Ipapburke Inf Dz Test 3- Joint Infections

Front 1

Predisposing factors for joint infections

Back 1

endocarditis, diabetes, trauma, etc

Front 2

Most commonly affected joint

Back 2

knee (usually large joints)

Front 3

#1 bacteria in infection of joint

Back 3

Staph aureus

Front 4

Common bacteria to infect prosthetics

Back 4

MRSA or staph pyogenes

Front 5

Joint infection spread hematogenously

Back 5

N. gonorrhea

Front 6

Labs valued with joint infections

Back 6

elevated ESR, synovial WBC ct over 50,000 when septic, over 75% PML, and low glucose

Front 7

S/S of joint infections

Back 7

sudden onset, pain, decreased motion of joint, fever over 102, joint swelling, diffuse tenderness, warmth, monoarticular infection

Front 8

What will initial xray in joint infection show?

Back 8

may be negative or show soft tissue swelling, distention or narrowing of joint space, bony erosions, and a fat pad

Front 9

Treatment for joint infection

Back 9

antimicrobial therapy dependent on organism; drainage/aspiration; possibly synovectomy

Front 10

What type of joint infection requires a quick response (bacterial type)?

Back 10

N. gonorrhea

Front 11

Drug for MSSA joint infection

Back 11

Nafcillin or Oxacillin

Front 12

Drug for MRSA joint infection

Back 12

Vanco and Rifampin

Front 13

Drug for Pseudomonas aeruginosa

Back 13

Fortaz

Front 14

Drug for N. gonorrhea

Back 14

Rocephin

Front 15

What causes septic bursitis?

Back 15

the position and activity of the bursa

Front 16

MC location of septic bursitis

Back 16

prepatellar and olecranon

Front 17

S/S of septic bursitis

Back 17

fever and surrounding cellulitis, swelling, TTP, erythema, decreased joint motion

Front 18

If these 2 symptoms are present in septic bursitis, immediate aspiration is necessary

Back 18

fever and cellulitis

Front 19

MC organism in septic bursitis

Back 19

staph aureus

Front 20

Septic bursitis may be the first sign of sepsis arthritis in what population?

Back 20

patients with RA

Front 21

What are the S/S of osteomyelitis?

Back 21

pain, muscle spasm, draining sinus, +/- chills/fever, +/- erythema

Front 22

What is the diagnostic for osteomyelitis?

Back 22

culture (start with blood, but bone and needle aspirate are standard)

Front 23

If osteomyelitis is spread hematogenously, what are the probable causes?

Back 23

IVDU, sickle cell, or elderly

Front 24

If osteomyelitis is from a contiguous source, what is the probable cause?

Back 24

an infected prosthetic joint, wounds like open fractures or nails through running shoes

Front 25

If osteomyelitis is from a vascular source, what is the probable cause?

Back 25

diabetes- foot and ankle usually

Front 26

What bones are most frequently affected by osteomyelitis?

Back 26

metaphases of long bones

Front 27

MC pathogens in osteomyelitis

Back 27

S. aureus, coag neg Staph, Enterococci, gram neg rods (Pseudomonas, Serratia, E. coli, Salmonella), anaerobes in diabetic foot infections, and MRSA

Front 28

If there is osteomyelitis from a fungal or mycobacterial origin, the patient is most likely _______________.

Back 28

immunocompromised

Front 29

When will xray show lytic lesions in osteomyelitis?

Back 29

usually not for 2 to 6 weeks

Front 30

What will show on the xray with osteomyelitis?

Back 30

periostitis, endosteal scalloping, focal or diffuse osteolysis

Front 31

How many days will it take for bone scan and CT/MRI to be positive in osteomyelitis?

Back 31

2 days

Front 32

What imaging is most sensitive for osteomyelitis?

Back 32

MRI

Front 33

Besides imaging, what diagnostic test should be done in osteomyelitis?

Back 33

bone biopsy

Front 34

What lab can be used to follow osteomyelitis infection ? ?

Back 34

ESR

Front 35

What is used to empirically treat Osteomyelitis?

Back 35

Nafcillin and Oxacillin

Front 36

How long is the duration of tx for osteomyelitis?

Back 36

4-6 weeks PO and pathogen specific

Front 37

If someone puts a nail through their shoe and gets osteomyelitis, what do you use to empirically treat?

Back 37

Cipro/Levaquin

Front 38

What is the treatment for diabetic osteomyelitis can by polymicrobials?

Back 38

6 weeks IV therapy that covers aerobic and anaerobic materials

Front 39

What are prosthetic joint infections usually due to?

Back 39

contamination at the time of surgery

Front 40

What joint is at the highest risk for prosthetic joint infections?

Back 40

elbows

Front 41

What patient population is at increased risk for prosthetic joint infections?

Back 41

diabetics

Front 42

Usual timeframe for onset of symptoms for prosthetic joint infections

Back 42

within 6 mths of operation

Front 43

S/S or prosthetic joint infections

Back 43

fever, edema/swelling, tenderness, decreased motion, ESR greater than 30 mm, and increased CRP

Front 44

What will be the radiologic findings in a prosthetic joint infection?

Back 44

periostitis, endosteal scalloping, focal or diffuse osteolytis

Front 45

Treatment for prosthetic joint infection

Back 45

eradication of infectious agent and maintenance of function of the joint

Front 46

What is done in addition to antimicrobial therapy for prosthetic joint infections?

Back 46

reimplantation, arthrodesis, amputation, or implant salvage