osteomyelitis Flashcards
STEM; Male patient presents with left knee swelling and redness with a history of a tibial fracture and internal fixation.
Male patient presented with his left knee swelling and redness with history of the tibial fracture and internal fixation.
..
Q1.Investigation?
Aspiration and send for C&S / Gram Stain
Q2: What you look for in aspirated fluid? what tests will you do?
Viscosity and
turbidity and
color
WBCs
PMNs
Crystals
/ Gram Stain, Crystal , Chemical analysis and C&S
You are given a pathological report showing proteins, cocci, and PMN.
Q3.Diagnosis?
Q4: What do you think the cause is?
Q5.Common organism?
3 . Chronic OstMyelitits
4 . Implant
5 . S. Aureus
Q6:How is pus formed (pathogenesis)?
after microbial invasion – > inflammation with vascular congestion this will cause exudation and infiltration with PMNs
Q7: Why pus burst through the bone?
due to increase in interaosseus pressure
2ry to tissue breakdown and cloaqal openening in the involcrum which will breakdown
Q8: Why SCC developed? Sequence of events?
Due to chronic irritation to tissue – > Metaplasia – > dysplasia and cancer formation.
Q9.Name of protein deposit in OM?
AA Amyloid
Q10.Specific pathological name for pus around the screw or implanted plate?
Biofilm
Q11.Define sequestrum & involucrum?
S; Dead bone tissue separated from normal tissue of bone
I; sheath of new bones that surround sequestrum
Q12:Type of crystals in gout & pseudogout?
Ps; Calcium pyrophosphate
G; Urate Crystals
Q14: Why amyloid can’t be removed from the body?
Large molecules and no enzymes to break it down and degrade it.
You are given a pathological report showing proteins, cocci, and PMN.
Q.From report what’s your Dx?
Bacterial Infection which is OM and not Septic arthritis as we cannot apply Kochers criteria (WBCs-Temp-NonWt Bearing)
What will do you for this pt?
Osteomyelitis
Remove implant and give Abx
How to prevent it before surgery?
Abx - Good preparation – Avoid long starvation – Aseptic technique – Laminar flow
What’s the cause of inf. Of this pt?
As this pt on steroids for RA – > suppression of immunity
