Wounds / Soft tissue Injury/Joints/STD Flashcards Preview

Emergency EOR > Wounds / Soft tissue Injury/Joints/STD > Flashcards

Flashcards in Wounds / Soft tissue Injury/Joints/STD Deck (21)
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1

Most frequent pathogen isolated from plantar puncture wound osteomyelitis

Pseudomonas aeruginosa

**particularly when puncture goes through an athletic shoe**

2

Recommendation for use of prophylactic antiobiotics in puncture wounds

1. high risk patients (diabetics, immunocompromised)
2. Forefoot injuries (deeper)
3. Puncture through athletic shoes

3

Antibiotic choices for puncture wounds, when indicated

1. Cipro for athletic shoe punctures
2. Cefazolin, Cephalexin, Cefadroxil
3. Antistaph penicillins (oxacillin, dicloxacillin)
4. Azithromycin
5. MRSA - Bactrim or Clindamycin

4

Indications for primary suture closure of animal bite wounds

1. Face or scalp
2. Simple, no devitalized tissue, single layer
3. No underlying fracture
4. Host not immunocompromised

5

Pathogen most often causing sepsis etc in immunocompromised patients w animal bites

Capnocytophaga canimorsus

*covered by Augmentin*

6

"High risk" animal bite wounds

1. Cat or human bites
2. Livestock bites
3. Monkey bites

4. Puncture wounds
5. HAND or foot wounds
6. Heavily contaminated, older, or devitalized wounds
7. Signs of infection at first evaluation

8. Diabetic or immunocompromised patients

7

Catbite infection is often due to

Pasteurella multicida

*covered by Augmentin*

8

Treatment / prophylaxis for high risk bite wounds

3-5 day course of:
1. Augmentin for most
2. Cipro for fish bites
3. Azithromycin for bartonella (cat scratch)

**Penicillin allergic patients**
1. Doxycycline or Cefuroxime (Ceftin) for CAT bites
2. Clindamycin + Cipro for DOG bites

9

"cat scratch fever" caused by and treated by

Bartonella henselae

Azithromycin

10

Regional lymphadenopathy + mild constitutional sx developing 7-12 days after a cat bite or scratch

Cat scratch fever - bartonella henselae

Azithromycin

11

Pathogens associated with human bites

Staph and strep
Eikenella corrodens

*Prophylaxis with Augmentin*

12

Calcium pyrophosphate crystals,
yellow, rhomboid
positive birefringence

Pseudogout

13

1st line tx acute gout

NSAIDs 5-7days
Indomethacin 50mg TID
or naproxen

or Colchicine 0.6mg/h

14

1st line tx acute gout in renal impaired patienst

Prednisone
Narcotics

15

most common causes of viral arthritis in US

Parvovirus B19
Rubella
Hepatitis B

16

Traumatic hemarthrosis has a high association with

Ligamentous injury or an intra-articular fracture

17

arthritis, urethritis, and conjunctivitis

Reactive arthritis

18

most common STD

Chlamydia

19

Chlamydia + Gonorrhea tx

Azithromycin, 1 G PO single dose (Chlamyd) +
Ceftriaxone 250mg IM single dose (Gonorr)
** OK for pregnant women **

OR
Doxy 100mg PO BID x 7 days

20

Syphilis tx

Benzathine Penicillin G 2.4 million u IM single dose
**OK for pregnant women**

Doxycycline twice daily for 2 weeks may be used in penicillin-allergic patients

21

Syphilis diagnosis

The VDRL and rapid plasma reagin tests are used as screening tests and also, once diagnosis is made, to assess disease activity and response to treatment.

Positive results must be confirmed with an immunoassay specific for T. pallidum antibodies.