CEN Ortho 2

  1. What should be done before admin of black widow antivenin?
    sensitivity test
  2. Drugs for Tx of brown recluse bite?
    dapsone and steroids
  3. Drugs for Tx of black widow spider bite?
    benzos, opiates, and muscle relaxants to relieve cramping
  4. Tx of wound with spider bites?
    immobilization in neutral position at level of injury

    cleansing of brown recluse bite with mild soap
  5. Complications of spider bites?
    • 1. anaphylaxis
    • 2. tissue necrosis and infection - loss of limb
    • 3. coagulopathies
    • 4. rhabdomyolysis
    • 5. renal failure
  6. Hymenopteran stings include what insects?
    bees, hornets, wasps, and ants
  7. Toxic reaction s/s with stings?

    When do they usually occur?

    When do they usually resolve?
    NVD, syncope

    with >/= 10 stings

    48 hours
  8. Systemic reaction to stings s/s?
    dyspnea, itching, chills, anaphylaxis
  9. S/S of systemic/anaphylactic reaction?
    • stridor/wheezing
    • fever
    • tachycardia
    • hypotension
    • changes in LOC
  10. What meds can block s/s of anaphylaxis?
    beta blockers
  11. Delayed hypersensitivity reaction occurs when?

    • </= 1 wk
    • joint effusions, serum sickness, pupura, heart failure, renal failure/nephrotic syndrome, jaundice or bruising r/t hemolytic anemia or thrombocytopenia
  12. Management of wound from a sting?
    remove stinger by scraping skin - do not squeeze skin

    immobilize in neutral position at level of injury

  13. Complications of stings?
    • anaphylaxis
    • MI
    • stroke
    • renal failure
    • coagulopathies
  14. Risk involved with human bites?
  15. Wound considerations with human bites?
    take pics if associated with a crime

    irrigate with lg amnt of NS

    usually delay closure to decrease infection

    immobiliozation in neutral position at level of injury
  16. Staphylococcus aureus skin infections?
    gram positive usually localized and associated with most skin infections in superficial subcutaneous tissues
  17. S/S of staphylococcus aureas skin infection?

    redness, rash, NVD, HA, and aches

    onset 2 - 33 days
  18. Pasteurella multocida skin infection?
    necrotizing infection that is also seen with animal bites
  19. Causes of pasteurella multocida skin infections?

    cellulitis, osteomyelitis, sinusitis, and pleuritis

    3h - 3 days
  20. Management of pasteurella multocida skin infections?
    antibiotics:  PNC
  21. Afipia felis or Bartonella henselae skin infections?
    cat scratch fever - caught by bite, lick, or scratch from a cat
  22. When does afipia felis/bartonella henselae usually occur?


    usually after dealing with kittens

    2-3 wks after exposure

    lymph node swelling, fever, NV, fatigue
  23. Management of afipia felis/bartonella henselae?
    abx not usually indicated unless immunocompromised

    antipyretics, analgesics, heat to area
  24. Botulism/Clstridium botulinum causes?


    can cause life-threatening paralysis r/t neurotoxin produced by this bacteria

    Causes:  crush injuries or major trauma

    s/s:  weakness, blurred vision, difficulty speaking or swallowing, dry mucous membranes, dilated pupils, and progressive muscular paralysis

    onset:  4-14 days
  25. Mgmt of botulism/
    • debridement of wound
    • antitoxin therapy
    • antibiotics
  26. Gas gangrene bacteria?
    clostridium perfringens

    intestinal or gallbladder Sx or minor trauma to old scars that contain spores

    s/s:  soft-tissue crepitus, pain, thin/watery brown drainage, increased pulse, NVD, coma

    1 day to 6 wks incubation period
  27. Tetanus bacterial cause?

    Where does the bacteria live?


    clostridium tetani

    soil, human/animal intestines

    early s/s:  restlessness, HA, muscle spasms, and pain

    Late s/s:  stiffness, tonic spasms, exaggerated reflexes, general convulsions, and respiratory depression

    onset:  2days to several months - usually 6-10 days
  28. Rabies?


    neurotoxin virus

    malaise, fever, HA, lymphadenitis, photophobia, muscle spasms, coma, osteomyelitis, abscess, and necrotizing fasciitis

    onset:  10 days to several months
  29. Management of rabies?
    • clean wound with virus-killing soap
    • rabies immune globulin
    • rabies vaccine during first 28 days after bite
    • days 1, 3, 7, 14, and 28
  30. Group A streptococcus infections?

    Where do they occur?


    found in throat and on skin

    causes necrotizing fasciitis and toxic shock syndrome

    • s/s:  necrotizing fasciitis, fever, severe pain, swelling, heat, redness - rapidly attacks tissue and destroys muscle and flesh
    • streptococcal TSS includes fever, dizziness, and confusion

    onset 1 to 3 days
  31. Management of necrotizing fasciitis?
    ABX:  beta-lactam, supportive therapy for shock
  32. Management of TSS r/t strep infection?
    • ABX
    • immunoglobulin G
    • supportive therapy
Card Set
CEN Ortho 2
CEN orthopedics