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Which of the following describes the most common organism cultured from septic olecranon bursitis?
Gram positive cocci in chains
Gram positive bacilli in branches
Gram positive cocci in pairs and clusters
Gram negative diplococci
Gram negative bacilli with thin rods
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A 55-year-old man presents with pain in his great toe that began 2 days ago. On physical exam, his first metatarsophalangeal (MTP) joint is red, warm, and tender to palpation (Figure A). His skin is intact with no evidence of ulceration. He reports pain with range of motion. He denies recent fevers and his admission temperature is 37.9°C. Labs are drawn and significant for a WBC of 15K (reference range [rr], 4500-11000 µL), ESR of 90 (rr, 0-20 mm/h), and CRP of 6.5 (rr, 0.08-3.1 mg/L). A radiograph of his foot is shown in Figure B. Which of the following is the next best step?
Joint irrigation and debridement
Outpatient oral antibiotics for 14 days
Oral indomethacin for 3 to 5 days
MRI of the foot
When performing a saline load test to evaluate for a traumatic arthrotomy of the knee, a minimum of how much saline should be utilized to obtain a 95% diagnostic accuracy?
Which of the following is true regarding the use of the saline injection load test to diagnose traumatic knee arthrotomies?
Addition of methylene blue to the saline load test increases the sensitivity of the test
Injection of 110ml of saline will diagnose 95% of knee arthrotomies
Injection of 175ml of saline will diagnose 99% of knee arthrotomies
A superomedial injection location requires significantly less fluid than a inferoeromedial injection location
A history and physical exam by an orthopaedic surgeon has equivalent sensitivity to saline load test at detecting a traumatic arthrotomy
A 20-year-old man presents with erythema, swelling, and pain at the left sternoclavicular joint shown in Figure A. His temperature is 38.9 degress Celsius, serum WBC is 14,000, and his C-reactive protein is elevated. He reports that he uses IV heroin. A coronal 3D CT scan of the left clavicle is shown in Figure B. Joint aspiration shows many grams stain positive organisms. Which of the following organisms is the most likely pathogen?
Group B streptococcus
A 45-year-old IV drug abuser has sternoclavicular (SC) joint pain for the past 2 weeks. He is afebrile and physical exam findings include point tenderness and swelling. He most likely has septic arthritis of the sternoclavicular joint. If so, what is the most likely infecting organism?