Infections

Question 1

which bones are most often affected by adult osteomyelitis

Answer 1

long bones

Question 2

what is continuous osteomyelitis

Answer 2

adjacent site of infection

Question 3

which organism is most common in osteomyelitis in children

Answer 3

haemophilus

Question 4

risk factors for adult osteomyelitis

Answer 4

vascular insufficiency, chronic ulcer, diabetes, open fracture,sickle cell, Gaucher’s disease

Question 5

which organism is most common in osteomyelitis in diabetic adults

Answer 5

polymicrobial

Question 6

what is SAPHO/CRMO adult osteomyelitis

Answer 6

osteomyelitis in >1 site

Question 7

type of osteomyelitis in PWID

Answer 7

contiguous or haematogenous

Question 8

most common infecting organisms in adult osteomyelitis in PWID

Answer 8

staph, strep, pseudo, candida, corrodens, TB

Question 9

most common infecting organism in adult myelitis in PWID who lick needles

Answer 9

corrodens

Question 10

causes of haematogenous osteomyelitis

Answer 10

child, PWID, central line, dialysis, immunosuppressed, old

Question 11

most common infecting organisms in haematogenous osteomyelitis

Answer 11

staph then strep

Question 12

aetiology of vertebral osteomyelitis (spondylodiscitis)

Answer 12

PWID, IV, GU

Question 13

investigations for vertebral osteomyelitis (spondylodiscitis)

Answer 13

normal WCC, get MRI, biopsy, abscess drainage

Question 14

presentation of vertebral osteomyelitis (spondylodiscitis)

Answer 14

months back pain, only 50% fever

Question 15

what is Potts disease

Answer 15

Skeletal TB

Question 16

do patients with skeletal TB always have pulmonary TB

Answer 16

<1/2 pulmonary TB

Question 17

area affects by skeletal TB

Answer 17

spans 2 vertebral bodies

Question 18

presentation of skeletal TB

Answer 18

back pain, no systemic symptoms

Question 19

most common infecting organisms in osteomyelitis from infected arthroplasty

Answer 19

coag –ve staph

then s. aureus, propionibacterium acnes (upper limb contaminant)

Question 20

pathology of osteomyelitis from infected arthroplasty

Answer 20

microbe biofilm on joint

Question 21

investigations for osteomyelitis from infected arthroplasty

Answer 21

multiple perioperative tissue cultures + bloods + CRP + bone scan + XR

Question 22

antibiotic for coag -ve osteomyelitis from infected arthroplasty

Answer 22

vanco

Question 23

most common infecting organisms in septic arthritis

Answer 23

mainly s. aureus

then strep, neisseria gonorrhea, viral

Question 24

antibiotic for septic arthritis

Answer 24

flucloxacillin

Question 25

antibiotic for septic arthritis if under 5 y.o.

Answer 25

flucloxacillin + ceftriaxone

Question 26

pathology of chronic osteomyelitis

Answer 26

bone abscess surrounded by sequestrum (dead/dying bone) & involucrum (new bone)

Question 27

what is a brodie's abscess

Answer 27

sclerotic margin with osteoclytic lesion, found in chronic osteomyelitis

Question 28

investigations for chronic osteomyelitis

Answer 28

+ve XR & MRI | +- +ve CRP

Question 29

what is osteitis pubis

Answer 29

osteomyelitis from urogynae procedure/ aseptic from surgery

Question 30

method of innoculation in osteomyelitis of clavicle

Answer 30

neck surgery, subclavian catheter

Question 31

1st investigation for osteomyelitis

Answer 31

CRP, PV

Question 32

investigation for direct confirmation of osteomyelitis

Answer 32

bone biopsy best for deep 7 day culture

Question 33

investigations for indirect conformation of osteomyelitis

Answer 33

MRI best | Less useful; WCC, ESR, XR, technetium scan, CT

Question 34

treatment of osteomyelitis

Answer 34

debridement, 6 wk fluclox, gram –ve;

Question 35

treatment of osteomyelitis if fluclox allergy

Answer 35

vancomycin, PO switch to doxy

Question 36

antibiotic for osteomyelitis if gram -ve infecting organism

Answer 36

gentamycin IV/ or doxycycline PO

Question 37

example of pyomyositis

Answer 37

tetanus

Question 38

tetanus pathology

Answer 38

spore, gram +ve anaerobic rod, neurotoxin

Question 39

tetanus presentation

Answer 39

spastic paralysis, lock jaw

Question 40

tetanus diagnosis

Answer 40

spore drumstick shape culture

Question 41

tetanus treatment

Answer 41

debride, antitoxin, support, booster vac, penicillin/ metron

Question 42

presentation of pyomyositis

Answer 42

severe pain, erythema, bullae

Question 43

infecting organisms in pyomyositis

Answer 43

bacterial 90% staph (PWID), viral (HIV, CMV, rabies), protozoa, fungal