Infection of the Hands 2011/2012 Name:................................................................... All questions to be attempted 1.

Label with the related diseases a)_______________ e)_______________ _ f)_______________ _ No: -

b)________________ _ c)_______________ (with vesicles)

g)_______________ _

d)_______________ _

h)_______________ _

Hints: Herpatic whitlow, Felon, Tenosynovitis, Ulnar bursatis, Deep Palmar Space Infections, Web space abcess, Paronychia, Cellulitis 2. Write [T] for true or [F] for false a. The most common microorganism that can causing infection of the hand is streptococcal pyogenes [ ] b. Dorsal swelling alone is not enough for diagnosis of dorsal hand infection [ ] c. Conservative therapies is enough and quite effective for treatment of chronic paronychial infection [ ] d. Surgical intervention for treament of falon should be started after 48 hours even though there is absence of fluctulance [ ] e. Early motion is not recommended in post volar longitudinal incision [ ] f. In pyogenic flexor tenosynovitis, findings in the thumb and small finger may be more obvious because of autodecompression mechanism. [ ] 3. Cellulitis of the hand cannot be treated at home with 24 hour follow up except when a. Immunocompromised b. Systemically ill c. Rapidly spreading d. Localized tenderness

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Infection of the Hands 2011/2012 4. Non surgical treatment give has no role in the below condition except in a. Cellulitis of the hand b. Felon c. Herpatic Whitlow d. Tenosynovitis 5. The basic goals of all surgical approaches are all of below except : a. avoid injury to the digital nerve and vessels, b. rapid evacuation for large amount of pus c. use an incision that will not leave a disabling scar, d. keep exploration distal enough so that the flexor tendon sheath is not violated and an iatrogenic tenosynovitis is not produced, e. provide adequate drainage. 6. The most commonly technique use for treatment of Felon is a. Volar longitudinal incision b. Fish (alligator)Mouth Incision c. J or Hockey Stick Incision d. Volar transverse incision 7. Differentiation between Paronychia and Herpetic Whitlow paronychia Herpetic whitlow Causative agents Pain Vesicle treatment 8. Kanavel signs are a. c. b. d. 9. The most valuable sign of ulnar bursal infection was the presence of _________________ at the junction of the _____________________________________ and the________________ eminence 10. Similarly valuable sign of radial bursal infection was the presence of _________________ at the junction of the _____________________________________ and the________________ eminence 11. Four mechanisms of human bite injuries to the hand have been described: a. _____________________ injury occurring from nail biting or secondary to sucking an open bleeding wound on the finger or thumb. b. _____________________________ secondary to bite injury. This usually occurs through the distal phalanx. c. ___________________________ into various parts of the hand. It less commonly results in infection. When infection occurs, it is usually localized around the area of the penetration. d. _________________ injury occurs when the hand strikes another person's mouth with a closed fist. This type is associated with the highest incidence of complications. hints: clenched fist, self inflicted, full thickness bite wound, traumatic amputation 2 [SULIT]