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43 Cards in this Set
- Front
- Back
Cellulitis predisposing factors
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i. skin trauma or ulceration
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Cellulitis major pathogens
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i.group A beta hemolytic strep
ii.staph aureus |
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Cellulitis treatment (minor)
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dicloxacillin PO 500mg QID or cephalexin PO 500mg QID
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Cellulitis treatment (advanced)
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nafcillin IV 1-2g Q4H
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How long should antibiotic therapy last for cellulitis
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7-10days
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Cellulitis treatment for suspected polymicrobial infection
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a. Augmentin 500mg TID
b. FQ (levofloxacin 500mg QD or ciprofloxacin 500mg BID) PLUS clindamycin 450mg Q6H |
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Cellulitis treatment for advanced polymicrobial infection
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IV clindamycin 900mg Q8H PLUS aminoglycoside
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Potential complications of cellulitis
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i.lymphangitis, lymphadenitis
ii.necrotising fasciitis, gangrene iii.osteomyelitis iv.bacteremia |
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Septic arthritis laboratory abnormalities
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i.leukocytosis
ii.ESR |
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Septic arthritis predisposing factors
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i.joint trauma or disease
ii.compromised immune system iii.systemic infection |
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Septic arthritis major pathogens
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i.staph aureus
ii.beta hemolytic strep iii.neisseria gonorrheae |
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Septic arthritis empiric treatment
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Nafcillin IV 1-2g Q4-6H PLUS 3rd gen cephalosporin
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Gonococcal septic arthritis treatment
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i.3rd gen cephalosporin (ceftriaxone 1g QD; cefotaxime 1g Q8H)
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Potential complications of septic arthritis
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i.synovitis
ii.irreversible cartilage and bone damage |
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Necrotising fasciitis presentation
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superficial cellulitis -> spreads to SQ tissue and fascia -> local pain and systemic fever -> dull gray fascia, may produce brown exudates
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Necrotising fasciitis predisposing factors
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i.PVD
ii.IV drug use iii.diabetes |
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Necrotising fasciitis major pathogens
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i. 90% polymicrobial
ii. Group A B-hemolytic strep iii.Staphylococci iv. variety of other aerobic and anaerobic bacteria (peptostreptococcus and bacteroides) |
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Necrotising fasciitis treatment
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Parenteral
Penicillin/B-lactamase inhibitor PLUS Clindamycin + Ciprofloxacin |
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Necrotising fasciitis potential complications
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i.severe systemic toxicity (hypotension, resp failure)
ii. life threatening |
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Toxic Shock syndrome presentation
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i. sunburn like rash
ii. HA, vomiting, myalgias iii.elevated CPK, LFTs, thrombocytopenia, hypocalcemia, hypoalbuminemia iv.advanced stages can cause systemic shock with hypotension, multiple organ failure, and high fever |
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Toxic shock syndrome predisposing factors
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i.tampon use
ii.previous skin or soft tissue infection |
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Toxic shock syndrome major pathogens
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i. strep pyogenes
ii. staph aureus |
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Toxic shock syndrome treatment
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Clindamycin 900mg IV Q8H PLUS beta-lactam (pen or nafcillin)
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Toxici shock syndrome potential complications
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i.shock
ii.multiple organ failure |
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Gangrene presentation
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i.sudden pain at wound site 24-48hrs after injury
ii. hemorrhagic and necrotic areas iii.clostridial gangrene affects muscle or deep skin levels iv.toxins can induce local thrombosis of cutaneous blood vessels |
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Gangrene predisposing factors
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i.trauma
ii.surgery |
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Gangrene major pathogens
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i. group A B-hemolytic strep
ii.clostridia (GAS gangrene) (perfringes, septicium, histolytica) |
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Gangrene treatment
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Parenteral Penicillin G (high doses) PLUS parenteral clindamycin
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Gangrene potential complications
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i.systemic shock
ii.amputation |
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Osteomyelitis presentation
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i.erythematous w/ drainage
ii.instability, impaired range of motion, bone pain |
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Osteomyelitis diagnositic criteria
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2 of 4 must be present
i.pus on aspiration ii.positive bacterial culture from blood/bone iii.classic signs iv.radiographic changes |
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Osteomyelitis predisposing factors
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i.open wounds
ii.compromised immune system iii.prior soft tissue infection iv.PVD |
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Osteomyelitis major pathogens in infants (<1yr)
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-Group B strep
-Staph aureus -E. coli |
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Osteomyelitis major pathogens in children (1-16yrs)
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-staph aureus
-strep pyogenes -h.influenzae |
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Osteomyelitis major pathogens in adults (>16yrs)
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-staph epidermidis
-staph aureus -pseudomonas -e.coli |
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Osteomyelitis treatment in infants
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Cefazolin 40mg/kg/day in 2 divided doses
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Osteomyelitis treatment in children (<5yrs)
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Cefuroxime 100mg/kg/day
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Osteomyelitis treatment in older children
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Nafcillin 100mg/kg/day OR
Cefazolin 100mg/kg/day |
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Osteomyelitis treatment in adults
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Nafcillin 2g Q4H OR
Cefazolin 2g Q8H |
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Osteomyelitis duration of treatment
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4-6weeks
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Osteomyelitis potential complications
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i.bacteremia
ii.amputation iii.recurrent osteomyelitis |
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Diabetic foot infections predisposing factors
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i.peripheral neuropathy
ii.hyperglycemia iii.vascular insufficiency iv.noncompliance w/ foot care precautions |
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Diabetic foot infections major pathogens
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i.staph aureus
ii.beta-hemolytic strep iii.chronic wounds more likely to contain gram negative species |