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Osteomyelitis Flashcards

1
Q

In children, microorganisms seed mainly in __________

A

long bones

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2
Q

In adults, the ____________ is the most commonly affected site

A

vertebral column

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3
Q

The most important aim of the management of osteomyelitis is to prevent progression to (acute/chronic) ___________ osteomyelitis

A

chronic

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4
Q

It is widely used classification system of osteomyelitis based on anatomic site, comorbidity, and radiographic findings

A

Cierny-Mader staging system

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5
Q

Three mechanisms underlying osteomyelitis

A

Hematogenous spread; spread of contiguous site following surgery; secondary infection of vascular insufficiency

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6
Q

In hematogenous osteomyelitis, the most common primary foci of infection are the ________, ________, _________, and the _________.

A

Urinary tract, skin/soft tissue, intravascular catheterization sites, endocardium

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7
Q

The most common underlying condition of osteomyelitis secondary to vascular insufficiency or peripheral neuropathy is __________.

A

diabetes

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8
Q

In poorly controlled diabetes, the _________ is caused by skin, soft tissue, and bone ischemia combined with motor, sensory, and autonomic neuropathy.

A

diabetic foot syndrome

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9
Q

In _____ (acute/subacute/chronic) osteomyelitis, it is treated with antibiotics alone.

A

acute

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10
Q

In _____ (acute/subacute/chronic) osteomyelitis, antibiotic treatment is combined with debridement surgery.

A

chronic

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11
Q

Subacute course of ________ osteomyelitis due to tuberculosis is caused mainly what specific type of low-virulence microorganisms?

A

vertebral; coagulase-negative staphylococci, P. acnes

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12
Q

Chronic osteomyelitis develops most often after ________, mandibular, or _____ infection

A

sternal, foot

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13
Q

Most common manifestation of hematogenous bone infection in adults

A

Vertebral osteomyelitis

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14
Q

Routes involved in pathogenesis of vertebral osteomyelitis

A

segmental arterial circulation; retrograde seeding through prevertebral venous plexus; direct inoculation during spinal surgery

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15
Q

Most common causative agent of acute vertebral osteomyelitis

A

S. aureus (40-50%)

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16
Q

Most common causative agent of subacute vertebral osteomyelitis

A

Mycobacterium tuberculosis

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17
Q

Most common causative agent of implant-associated osteomyelitis

A

coagulase-negative staphylococci and P. acnes

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18
Q

Leading initial symptom of vertebral osteomyelitis

A

Back pain

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19
Q

Most affected part in vertebral osteomyelitis

A

Lumbar spine (60%)

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20
Q

In implant-associated spinal osteomyelitis, early-onset infection is diagnosed within _____ days.

A

30

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21
Q

Diagnosis of vertebral osteomyelitis with high levels of sensitivity

A

ESR and CRP

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22
Q

When blood and tissue cultures are negative, what type of analysis should be used?

A

PCR

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23
Q

Reasonable first step in evaluating vertebral osteomyelitis

A

Plain radiography (Xray)

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24
Q

Useful in subacute or chronic cases, but NOT in acute osteomyelitis

A

Plain radiography (Xray)

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25
Gold standard in diagnosing osteomyelitis
MRI
26
In antibiotic therapy in adults without implants, drug which can be used for DELAYED-type penicillin hypersensitivity
Cerufoxime (1.5g IV q6-8h)
27
In antibiotic therapy in adults without implants, drug which can be used for IMMEDIATE-type penicillin hypersensitivity
Vancomycin (1g IV q12h)
28
Epidural abscesses occur as complication of vertebral osteomyelitis in what part of spine?
Cervical (30%)
29
In antibiotic therapy in adults with orthopedic devices, drug which can be used for DELAYED-type penicillin hypersensitivity
Cefazolin (2g IV q8h)
30
In antibiotic therapy in adults with orthopedic devices, drug which can be used for IMMEDIATE-type penicillin hypersensitivity
Vancomycin (1g IV q12h)
31
This drug can be administered to patients with hypersensitivity to B-lactams
Ciprofloxacin (PO or IV)
32
Treatment for early staphylococcal implant-associated infections are _________ + ____________
Fluoroquinolone + rifampin
33
This drug is efficacious against staphylococcal biofilms < 3 weeks' duration
Rifampin
34
Group of drugs which are effective against biofilm formed by gram-negative bacilli
Fluoroquinolones (ciprofloxacin, levofloxacin, ofloxacin)
35
Main complication of long-bone osteomyelitis
Persistence of infection with progression to chronic osteomyelitis
36
Favors the adherence of staphylococci and the formation of a biofilm that resists phagocytosis
Fibronectin / Collagen
37
Most common causative agent of prosthetic joint infection
S. aureus
38
Chronic PJI is commonly caused by what microorganisms
coagulase-negative staphylococci or P. acnes
39
Biomarker that can be tested in synovial fluid
a-defensin
40
Treatment of patients with severe comorbidity
Lifelong suppressive antimicrobial therapy
41
Most common causative agent of poststernotomy osteomyelitis
coagulase-negative staphylococci
42
Hematogenous sternal osteomyelitis common causative agent
S. aureus
43
Sickle cell anemia common causative agent
Salmonella
44
Common causative agent in IV drug users
P. aeruginosa
45
Feared complication of sternal osteomyelitis
Contiguous mediastinitis
46
Leading pathogen of foot osteomyelitis
S. aureus
47
Diagnostics for foot osteomyelitis which has 90% positive predictive value
probe to bone test
48
Anaerobes are prevalent in _____ (acute/chronic) wounds.
Chronic
49
Diagnostic test for foot osteomyelitis with high degree of sensitivity and specificity
MRI
50
Drug of choice against methicillin-resistant S. aureus
Vancomycin
51
TRUE or FALSE. Osteomyelitis is the inflammation of bone and marrow, always secondary to infection
TRUE
52
TRUE or FALSE. Pyogenic is almost always caused by bacterial infection
TRUE
53
What disease has a radiographic finding of a lytic focus of bone destruction surrounded by sclerosi
Osteomyelitis
54
Which is more destructive? Pyogenic or mycobacterial osteomyelitis?
Mycobacterial
55
Histological findings for TB caused by Mycobacteria
Granulomatous inflammation and caseous necrosis
56
Characteristic produced by reactive periosteal bone deposition on the medial and anterior surfaces of the tibia
saber shin
57
The ankle is a hinge joint formed by ______, the _____ and the _______
tibia, fibula, and talus
58
Principal joints of the ankle
Tibiotalar and subtalar (talocalcaneal) joints
59
Principal landmarks of the ankle
Medial malleolus - Tibia | Lateral malleolus - Fibula
60
Dorsiflexion and Plantar flexion are movements of what ankle joint?
Tibiotalar joint
61
This movement is powered by gastrocnemius, the posterior tibial muscle, and toe flexors
Plantar flexion
62
This movement is powered by the anterior tibial muscle, and toe extensors
Dorsiflexion
63
Ligament found medially involved in protecting against stress from eversion
Deltoid ligament
64
Ligament found laterally which s most at risk in injury from inversion
Anterior talofibular ligament
65
This tendon attached the gastrocnemius and soleus to posterior calcaneus
Achilles tendon
66
Muscles for eversion
Peroneus longus and brevis
67
Muscles for inversion
tibialis posterior and anterior
68
It also means "bend your heel outward"
eversion
69
It also means "point your foot toward the floor"
Plantar flexion
70
It also means "point your foot toward the ceiling"
Dorsiflexion

CIMS (6 decks)

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