bone, joint, MRSA, and more therapeutics Flashcards Preview

PT2 ID 1-6 > bone, joint, MRSA, and more therapeutics > Flashcards

Flashcards in bone, joint, MRSA, and more therapeutics Deck (65)
Loading flashcards...
1

how does osteomyelitis develop

-in epiphysis of bones blood flow is slow allowing bacteria to accumulate
-multiplication leads to increased bone pressure and eventually necrosis of bone

2

types of osteomyelitis

-hematogenous
-contiguous spread
-contiguous w/ vascular insufficiency

3

hematogenous osteomyelitis age range

-ages 1-20; >50

4

hematogenous osteomyelitis location

long bones
vertebrae

5

hematogenous osteomyelitis symptoms

fever
tenderness
swelling
reduced ROM
drainage

6

hematogenous osteomyelitis source

pharyngitis
lacerations
cellulitis
sickle cell
respiratory infections
IV catheters
hemodialysis

7

hematogenous osteomyelitis most common pathogen

Staph aureus

8

contiguous spread osteomyelitis age range

>50

9

contiguous spread osteomyelitis location

femur
tibia
skull
mandible

10

contiguous spread osteomyelitis symptoms

fever
erythema
swelling
sinus tracts
drainage

11

contiguous spread osteomyelitis source

-penetrating trauma
-open reductions of fractures
-gunshot wounds
-orthopedic procedures
-animal bites
-puncture wounds

12

contiguous spread osteomyelitis pathogens

-mostly Staph aureas
-proteus
-pseudomonas
-anaerboes

13

contiguous w/ vascular insufficiency age range

>50

14

contiguous w/ vascular insufficiency location

feet
toes

15

contiguous w/ vascular insufficiency symptoms

pain
swelling
erythema
ulcerations
drainage

16

contiguous w/ vascular insufficiency source

-DM
-peripheral vascular disease
-bed sores

17

contiguous w/ vascular insufficiency pathogens

mixed infections of:
-S.aureus
-proteus
-pseudomonas
-GNB anaerobes

18

types of cultures for identifying osteomyelitis infections

-blood
-wound swab
-bone aspirate
-bone biopsy

19

preferred culture technique

bone biopsy

20

why are wound cultures not very effective

high amounts of S.aureus on skin can contaminate the sample very easily

21

most common pathogens in osteomyelitis

-s.aureus
-coagulase-negative staph

22

occasionally seen pathogens in osteomyelitis

strep
enterococci
pseudomonas
GNB

23

when can x-ray detect osteomyelitis

at least 50% of matrix is damaged, usually 10-14 days after illness starts

24

when to use bone scans

when x-ray is not helpful

25

labs to get in osteomyelitis

-WBC w/ diff
-CBC
-ESR
-CRP
-MRSA nasal screen

26

lab indicators that infection is healing

decreasing ESR and CRP

27

what to do before selecting most appropriate antibiotic for osteomyelitis

-bone biopsy
-culture
-determine if its acute or chronic

28

treatment plan for chronic osteomyelitis

at least 6 weeks of IV antibiotics; may extend w/ oral therapy for 2-4 more weeks

29

empiric therapy of hematogenous osteomyelitis

-if possible wait for blood/bone cultures
-if MRSA use vanco + Ceftriaxone/cefepime/levofloxacin
-if no MRSA use cetriaxone, cefepime, or levofloxacin

30

D-test

-used to detect possible MRSA
-uses erythromycin and clindamycin discs
-flattened growth area near clindamycin disc looks like a D indicating resistance