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CIMS > Osteomyelitis > Flashcards

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
Q

Gold standard in diagnosing osteomyelitis

A

MRI

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26
Q

In antibiotic therapy in adults without implants, drug which can be used for DELAYED-type penicillin hypersensitivity

A

Cerufoxime (1.5g IV q6-8h)

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27
Q

In antibiotic therapy in adults without implants, drug which can be used for IMMEDIATE-type penicillin hypersensitivity

A

Vancomycin (1g IV q12h)

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28
Q

Epidural abscesses occur as complication of vertebral osteomyelitis in what part of spine?

A

Cervical (30%)

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29
Q

In antibiotic therapy in adults with orthopedic devices, drug which can be used for DELAYED-type penicillin hypersensitivity

A

Cefazolin (2g IV q8h)

30
Q

In antibiotic therapy in adults with orthopedic devices, drug which can be used for IMMEDIATE-type penicillin hypersensitivity

A

Vancomycin (1g IV q12h)

31
Q

This drug can be administered to patients with hypersensitivity to B-lactams

A

Ciprofloxacin (PO or IV)

32
Q

Treatment for early staphylococcal implant-associated infections are _________ + ____________

A

Fluoroquinolone + rifampin

33
Q

This drug is efficacious against staphylococcal biofilms < 3 weeks’ duration

A

Rifampin

34
Q

Group of drugs which are effective against biofilm formed by gram-negative bacilli

A

Fluoroquinolones (ciprofloxacin, levofloxacin, ofloxacin)

35
Q

Main complication of long-bone osteomyelitis

A

Persistence of infection with progression to chronic osteomyelitis

36
Q

Favors the adherence of staphylococci and the formation of a biofilm that resists phagocytosis

A

Fibronectin / Collagen

37
Q

Most common causative agent of prosthetic joint infection

A

S. aureus

38
Q

Chronic PJI is commonly caused by what microorganisms

A

coagulase-negative staphylococci or P. acnes

39
Q

Biomarker that can be tested in synovial fluid

A

a-defensin

40
Q

Treatment of patients with severe comorbidity

A

Lifelong suppressive antimicrobial therapy

41
Q

Most common causative agent of poststernotomy osteomyelitis

A

coagulase-negative staphylococci

42
Q

Hematogenous sternal osteomyelitis common causative agent

A

S. aureus

43
Q

Sickle cell anemia common causative agent

A

Salmonella

44
Q

Common causative agent in IV drug users

A

P. aeruginosa

45
Q

Feared complication of sternal osteomyelitis

A

Contiguous mediastinitis

46
Q

Leading pathogen of foot osteomyelitis

A

S. aureus

47
Q

Diagnostics for foot osteomyelitis which has 90% positive predictive value

A

probe to bone test

48
Q

Anaerobes are prevalent in _____ (acute/chronic) wounds.

A

Chronic

49
Q

Diagnostic test for foot osteomyelitis with high degree of sensitivity and specificity

A

MRI

50
Q

Drug of choice against methicillin-resistant S. aureus

A

Vancomycin

51
Q

TRUE or FALSE. Osteomyelitis is the inflammation of bone and marrow, always secondary to infection

A

TRUE

52
Q

TRUE or FALSE. Pyogenic is almost always caused by bacterial infection

A

TRUE

53
Q

What disease has a radiographic finding of a lytic focus of bone destruction surrounded by sclerosi

A

Osteomyelitis

54
Q

Which is more destructive? Pyogenic or mycobacterial osteomyelitis?

A

Mycobacterial

55
Q

Histological findings for TB caused by Mycobacteria

A

Granulomatous inflammation and caseous necrosis

56
Q

Characteristic produced by reactive periosteal bone deposition on the medial and anterior surfaces of the tibia

A

saber shin

57
Q

The ankle is a hinge joint formed by ______, the _____ and the _______

A

tibia, fibula, and talus

58
Q

Principal joints of the ankle

A

Tibiotalar and subtalar (talocalcaneal) joints

59
Q

Principal landmarks of the ankle

A

Medial malleolus - Tibia

Lateral malleolus - Fibula

60
Q

Dorsiflexion and Plantar flexion are movements of what ankle joint?

A

Tibiotalar joint

61
Q

This movement is powered by gastrocnemius, the posterior tibial muscle, and toe flexors

A

Plantar flexion

62
Q

This movement is powered by the anterior tibial muscle, and toe extensors

A

Dorsiflexion

63
Q

Ligament found medially involved in protecting against stress from eversion

A

Deltoid ligament

64
Q

Ligament found laterally which s most at risk in injury from inversion

A

Anterior talofibular ligament

65
Q

This tendon attached the gastrocnemius and soleus to posterior calcaneus

A

Achilles tendon

66
Q

Muscles for eversion

A

Peroneus longus and brevis

67
Q

Muscles for inversion

A

tibialis posterior and anterior

68
Q

It also means “bend your heel outward”

A

eversion

69
Q

It also means “point your foot toward the floor”

A

Plantar flexion

70
Q

It also means “point your foot toward the ceiling”

A

Dorsiflexion

CIMS (6 decks)

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