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40 Cards in this Set
- Front
- Back
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1. How can you distinguish between infectious or non-infectious arthritis?
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a. Aspirate synovial fluid using a large bore needle
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2. What are the most common etiologic agents of septic arthritis?
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a. **S. aureus
b. **N. gonorrhoeae c. M. tuberculosis d. Spirochetes e. Fungi/viruses |
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3. How many joints does acute bacterial arthritis involve?
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a. One
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4. Where does septic arthritis usually present in infants?
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a. Hip
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5. Where does septic arthritis usually present in children?
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a. Knee
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6. Where does septic arthritis usually present in adults?
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a. Knee
b. Hip c. Shoulder d. Ankle e. Wrist |
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7. Where does septic arthritis usually present in IV drug users?
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a. Sternoclavicular and SI joints
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8. How does septic arthritis cause damage?
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a. Destruction of cartilage through collagenase
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9. Who is predisposed to septic arthritis?
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a. Patients with RA
b. Those on glucocorticoid therapy c. Diabetes d. Malignancies e. Alcoholics f. IV drug use |
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10. What predisposes a patient to MTB septic arthritis?
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a. TNFa inhibitors
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11. What are the most common causes of septic arthritis in neonates?
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a. S. aglacticiae
b. S. aureus c. GN rods |
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12. What are the most common causes of septic arthritis in children under 2?
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a. H. influenzae
b. S. aureus c. Kingella kingae |
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13. What are the most common causes of septic arthritis in children over 2?
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a. S. aureus
b. S. pyogenes |
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14. What are the most common causes of septic arthritis in sexually active young adults?
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a. N. gonorrhoeae
b. S. aureus |
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15. What are the causes of a late-infection induced septic arthritis?
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a. S. epidermidis
b. S. aureus |
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16. What are the symptoms of non-gonococcal septic arthritis?
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a. Moderate to sever pain around the joint
b. Effusion, muscle spasm, decreased range of motion c. Fever d. Swollen joint e. External findings less obvious but VERY PAINFUL ROM |
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17. How can you distinguish between non-gonococcal septic arthritis and osteomyelitis?
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a. Osteomyelitis will have less pain on active motion of the joint
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18. What are some complications of non-gonococcal septic arthritis?
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a. Impaired growth in children
b. Limb discrepancy c. Occlusion of blood supply d. AVN of femoral head e. Systemic sepsis in elderly and IC |
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19. What are the symptoms of gonococcal polyarthritis?
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a. Migratory polyarthritis
b. Tenosynovitis c. Dermatitis |
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20. What is migratory polyarthritis in gonococcal polyarthritis?
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a. Starts as small number of papules that progress to hemorrhagic pustules
b. Usually on trunk and exterior surface of distal extremities |
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21. What will a culture of synovial fluid in gonococcal polyarthritis yield?
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a. Negative
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22. What tests should be run to dx gonococcal polyarthritis?
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a. Blood test ~50% positive
b. Sample from mucosal site c. Pharyngeal, rectal, cervical, urethral samples d. Thayer Martin Agar |
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23. What is the most common cause of gonococcal polyarthritis?
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a. N. gonorrhoeae
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24. What is the most common cause of non-gonococcal septic arthritis?
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a. S. aureus
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25. How many joints are usually involved in gonococcal septic arthritis?
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a. One
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26. If you get a positive blood culture back in septic arthritis, what is the most likely etiologic agent?
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a. S. aureus
b. Positive ~90% of the time |
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27. What test can be useful when attempting to culture a fastidious organism or in culture negative cases?
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a. PCR
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28. How can synovial fluid aspirate be helpful in a dx of septic arthritis?
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a. Culture
b. Gram stain c. Use for crystal and cell count |
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29. What will a positive synovial fluid aspirate show in septic arthritis?
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a. Turbid/purulent
b. Gram stain--50-75% is S. aureus c. May show other organisms and PMNs |
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30. How many WBCs/uL will be present in an SF analysis in septic arthritis?
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a. 25,000-100,000
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1. What will the glucose joint fluid/serum ratio be in SF in septic arthritis?
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a. 1:2
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32. What will the % PMNs be in septic arthritis in SF?
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a. >75%
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33. What will radiographs show in septic arthritis?
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a. Soft-tissue swelling
b. Joint space widening c. Joint space narrowing d. Tx monitoring |
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34. What will US show in septic arthritis?
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a. Small collections of fluid deep in joints
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35. What will CT show in septic arthritis?
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a. Soft-tissue swelling
b. Joint effusion c. Abscess formation |
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36. What will an MRI show in septic arthritis?
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a. Extent of infection
b. Differentiating between bone and soft-tissue infections |
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37. What will bone scans show in septic arthritis?
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a. Localized areas of inflammation
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38. How do you tx septic arthritis?
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a. Complete drainage and washing by arthroscopy or surgery
b. Parenteral antibiotics for 3-4 weeks |
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39. How do you tx an early acute prosthetic joint infection?
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a. Local debridement
b. Prolonged antibiotic tx |
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40. How do you tx a prosthetic joint infection if the prosthetic has loosened?
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a. Antibiotic impregnated cement OR
b. Removal, debridement and 4-6 wks of antibiotic therapy OR c. Replace prosthesis |
