MSK 1

Question 1

risk factors for prostethic joint infection

Answer 1

RA, DM, malnutrition, obesity

Question 2

0-3 months early post op PJI caused by what and symptoms

Answer 2

SA, strep, enterococci

fever, warmth, effusion, drainage

Question 3

3-12 months causes and symptoms

Answer 3

coag neg staph

persistent pain, device loosening, fistula

Question 4

> 24 months spread how and what

Answer 4

blood spread

SA, E Coli

Question 5

investigations for PJI

Answer 5

3 sets of culture, ECHO, ESR, CRP, FBC, U&Es, inflam markers

Question 6

DAIR

how long course of antibiotics

Answer 6

debridement, antibiotics, implant retention

4-6weeks

Question 7

2 stage how long

Answer 7

6 weeks of antibiotics then break for surgery

Question 8

ABs given proph

PA

Answer 8

1.2g Co-amox peri op within 60 mins of op and then 2 doses post op within 72 hours of op
PA - cotrimoxazole

Question 9

ABs in theatre

Answer 9

Cipro 400mg IV

Vancomycin IV

Question 10

ABs on ward

Answer 10

Cipro 500mg BD
continue vanc
PO rifampicin if rifampicin sensitive staph

Question 11

when should ciprof be stopped

Answer 11

if no GN bacteria on culture results

Question 12

osteomyelitis is what

Answer 12

inflammation of bone and medullary cavity

Question 13

Acute osteo

where

Answer 13

few days to 2w

shoulder, ankle, hip, elbow

Question 14

chronic osteo

Answer 14

2w over
SIRS usually absent
delay in treatment of acute
No ABs till culture results

Question 15

ix important to do and why

Answer 15

joint washout/aspirate for microscopy and culture in case septic joint

Question 16

treatment of osteomyelitis

PA

Answer 16

Fluclox IV 2g QDS 2 w then ORAL total 4-6w

IV Clindamycin 600mg QDS

Question 17

treatment of chronic osteo

Answer 17

PO fluclox 1g QDS

Question 18

MRSA osteo

Answer 18

IV vanc

Question 19

investigations for septic arhtiris

Answer 19

cultures, CRP, FBC, U&Es, ERP, lactate, fluid washout/aspirate, USS, MRI, XR, CT

Question 20

symptoms of septic arhtritis

Answer 20

single joint
decreased ROM, pain, swelling, red, hot
systemic upset

Question 21

treatment septic

Answer 21

IV fluclox 2g QDS for 2w then oral

PA IV clindamycin 600mg QDS

Question 22

if under 5 for septic

Answer 22

add ceftriaxone for HI and king ella cover

Question 23

SIRS is 2 or more of what

Answer 23

temp >38 or <36
HR >90
RR>20 or PaCO2 <4.3
WBC>12000 or <4000

Question 24

cellulitis treatment mild

Answer 24

oral fluclox 1g WDS for 7days

Question 25

if not resolving cellulitis

Answer 25

doxy 100mg BD for 7d

Question 26

septic cellulitis

Answer 26

fluclox 1g QDS IV 2g if BMI>30

Question 27

symptoms of abscess

Answer 27

defined and fluctuating, red, pain | history of trauma

Question 28

treatment of abscess

Answer 28

surgical incision and drainage analgesia splint ABs

Question 29

gas ganagrene caused by what which is what

Answer 29

clostridium perfringes | GN strictly anaerobic rods

Question 30

how does gas gangrene happen and what are the predisposing factors

Answer 30

spores into tissue PDF - dead tissue, anaerobic conditions spores germinal creating gab bubbles which leads to crepitus

Question 31

treatment of gas gangrene

Answer 31

urgen debridement penicillin or metro or both +/- hyperbaric oxygen if severe

Question 32

tetanus causes by what which is what

Answer 32

clostridium tetanus | gram positive anaerobic rods

Question 33

where are tetanus spores found | incubation periods

Answer 33

soil, gardens, animal bites | 4d-several weeks

Question 34

what does tetanus do

Answer 34

neuroxin - spastic paralysis - locked jaw - muscles spasm

Question 35

treatment of tetanus

Answer 35

surgical debridement antitoxins penicillin/metro booster vaccination

Question 36

how long is tip toeing common | any action

Answer 36

<3s | wil resolve

Question 37

cavus feet causes | any action

Answer 37

can be inherited | if assymetrical investigate

Question 38

flat feet normal? any action causes

Answer 38

normal resolves at ages 4-8 flexible ligamentous laxity rigid - tarsal coalition

Question 39

intoeing causes

Answer 39

femoral neck anteverions internal tibial torsion metatarsal adductus

Question 40

femoral neck anteversion check what any action

Answer 40

hip rotational angle | resolves

Question 41

internal tibial torsion check what | any action

Answer 41

check foot shape. thigh-foot angle | resolves

Question 42

metatarsal adducts is what | any action

Answer 42

banana feet | resolves spontaneously if persists - cast

Question 43

out toeing normal | action

Answer 43

resolves by age 2 | interfere if does not resolve as risk of patellofemoral pain

Question 44

bow legs are what resolves? when to investigate

Answer 44

genu varum resolves by age 4-5 decreased height - skeletal dysplasia assym - pathology

Question 45

knock knees another name for what peak at when what should the intermaleolar distance be at age 11

Answer 45

genu valgus 3. 5 yo 8cm. if >8 -> refer

Question 46

club foot is what

Answer 46

deformation of cavus | adducts varus equinos

Question 47

causes of clubfoot | associations

Answer 47

idiopathic | associated with CP, spina bifida, edwards, oligohydraminos, arthrogryoposis

Question 48

treatment of clubfoot

Answer 48

Ponseti method - cast and maniupalation from birth till 10-12 weeks night brace till child is 4yo

Question 49

relapse rate of clubfoot

Answer 49

15%

Question 50

opposite of clubfoot

Answer 50

rocker bottom feet