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Flashcards in infections, gynecology, dermatology Deck (29)
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Acute abdominal/pelvic in women

1. Mittelschmerz
2. ectopic pregn
3. Ovarian torion
4. Ruptured ovarian cyst
5. PID


ruptured ovarian cysts can be presented as .... due to ....

acute abdomen due to hemoperitoneum


Acute bacterial parotitis - presentation

painful swelling of the parotid gland that is aggravated by chewing
high fever and a tender swollen and erythematous parotid gland are common


post-operative acute bacterial parotitis - how to prevent

adequate fluid hydration + oral hygiene


acute bacterial parotitis - MC organism

S. aureus


role of incentive spirometry in surgery

reduce post operative pulm complications


necrotizing fasciitis - microbiology

1. strep pyog
2. Staph
3. Clostiridium perfringens
4. polymicrobial


necrotizing fasciitis - pathogenesis

bacterai spread rapidly through subcutaneous tissue + deep fascia, undermining the sin
MC imvolves extremities + perineal region


necrotizing fasciitis - clinical manifestation

- often antecedent history of minor trauma
- erythema of the overlying skin
- swelling + edema
- pain out of proportion to emanination findings
- systemic symptoms (FEVER + HYPOTENSION)


necrotizing fasciitis - treatment

requires surgical debridement + broad spectrum antibiotics



muscle abscess
similar presentation to necrotizing fasciitis, with fever, erythema, swelling + pain
limited to 1 muscle group and does not spread rapidly


Prosthetic joint infection - time

early (less than 3 months)
delayed (3-12 months)
late more than 12 months


Prosthetic joint infection - presentation regarding onset

early onset: acute pain, wound infection or breaskdown, fever
delayed: chronic joint pain, implant loosening, sinus tract formation
late: acute symptoms in prev asymptomaitc joints, recent infection at distant site


prostetic joint infection - MC organisms

early: s. aures, gram (-) robs, anaerobes
delayed: coagulase (-) staph, enterococcim, propionibacerium species
late: staph aureus, gram (-) robs, beta hemolutic strep


Most frequent caues of of nosocomial bloodstream infection in patients with IV devices

coagulase (-) staph


factos that favor infection of contamination

1. systemic signs (hypotensioon, fever, leukocytosis)
2. erythema and tenderness at the catheter entry site (absence of local signs does not rule out infection)
3. culture growth within 48 h and in both aerobic and anaerobic bottles
4. 2 or more blood culture samples wit the same organism and drug susceptibility


signs and symptoms suggestive of necrotizing surgical site infection

1. pain, edema, erythema spreading beyond the surgical site
2. systemic signs (fever, tachycardia, hypotension)
3. parestesia or anesthesia at the edges
4. subcut gas or crepitus
5. purulent cloudy gray discharge (dishwater drainage)


postoperative fever - MNEMONIC

Wind (day 1-2) (lungs): Atelectasis, postoperative pneumonia
Water (day 3-5): UTI
Walk (day 5-7): DVT / PE + IV ACCESS LINES
Wound (day 7): surgical site infection
Weird (8-15): drug fever or deep abscess
Wonder (drugs/products): drug fever, blood products, IV lines


Postoperative fever: immediately

prior infection, blood products, malignant hyperthermia


which skin SCC are more aggressive

SCC arises from chronic wounds


skin cancer arises from scar or burn

SCC (Marjolin ulcer)


sepsis after burn - organisms

immediately after sever burn: gram (+) from hair follicles and sweat glands
after 5 or more daysL gram (-) of fungi


wound infections are common after burns - highest risk

if large surface area (more than 20%)


burn wound sepsis - manifestation

Q: more than 39 or les than 36. 5
2. tachycardia
3. tachypnea
4. Refractory hypotension
ALSO: oliguria, unexplained hyperglycemia, thrombocytopenia, mental status


burn wound sepsis - diagnosis

quantitative wound culture and biopsy for histopathology.


burn wound sepsis - treatment

empiric, broad spectrum IV antibiotcs (tazosin, carbapeneme) with the addition of potential coverage for MRSA or multi-resistant Pseudomonas (aminoglycoside)
local wound care and debridement are usually necessary


compartment syndrome after burn?

the eschar results drom circumferential, full thickness (3rd degree) burn often leads to constriction of venous and lymphatic drainage, fluid accumulation --> acute compartment syndrome


first sign og burn wound infection

change in burn wound appearance or loss of skin graft


drug fever

diagnosis of exclusion
1-2 wls after medication administration
- rash and peripheral eosinophilia