Musculoskeletal

Question 1

Bone factors in infection (3)

for exam 50/50 I&I/Pharm

Answer 1

1. Microscopic channels allow infection footholds
2. Microcirculation allows for thrombosis and necrosis
3. New bone formation is slow

Question 2

Infection of MEDULLARY bone caused by bac (usually) or other organism

Answer 2

Osteomyelitis

Question 3

(2) types of osteomyelitis

Answer 3

1. exogenous–fx, surg, injection, bac in soft tissue

2. endogenous (Hematogenous)–inside-out –pathogen in bloodstream

Question 4

Exogenous osteomyelitis etiology

Answer 4

Staphylococcus aureus from deep bite, penetration, venous draws, needles, spreading cellulitis

Question 5

endogenous aka

Answer 5

Hematogenous

Question 6

Hematogenous osteomyelitis common sites–pathogens travel in.

Answer 6

• spine, pelvis (travel from pelvic organs), small bones

- arteries, veins, lymph vessels

Question 7

Bacteria from bite (exogenous osteomyelitis)
human bite:
animal bite:

Answer 7

• Staph aureau

- Pasteurella multocida

Question 8

Common sources of Hematogenous osteomyelitits – “hematogenous seeding”

Answer 8

1. skin infection
2. ear infection
3. dental infection
4. GI infection
5. Post total joint replacement

Question 9

most common pathogen in hematogenous osteomyelitis

Answer 9

Staph aureus

Question 10

Other common hematogenous osteomyelitis pathogens for CHILDREN

Answer 10

1. Group B strep

2. Haemophilus influenzae

Question 11

major pathogen in sickle cell for hematogenous osteomyelitis

Answer 11

Salmonella

Question 12

trapped necrotic bone

Answer 12

sequestrum

Question 13

In Children:

bac growth lifts off _______, discupts ______ _____, leading to ______ and _______

Answer 13

periosteum,
blood supply,
necrosis & sequestrum

Question 14

Osteoblasts lay down new bone to surround infected bone:______

Answer 14

involucrum

Question 15

Exudate escapes _______ to surrounding tissue and through tracts to the ____

Answer 15

involucrum,

skin

Question 16

Periosteum _____ attached in adults, _____ in children

Answer 16

firmly,

loosely

Question 17

Types of osteomyelitis (3)

Answer 17

1. acute (sudden inflammation)
2. subacute (inadequate therapy for past osteomyelitis)
3. Chronic (indolent btwn exacerbations)

Question 18

May accompany site of exogenous osteomyelitis: (4) from puncture

Answer 18

1. inflammatory exudate
2. abscesses
3. fever/ lymphadenopathy
4. local pain/ swellin

Question 19

May accompany hematogenous (4)

Answer 19

1. gradual fever
2. malaise
3. anorexia
4. weight loss

Question 20

spinal osteomyelitis labs

Answer 20

1. CBC (^ WBC)
2. ^ ESR
3. Bone scan

Question 21

spinal osteomyelitis treatments

Answer 21

1. IV antibiotic & debridement (bx and culture)

Question 22

risk of osteomyelitis in adults

Answer 22

pathologic fx

Question 23

infection secondary to a primary infection in another organ (often lungs)

Answer 23

Mycotic Infection (in already ^ sick ppl)

Question 24

Mycotic infection pathogens

Answer 24

1. Candidiasis osteomyelitis (from IV catheter)

2. Coccididioidomycosis- (valley fever–Tx w/ oral axole)

Question 25

arthritis causing pathogen that lies dormant in joint–monoarticular (rare)–hip/knee most often effected

Answer 25

Mycotic-Tuberculous Arthritis (Mycobacterium tuberculosis)

Question 26

Reactive Arthritis aka

Answer 26

Reiter’s syndrome

Question 27

Distortion of body’s immune response following GI or GU infection

Answer 27

Reactive Arthritis

Question 28

painful, swollen toes,fingers,heels

Answer 28

Reiter’s syndrome

Question 29

Nongonococcal (not from gonorhea) acute bacterial arthritis aka

Answer 29

septic arthritis

Question 30

Acute MONOARTICULAR (like TB arthritis) inflammation of large weight-bearing joints and wrists

Answer 30

Septic arthritis–HOT joint

Question 31

most common pathogen for septic arthritis

Answer 31

Staph aureus (less common MRSA, Group B strep)

Question 32

septic arthritis labs

Answer 32

1. synovial fluid WBC count
2. Gram stain
3. synovial culture
   Imaging
   Tx: drain, hospitalization

Question 33

Other infectious arthritis (5)

Answer 33

1. Lyme arthritis–similar to hematogenous
2. Gonococcus
3. Staph
4. Strep
5. Viral

Question 34

1-4 day “migrating polyarthralgies”, skin lesions

Answer 34

Gonococcal arthritis

Question 35

inflammatory changes in skeletal muscle

Answer 35

myositis

Question 36

myositis etiology:

Answer 36

1. viral
2. bacterial (Tuberculosis and sarcoidosis)
3. parasitic infections (trichinelosis, toxoplasmosis)