Infection, Pharmacology & VTE MCQs

Which of the following bacterial organisms is most highly associated with early implant-related infections mediated by excessive glycocalyx (biofilm) production?

During the pathogenesis of periprosthetic joint infection, which phase of biofilm formation is characterized by the secretion of extracellular polymeric substances (EPS) leading to irreversible bacterial attachment?

During orthopedic implant infections, bacteria such as Staphylococcus epidermidis evade host immunity and antibiotics by forming a biofilm. The crucial structural component of this biofilm is the extracellular polymeric substance (EPS), which is primarily composed of:

During the development of a periprosthetic joint infection, bacteria adhere to the implant surface and begin to communicate via signaling molecules to coordinate gene expression and biofilm maturation. This communication process is known as:

A 55-year-old man presents with an acutely swollen, red, and painful knee. Arthrocentesis yields cloudy fluid with a white blood cell count of 85,000 cells/mm3 and 90% polymorphonuclear leukocytes. What is the most appropriate next step in management?

A 7-year-old boy from an endemic region develops a large, painless knee effusion without fever. Joint fluid analysis shows 35,000 WBC/mm3. Serology confirms Borrelia burgdorferi infection. What is the recommended initial management?

An 18-year-old male complains of dull, aching pain in his right tibia that is worse at night and completely relieved by ibuprofen. A CT scan reveals a 1 cm cortical radiolucent nidus surrounded by dense reactive sclerosis.

The profound pain relief from NSAIDs is due to the inhibition of which molecule highly expressed by the nidus?

Following total knee arthroplasty, a patient develops a periprosthetic joint infection caused by Staphylococcus epidermidis. The resistance of these bacteria to systemic antibiotics is primarily mediated by their ability to form a biofilm. What is the principal structural component of this biofilm matrix?

The pes anserinus insertion on the proximal medial tibia consists of three tendon insertions. From anterior to posterior, what is the correct anatomical order of these tendons?

A 55-year-old male renal transplant recipient on cyclosporine develops acute podagra. His serum creatinine is 2.8 mg/dL. Which of the following is the most appropriate acute treatment?

A 52-year-old male with a history of chronic gout on allopurinol 300mg daily presents with an acute, severely painful flare in his right knee. Synovial fluid shows negatively birefringent crystals. What is the most appropriate management of his allopurinol during this acute attack?

A 60-year-old male with chronic gout currently taking allopurinol 300 mg daily presents to the clinic with an acute gout flare in his left knee. What is the most appropriate modification to his allopurinol regimen during this acute flare?

A 58-year-old male hospitalized for severe COPD exacerbation develops acute, intense swelling and erythema in his left knee. Synovial fluid analysis confirms acute gout. He has Stage 4 chronic kidney disease (eGFR 20 mL/min). What is the safest acute treatment option?

A 60-year-old male with an acute gout flare in his knee has a medical history significant for stage 4 chronic kidney disease and a recent bleeding gastric ulcer. Which is the safest and most appropriate acute treatment option for his knee?

A 55-year-old man with recurrent gouty arthropathy is started on daily allopurinol for long-term medical management. Which of the following describes the primary mechanism of action of this medication?