126 - Osteomyelitis

Question 1

OM (osteomyelitis) may spread via __ pathway or as a result of an __ in a nearby tissue/__ wound.

Answer 1

hematogenic
infection
puncture

Question 2

OM in elder patients is usually in the __, while in children the commonly affected areas are __

Answer 2

vertebrae

long bones

Question 3

The most common area for OM is the __

Answer 3

vertebrae

Question 4

The most common pathogen causing vertebral OM is __, followed by (3)

Answer 4

staph aureus
strep
G (-)
candida (IVDU)

Question 5

The chronic form of OM is usually caused by: 3

Answer 5

TB

brucella

Question 6

Typical clinical presentation of vertebral OM include- 3. The vertebrae most commonly involved are: __>__>__

Answer 6

back pain
fever > 38
neurological deficiency
lumbar>thoracic>cervical

Question 7

Lab results of OM will show normal __, increased __ markers (__ is more specific together with __). Cultures will be positive only in -%. the gold standard imaging tests are__ and __, helping to locate __

Answer 7

WBC
inflammatory 
ESR
CRP
30-80
MRI
CT
abscess

Question 8

Treating OM is done first with __. Surgical treatment is recommended only in the case of an infected __.

Answer 8

Abx

prosthetic

Question 9

If the pain lingers even after __ is normalized, consider __/__.

Answer 9

CRP

osteonecrosis/spine instability

Question 10

What is the recommended Abx for OM due to SA and MRSA?

Answer 10

nafcillin/oxacillin -> rifampin + levofloxacin

vancomycin->rifampin + levofloxacin/TMP-SMX

Question 11

What is the recommended Abx for OM due to strep?

Answer 11

penicillin G/ceftriaxone

Question 12

What is the recommended Abx for OM due to enterobacteria which is susceptible and resistant to quinolone?

Answer 12

ciprofloxacin

imipenem

Question 13

What is the recommended Abx for OM due to pseudomonas?

Answer 13

cefepime/ceftazidime + aminoglycoside -> ciprofloxacin
or
piperacillin-tazobactam + aminoglycoside -> ciprofloxacin

Question 14

What is the recommended Abx for OM due to anaerobes?

Answer 14

clindamycin

Question 15

OM of long bones is caused by: 3

Answer 15

hematological pathway
trauma (open fracture)
post op

Question 16

OM of long bones may appear even after __ years

Answer 16

50

Question 17

Which the imaging test is most suitable for OM of long bones?

Answer 17

SPECT CT

Question 18

What are the RF for foot OM? 5

Answer 18

peripheral neuropathy
deformations
vascular damage
unstable diabetes
injuries

Question 19

In foot OM the cultures of the __ and __ might not match.

Answer 19

skin

bone

Question 20

The test of choice for foot OM is __

Answer 20

MRI

Question 21

What is probe to bone test?

Answer 21

examining by looking for and touching the bon