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Flashcards in Ortho Infections Deck (85)
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1

Why is staph aureus having an increased resistance to antibiotics?

Plasmids

2

When do bacteria enter the body?

Altered hemostasis

3

In regards to blood supply, when does the risk of infection increase?

Decreased blood supply

4

What increases microcirculation & vasodilation?

Warming of the source of infection

5

How does a traumatic injury & the presence of implants increase the risk of infection?

Periosteal injury, micro/macrovascular compromise
Bacteria have affinity for exposed sites
Form glycocalyx capsule
Impair normal immune function & abx penetration

6

Factors that Decrease Local Immune Responses

Decreased blood flow
Neuropathy
Trauma
Medication

7

Medications that can Decrease the Local Immune Response

NSAIDs
Rheum
Steroids

8

Factors that Decrease the Systemic Immune Response

Renal & liver disease
DM
ETOH
Rheum diseases
Immunocompromised state
Malnutrition

9

Diagnostic Test with Musculoskeletal Infections

H&P
Labs
Culture of fluid or tissue

10

Presentation of a Musculoskeletal Infection

Pain
Warmth
Swelling
Redness
Refusal to bear weight (esp. children)
Fever/chills
Night sweats
N/V
Loss of joint motion

11

Labs to Diagnose Musculoskeletal Infections

CBC with differential
ESR
CRP
Blood cultures
Gram stain
Frozen section
PCR: polymerase chain reaction

12

When does ESR elevate in infection?

Within 2 days of infection

13

When does CRP elevate, peak, and return to normal in an infection?

E: within 6 hours
P: 48 hours
Return: 1 week after appropriate treatment

14

What is the best indicator for diagnosis & monitoring treatment of an infection?

CRP

15

What diagnostic modality has shown to be helpful in peri-prosthetic infections?

IL-6

16

Things you can see on Plain Films for Musculoskeletal Infections

Soft tissue swelling
Loss of tissue planes
Bony changes (40+% loos to see)
Brodies Abscess

17

Other Radiologic Tests to Detect Musculoskeletal Infections

Bone scan: vague
Indium 111 leukocyte nuclear scan
Gallium citrate scan
PET scan
MRI

18

What diagnostic modality is used frequently for infection?

MRI

19

When do musculoskeletal infections frequently happen?

Open fractures
DM
Recent surgery

20

Describe Hematogenous Osteomyelitis

Osteomyelitis which was transferred by the blood

21

Desccribe Contiguous Focus Osteomyelitis

Infection caused by a prior infection

22

Classification of Musculoskeletal Infections that Describes the Anatomic Involvement

Stage 1: medullary
Stage 2: superficial
Stage 3: localized
Stage 4: diffuse

23

Classification of Musculoskeletal Infections that Describes the Host

Normal
Compromised
Treatment worse than disease

24

Most Common Sites of Hematogenous Osteomyelitis

Vertebrae***
Long bones
Pelvis
Clavicle

25

Vertebral Osteomyelitis

50+
May involve 2 vertebrae + disc

26

Most Common Bug with Hematogenous Osteomyelitis

S. aureus

27

Most Common Bugs in Vertebral Osteomyelitis

S. aureus
Pseudomonas (IVDU)

28

Presentation of Vertebral Osteomyelitis

Fever
Pain over area
Possible: meningitis, abscesses

29

Most Common Reasons for Contiguous-Focus Osteomyelitis without General Vascular Insufficiency

Trauma with direct contact to bone
Infection from soft tissue
Nosocomial infection
ORIF
Prosthetics
Open fractures
Chronic soft tissue infections

30

When does a continguous-focused osteomyelitis without general vascular insufficiency occur?

About 1 month after primary cause of infection