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Flashcards in infections, gynecology, dermatology Deck (29)
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1

Acute abdominal/pelvic in women

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

2

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

acute abdomen due to hemoperitoneum

3

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

4

post-operative acute bacterial parotitis - how to prevent

adequate fluid hydration + oral hygiene

5

acute bacterial parotitis - MC organism

S. aureus

6

role of incentive spirometry in surgery

reduce post operative pulm complications

7

necrotizing fasciitis - microbiology

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

8

necrotizing fasciitis - pathogenesis

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

9

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)

10

necrotizing fasciitis - treatment

requires surgical debridement + broad spectrum antibiotics

11

pyomyositis?

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

12

Prosthetic joint infection - time

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

13

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

14

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

15

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

coagulase (-) staph

16

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

17

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)

18

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

19

Postoperative fever: immediately

prior infection, blood products, malignant hyperthermia

20

which skin SCC are more aggressive

SCC arises from chronic wounds

21

skin cancer arises from scar or burn

SCC (Marjolin ulcer)

22

sepsis after burn - organisms

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

23

wound infections are common after burns - highest risk

if large surface area (more than 20%)

24

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

25

burn wound sepsis - diagnosis

quantitative wound culture and biopsy for histopathology.

26

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

27

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

28

first sign og burn wound infection

change in burn wound appearance or loss of skin graft

29

drug fever

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