gonorrhoea

Question 32

What is the initial treatment if coagulase negative staphlococci

Answer 32

Vancomycin

Question 33

What mimics septic arthritis?

Answer 33

Pseudogout

Question 34

What is septic arthritis

Answer 34

Inflammation of the joint space caused by infection

Question 35

What are the bacterial causes of septic arthritis

Answer 35

``` Staph aureus Streptococci Coag negative staph;ococci- prosthetic joins Neisseria gonorrhoea- sexually active Haemophilus influenza- pre-school ```

Question 36

How do you diagnose septic arthris

Answer 36

Clinical picture- severe pain, red, swollen plus limited movement Joint fluid- microscopy, C and S Blood culture if pyritical Exclude crystals

Question 37

If treating septic arthritis with fluclox and the patient is less than 5 years old what other antibiotic do you add and why?

Answer 37

Ceftriaxone - for H influenza cover

Question 38

Pyomyositis

Answer 38

Clostridial infection in contaminated wounds | soem site specific

Question 39

Tetanus

Answer 39

``` gram + Strictly anaerobic rods forms spores ( which are found in soil) can have muscle spasms from stimulation such as noise or bright lights clinical-spastic paralysis ```

Question 40

What is the treatment of tetnus

Answer 40

surgical debridement antitoxins Prevent by routine vaccination

Question 41

What are the three causes of myositis

Answer 41

Viral Protozoa Fungal