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N1115 - Trans. to Associates > Exam 3 - Osteomyelitis > Flashcards

Exam 3 - Osteomyelitis Flashcards

1
Q

severe infection of the bone, bone marrow, and surrounding soft tissue

A

osteomyelitis

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2
Q

most common organism for osteomyelitis

A

Staphylococcus aureus

*educate: keep your nails short

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3
Q

indirect entry (hematogenous) risk factors

A

blunt trauma
GU, respiratory infection marked by vascular insufficiency disorder (infection spreads to the bone)
boys < 12 y/o

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4
Q

most common sites of osteomyelitis

A

vascular bones

  • pelvis
  • tibia
  • vertebrae
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5
Q

direct entry risk factors

*most common

A

open wounds

foreign body present (including artificial joints, plates, etc)

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6
Q

bone death occurs as a result of ___

A

ischemia

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7
Q

dead bone is aka

A

sequestrum

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8
Q

thin membrane on the outside of your bones

A

periosteum

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9
Q

part of the periosteum that continues to have blood supply forms new bone called ___

A

involucrum

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10
Q

if sequestrum does not resolve on its own or debrided a sinus tract develops. What occurs with a sinus tract?

A

chronic, purulent cutaneous drainage from the tract

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11
Q

acute osteomyelitis last how long

A

< 1 month

*initial infection

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12
Q

local s/sx of osteomyelitis

A 
pain, worsens with activity; unrelieved by rest
swelling
tenderness
warmth
restricted movement
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13
Q

systemic s/sx of osteomyelitis

A 
fever
night sweats
chills
restlessness
nausea
malaise
drainage (late)
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14
Q

how long does chronic osteomyelitis last

A

> 1 month

fails to respond to abx treatment; process of exacerbation and treatment

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15
Q

granulation tissue turns into

A

scar tissue > avascular > ideal site for microorganism growth > cannot penetrate abx

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16
Q

long term and most rare complications

A

septicemia
septic arthritis
pathologic fractures
amyloidosis

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17
Q

Dx studies for osteomyelitis

A 
bone, soft tissue injury (definitive way to Dx)
blood, wound culture
WBC
ESR
CRP
CXR, MRI, CT scan
bone scan
18
Q

how long does it take for osteomyelitis to show on an XR?

A

10 days to weeks

19
Q

how long for IV abx therapy

A

4-6 weeks or as long as 3-6 months

20
Q

how are IV abx give at home

A

PICC (peripherally inserted central catheter)
port
CVAD (central venous access device; central line)

21
Q

IV abx used for osteomyelitis

A 
PCN
naficillin( Nafcil)
neomycin
vancomycin
Keflex
cefazolin (Ancef)
cefoxitin (Mefoxin)
gentamycin (Garamycin)
tobramycin (Nebcin)
22
Q

PO abx used for chronic osteomyelitis or given after IV abx therapy

A

cipro

*6-8 weeks

23
Q

bone grafts may help restore __ __

A

blood flow

24
Q

what can develop d/t achilles tendon contracture if the foot is not properly supported in a neutral position by splint or boot

A

footdrop

25
Q

what can occur to pts taking fluoroquinolone (cipro, levo)

A

tendon rupture

26
Q

side effects of cefazolin (Ancef)

A

hives
severe, watery diarrhea
blood in stool
throat, mouth sores

27
Q

lengthy abx use can cause an overgrowth of what?

A

candida albicans

c. diff

28
Q

hematogenous osteomyelitis

A

d/t blood infection

29
Q

contagious-focused ostemomyelitis

A

d/t contaminated bone surgery r/t hardware, open fracture, traumatic injury

30
Q

osteomyelitis with vascular insufficiency

A

d/t decrease perfusion: common in DM and PVD

commonly affects the feet

31
Q

any diabetic foot ulcer more than __ cm in diameter is highly suspicious for osteomyelitis

A

2 cm

32
Q

are systemic s/sx constant with chronic osteomyelitis?

A

No, they may be reduced but local s/sx such as constant pain, swelling, warmth at site may be present.

33
Q

should elective orthopedic sx be performed if the pt currently has an infection?

A

No, increased risk for osteomyelitis

34
Q

surgical interventions to help reduce risk for osteomyelitis

A

prophylactic abx pre-op
abx 24 hr post op
D/C foley, drains ASAP
aseptic wound care

35
Q

MRI can detect ___ ___ ___ which is an early indication of osteomyelitis

A

bone marrow edema

36
Q

which 2 scans are most helpful to identify the extent of infection

A

MRI

CT

37
Q

sx treatment for chronic osteomyelitis includes extended abx use and which type of surgery?

A

sequestrectomy

38
Q

what occurs during a dequestrectomy?

A

removal of enough involucrum to enable the surgeon to remove sequestrum

39
Q

irritation does not extend beyond __ week and uses a ___ physiologic saline solution

A

1 week

sterile saline solution

40
Q

which technique is essential when changing dressing r/t osteomyelitis

A

sterile

41
Q

what labs must be monitored to avoid adverse abx reaction

A

peak

trough

N1115 - Trans. to Associates (21 decks)

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