The Hip - book

WBC Differential

    – See Neutrophils/Left Shift  – Lymphocytes: (24-44%)  – Increased: Measles, German Measles, Mumps, Whooping Cough, Small pox, Chicken pox, Influenza, Hepatitis, Infectious Mononucleosis, Acute Infectious Lymphocytosis in children, Virtually any Viral Infection, Acute and Chronic Lymphocytic Leukemias;  – Decreased: After Stress, Burns, Trauma, Nl variation, Uremia;  – Monocytes (3-7%)  – Increased: Bacterial infection … Read more

Warfarin Interactions and Resistance

– Contraindications same as Heparin:  – ASA (Bleeding)  – w/ hemorrhagic tendencies  – pregnancy  – severe hepatic or renal disease  – severe hypertension  – blood dyscrasis  – Agents which Increase Prothrombin Time:  – Acetaminophren;  – Allopurinol  – ASA – Steroids  – Cimetidine – Indomethacin  – Flaggyl  – Hypoglycemics  – Phenothiazines – Phenylbutazone  – Propylthiouracil  – … Read more

Vertebral Osteomyelitis

– See:        – Diskitis        – Gun Shot Wounds to the Spine        – Tuberculous Spondylitis – Discussion:     – in adults, lumbar infections may often originate from urinary tract infections which drain thru Batson’s venous plexus;           – respiratory system is also … Read more

Vancomycin

– Discussion:      – for penicillin resistant to staph – MSSA / MRSA – and w/ enterococci endocarditis (in combination with aminoglycosides);     – it is ineffective against gm neg bacterial (its large molecular weight keeps it from penetrating the outer cell membrane of            gram-negative bacilli);     – basic science:            – blocks glycopeptide polymerization in … Read more

Urinary Tract Infection

– UTI in the Spine Injured Patient  Management:    – Rx with ATB’s, pending urine culture    – Consider single dose therapy for symptomatic non-pregnant women with no known anatomic abnormalities;    – Follow up culture in 7 to 14 days;    – Prolonged therapy (7-10 days) is for symptomatic men, pregnant women or patients with … Read more

Tuberculosis

Discussion although the disease is generally more likely to be chronic, acute mycobacterial arthritis has been reported; periarticular bone lesions may accompany the synovial involvement; pulmonary tuberculosis is evident in only half the patients with skeletal involvement; pulmonary TB signs vary with stage of dz, few early on; later high fever, wt loss, prolonged, productive … Read more

Trimethoprim-Sulfamethoxazole/Bactrim/Septra

– Discussion:     – for UTI, otitis media, acut exacerbation of chronic bronchitis, pneumocystis carini;     – has an excellent spectrum of activity against beta lactamase-producing staph, and can be effective as an antistaphylococcal agent;     – septra not effective vs. group A strep;     – adult dose:       … Read more