DxIm- Final General

Question 1

Osteomyelitis

Answer 1

infx of bone (marrow spaces)

Question 2

Septic arthritis

Answer 2

infxn of joint

Question 3

Drug addicts are prone to infxn where?

Answer 3

S Joints: Spine, Sacroiliac, Symphysis Pubis, Sternoclavicular

Question 4

MC Infectious organism

Answer 4

Staph aureus

Question 5

Modes of infxn

Answer 5

trauma/post surgical, UTI, pneumonia, skin infxn, open wound or cellulitis, heel stick in infants

Question 6

Routes of dissemination

Answer 6

Hematogenous (MC)
Direct extension/implantation
Postoperative

Question 7

Infants and YA acute process may have…

Answer 7

fever, chills, swelling, loss of limb fxn, inc. ESR &/or WBC w/ a shift to the left

Question 8

Adult patterns have _______ process. May have…

Answer 8

insidious process.

may have fever, edema, erythema, pain

Question 9

Preexisting infxn of skin go to…

Answer 9

respiratory and GI tract in 50%

Question 10

Suppurative osteomyelitis occurs in

Answer 10

2-12 yo males 3:1

Question 11

Vascular pattern in infants

Answer 11

Metaphyseal and diaphyseal vessels may penetrate physis

Septic arthritis and osteomyelitis

Question 12

Vascular pattern in children

Answer 12

1 yr to physis closure
Metaphyseal blood flow is slow and turbulent
Metaphyseal vessels do NOT penetrate physis
Separate epiphysis blood supply- spares epiphysis and joints

Question 13

Vascular pattern in adults

Answer 13

Metaphyseal vessels penetrate the vanishing physis
Reestablishes communication w/ subarticular bone end
Osteomyelitis and septic arthritis (Same as INFANT)

Question 14

MC locations of infxn

Answer 14

Knee, hip, ankle (distal tibia), shoulder, spine

Question 15

Categories of infxn

Answer 15

Suppurative- staph

Non-suppurative- TB

Question 16

Suppurative osteomyelitis = bone marrow infxn by…

Answer 16

pyogenic non-tubercular organism (anything but TB)

Staph a, strep pneumoniae, e coli, pseudomonas

Question 17

4 stages of infxn

Answer 17

Latent- 1-10 days
Early- 10-21 days
Middle- weeks
Late- moths

Question 18

Latent stage also called…

Answer 18

hidden stage

Question 19

Cellulitis

Answer 19

inxn of skin, subcutaneous fat or CT

Question 20

Early stage spinal lesion occurs

Answer 20

3 weeks

Question 21

Early stage soft tissue edema displaces ___ and then tends to …

Answer 21

displaces lucent fat planes and then tends to obliterate soft tissue margins to become mass like

Question 22

Middle stage patterns of bone destruction

Answer 22

geographic, moth-eaten, permeative

Question 23

Middle stage patterns of periosteal rxns

Answer 23

buttressing, single layer, multiple layers (laminated), speculated, codmans triangle

Question 24

Late stage has ____ destruction and _____ sinus

Answer 24

cortical destruction and a draining sinus

Question 25

Late stage involcrum (how)

Answer 25

“surround bone” bony collar (chronic periosteal response)

pus lifts the periosteum and causes new bone formation, trying to wall off infxn

Question 26

Late stage cloaca

Answer 26

rare complication. develop squamos cell carcinoma w/in channel of cloaca

Question 27

Marjolins ulcer

Answer 27

Ulcerative channel w/ malignant transformation

Question 28

Late stage sequestrum

Answer 28

chalky white area representing isolated dead bone
cortical and medullar infarcts
island of dead bone

Question 29

Brodies abcess- what is it, symptoms, location, appearance

Answer 29

What is it: localized aborted form of suppurative osteomyelitis (mimics osteoid osteoma but bigger); may be sterile
Symptoms: worse at night relieved by aspirin
Location: metaphyseal - distal tibia
Appearance: oval, elliptical surrounded by heavy reacting sclerosis