Skin IX

Question 1

osteomyelitis and infectious arthritis are caused primarily by ___ or ___

Answer 1

osteomyelitis and infectious arthritis are caused primarily by bacteria (G+ve) or fungi

Question 2

immune-complex arthritis, reactive arthritis and rheumatic fever are caused by ____ to either ___ or ____

Answer 2

immune-complex arthritis, reactive arthritis and rheumatic fever are caused by immune reactions to either bacteria or viruses

Question 3

the most common cause of osteomyelitis is by ____ spread from ___

Answer 3

the most common cause of osteomyelitis is by hematogenous spread from a distant site

Question 4

acute bacterial osteomyelitis presents ____ after infection and is common in ____

Answer 4

acute bacterial osteomyelitis presents within 2 weeks after infection and is common in children

Question 5

chronic osteomyelitis symptoms typically present ____ after infection and tends to occur in ____

Answer 5

chronic osteomyelitis symptoms typically present within 6 weeks after infection and tends to occur in in the lower extremity especially in diabetics with vascular insufficiency

Question 6

osteomyelitis in children occurs most commonly in (which bones?) and is localized (to which part of the bone?)

Answer 6

osteomyelitis in children occurs most commonly in long bones and is localized the metaphysis (richly endowed with blood vessels)

Question 7

osteomyelitis in adults spreads to (which bones?) and most often occurs from infections of ____

Answer 7

osteomyelitis in adults spreads to vertebral osteomyelitis and discitis and most often occurs from infections of the lung

Question 8

in vertebral osteomyelitis, the ___ region is affected more often than ____ or ____ regions

Answer 8

in vertebral osteomyelitis, the lumbar region is affected more often than cervical or thoracic regions

Question 9

in chronic osteomyelitis, ___ of the bone occurs and ___ can form

Answer 9

in chronic osteomyelitis, necrosis of the bone occurs and sequestrum (an avascular piece of infected bone) can form

Question 10

relapses occur in ___ osteomyelitis more than in ____ osteomyelitis

Answer 10

relapses occur in chronic osteomyelitis more than in acute osteomyelitis

Question 11

a radiologic finding in osteomyelitis is a defect in the bone with ____

Answer 11

a radiologic finding in osteomyelitis is a defect in the bone with periosteal elevation

Question 12

_____ are positive in osteomyelitis in approx. half of cases

Answer 12

blood cultures are positive in osteomyelitis in approx. half of cases

Question 13

infectious (septic) arthritis is an infection of ___

Answer 13

infectious (septic) arthritis is an infection of the joints

Question 14

the most common cause of infectious arthritis is ___

while in young, sexually active adults, it is ____

Answer 14

the most common cause of infectious arthritis is S. aureus

while in young, sexually active adults, it is N. gonorrhea

Question 15

list the most commonly affected joints in descending order in infectious arthritis

Answer 15

• knee
• hip (most common in < 3 years old)
• elbow
• ankle
• sterno-clavicular joint

Question 16

analysis of ___ plays an important role in the diagnosis of infectious arthritis

Answer 16

analysis of synovial fluid plays an important role in the diagnosis of infectious arthritis

Question 17

synovial fluid from an infected joint may appear…. (3 things)

Answer 17

• cloudy
• high WBC
• low glucose concentration

Question 18

in infectious arthritis, organisms typically reach the joint via ___ from ____

Answer 18

in infectious arthritis, organisms typically reach the joint via the bloodstream from a skin site

Question 19

list the clinical manifestations of infectious arthritis

Answer 19

• acute onset of inflamed joints
• fever
• affected joint is red, warm and swollen
• reluctance to use a joint

Question 20

diagnosis of infectious arthritis is via Gram stain of ___

Answer 20

diagnosis of infectious arthritis is via Gram stain of joint fluid

Question 21

in infectious arthritis, there is elevated serum ___, ___ and ____

Answer 21

in infectious arthritis, there is elevated serum WBC, ESR>30 mm/h and CRP > 5 mg/dl

Question 22

the typical radiologic finding in infectious arthritis is ____

Answer 22

the typical radiologic finding in infectious arthritis is soft tissue swelling

Question 23

viral arthritis is caused by ____

Answer 23

viral arthritis is caused by a virus-induced immune complex formation that is deposited in the joints

Question 24

list the most common viruses involved in viral arthritis

Answer 24

• Parvovirus B19
• hepatitis B
• hepatitis C
• rubella
• Epstein-Barr
• arbovirus (dengue virus)

Question 25

in viral arthritis, the ___ joints are most often affected

Answer 25

in viral arthritis, the **small** joints are most often affected

Question 26

list causes of reactive arthritis

Answer 26

* Campylobacter * Shigella * Salmonella * Yersinia * Chlamydia

Question 27

in reactive arthritis, there is ___ arthritis of the knee or ankle accompanied by \_\_\_

Answer 27

in reactive arthritis, there is **asymmetric** arthritis of the knee or ankle accompanied by **fever**

Question 28

what does the culture of synovial fluid in reactive arthritis show?

Answer 28

**negative culture**

Question 29

reactive arthritis accompanied by ___ and ___ is called ___ syndrome

Answer 29

reactive arthritis accompanied by **conjunctivitis** and **urethritis** is called **Reiter's** syndrome

Question 30

\_\_\_\_ have no effect on reactive arthritis

Answer 30

**antibiotics** have no effect on reactive arthritis remember it is caused by IMMUNE COMPLEXES; the bacteria are not the primary cause

Question 31

skin involvement in rheumatic fever consists of ___ and \_\_\_\_

Answer 31

skin involvement in rheumatic fever consists of **erythema marginatum** and **subcutaneous nodules**