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Host and Defense 2020 > 2/14/17 Spivak Bone and Joint TEST #2 > Flashcards

2/14/17 Spivak Bone and Joint TEST #2 Flashcards

1
Q

What is the hematogenous source of Osteomyelitis?

A
  • Staph aureus (gram + organisms)

- Gram - rods

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2
Q

What are three broad sources of getting osteomyelitis?

A
  • Hematogenous (monomicrobial)
  • Contiguous spread (periodontal)
  • Direct inoculation (result of trauma or surgery)
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3
Q

What location of the body do we see hematogenous osteomylitis in children?

A

-long bones

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4
Q

What location of the body do we see hematogenous osteomyelitis in adults?

A

-Vertebrae

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5
Q

What is sequestra?

A

-Separated dead bone

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6
Q

In the anatomic classification of osteomyelitis what is Stage 1?

A

-Medullary

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7
Q

In the anatomic classification of osteomyelitis what is stage 2?

A

-Superficial (involves only the cortical bone)

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8
Q

In the anatomic classification of osteomyelitis what is stage 3?

A

-Localized (involves both cortical and medullary bone, but doesn’t involve the entire diameter of the bone)

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9
Q

In the anatomic classification of osteomyelitis what is stage 4?

A

-Diffuse (involve the entire thickness of the bone)

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10
Q

If you have infection prior to development of sequestra do you have acute or chronic osteomyelitis?

A

-Acute

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11
Q

If you have an acute classification of osteomyelitis what is the time frame you have to be in?

A

-Less than 2 weeks

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12
Q

If you have an infection after sequestra have formed to you have acute or chronic osteomyelitis?

A

-Chronic

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13
Q

What are three hallmarks that you find in chronic osteomyelitis?

A
  • Formation of involucrum (new bone development)
  • Bone loss
  • Sinus tract formation
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14
Q

If you have chronic osteomyelitis can you treat it with antibiotics alone?

A

-No it will also require surgery

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15
Q

What are the acute clinical presentations of osteomyelitis?

A
  • Gradual onset over several days
  • Dull pain/local tenderness on exam
  • Warmth, erythema, swelling, fevers may happen
  • Septic arthritis (possibly)
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16
Q

What are the chronic clinical presentations of osteomyelitis?

A
  • Mild pain over several weeks
  • Localized swelling or erythema
  • Draining sinus tract
17
Q

If you are looking for acute osteomyelitis can you see it typically on a plain x-ray?

A
  • No usually takes an MRI

- Chronic you can see on a radiograph

18
Q

How do you treat acute osteomyelitis?

A

-3-6 weeks antibiotics

19
Q

What is the gold standard of osteomyelitis diagnosis?

A

-Bone biopsy

20
Q

How do you treat chronic osteomyelitis?

A

-3-6 weeks antibiotics with surgery

21
Q

What usually causes osteomyelitis of the jaw?

A

-Contiguous (spread from somewhere else)

22
Q

Is the mandible or maxilla more susceptible to osteomyelitis of the jaw?

A

-Mandible

23
Q

T/F The lingual aspect of the mandible in region of molar teeth is the greatest risk for osteomyelitis

A

True

24
Q

What are the symptoms of osteomyelitis of the jaw?

A
  • Mandibular pain
  • Anesthesia/paresthesia on affected side
  • Lymphadenopathy
  • Progress to trismus
25
Q

What is the treatment for osteomyelitis of the jaw?

A

-Combo of surgery and antibiotics targeting oral flora

26
Q

What are two types of medicines that are associated with osteonecrosis of the jaw?

A
  • Antiresorptive

- Antiangiogenic

27
Q

What are the leading cause of arthroplasty failure?

A

-Prosthetic Joint Infections

28
Q

What type of bacteria cause Prosthetic joint infections?

A
  • gram + cocci (65%)
  • Aerobic gram - bacilli 6%
  • anaerobes 4%
  • Polymicrobial 20%
29
Q

What are five surgical management options to treat Prosthetic joint infections?

A
  • Debridement and retention
  • 2 stage exchange
  • 1 stage exchange
  • Resection arthroplasty with arthrodesis (fusion)
  • Amputation
30
Q

When you do a debridement and retention surgery for PJIs what type of therapy do you do for treatment?

A

-2-6 weeks of IV therapy + rifampin

31
Q

T/F In general, for patients with prosthetic joint implants, prophylactic antibiotics are recommended prior to dental procedures to prevent prosthetic joint infections.

A

False

-Antibiotics are not recommended

Host and Defense 2020 (61 decks)

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