Podiatry Boards Part 2

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Author:
dhubbard
ID:
189220
Filename:
Podiatry Boards Part 2
Updated:
2012-12-12 23:18:39
Tags:
Infection
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Description:
Infection Work-up Presby
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  1. Diabetic infections?
    Polymicrobial
  2. Puncture wounds what organisms?
    Staph, strept and psuedo (OM)
  3. What is the stimuli that affects the hypthalamus changing body temperature?
    Endogenous pyrogens secreted by leukocytes
  4. What bacteria has a greater affect on fever, gram negative or positive?
    Gram negative
  5. What are the signs of a systemic septic patient?
    • Elevated temp
    • Hypotension
    • Tachycardic
    • Tachypynic
  6. What do the ABI and toe pressure need to be to heal a wound?
    ABI > .50 and pressure of 30mmHg
  7. What are the 5 cardinal signs of infection?
    • Dolor- pain
    • Rubor- redness
    • Calor- Heat
    • Tumor- swelling
    • Functio lasea- loss of function
  8. What is the common lag time of seeing osseous changes do to infection?
    10-14 days
  9. What tests would you order for infection?
    • CBC with diff
    • Chem panel
    • ESR/CRP
    • Blood cultures
    • Urinalysis
    • Urine culture
  10. What are your agranulocytes?
    • Monocytes¬†
    • Lymphocytes
  11. What are PMN cells?
    Polymorphonuclear cells- Mature Nuetrophils and contain lactoferrin and are macrophages.
  12. Band cells are?
    Immature neutrophils- left shift, can't phagocytize very well.
  13. What cells come in around 24 hours and replace neutrophils as the main macrophages?
    Monocytes
  14. What is ESR?
    • Mesaures the distances in mm that a erythrocyte falls in 1 hour.
    • Nonspecific for inflammation, infection, malignancy, renal disease, connective tissue disease, age
    • >70mm sign of OM
    • >20 sign of ST infection
  15. What are we looking for in a UTI?
    Leukocytes and nitrates and organisms.
  16. Who are our immunocompromised pts?
    • DM
    • PVD
    • HIV
    • Cancer
    • RA
    • Steriod Therapy
    • Elderly
  17. What are some situations that would need OR debridement?
    • Unknown extent of infection
    • Wound probes to bone or bone is exposed
    • Wound tracks up fascial planes or tendon sheaths
    • Abcess
    • Gass in soft tissue
  18. What is the closure after sx?
    Usually delayed primary closure 3-4 days to do local wound care and monitor.

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