Osteomylitis & arthritis Flashcards
Where do hematogenous osteomyelitic infections start? Why?
-Metaphysis
- Metaphyseal capillary loops have inefficient phagocytic cells
- flow is sluggish
HEMATOGENOUS OSTEOMYELITIS: WHY THE METAPHYSIS?
A. Metaphyseal capillary loops have inefficient phagocyte cells
B. Flow is sluggish in sinusoidal venous connections
C. Traumatic thrombosis and infarction provides an avascular milieu well- suited for bacterial growth
D. All of the above
D. All of the above
HEMATOGENOUS OSTEOMYELITIS: WHY THE METAPHYSIS?
A. Metaphyseal capillary loops have inefficient phagocyte cells
B. Flow is sluggish in sinusoidal venous connections
C. Traumatic thrombosis and infarction provides an avascular milieu well- suited for bacterial growth
D. All of the above
D. All of the above
Where is the most common site of hematogenous osteomyelitis in adults?
Vertebral bodies
Where is the most common site of hematogenous osteomyelitis in children?
-weight-bearing long-bones
A 10-year-old had heart
surgery 2 weeks ago. His incision is draining serosanguinous fluid.
What evaluation will best help you distinguish whether this is a superficial
or deeper infection ?
A. Sternal stability by physical exam
B. Blood culture
C. CT of the sternum
D. Culture of material draining from the wound
A. Sternal stability by physical exam
A 10-year-old had heart
surgery 2 weeks ago. His incision is draining serosanguinous fluid.
What evaluation will best help you distinguish whether this is a superficial
or deeper infection ?
A. Sternal stability by physical exam
B. Blood culture
C. CT of the sternum
D. Culture of material draining from the wound
A. Sternal stability by physical exam
What are the three ways to get osteomyelitis from a contiguous focus of infection?
- postoperative
- Extenstion from soft tissue (fingers & toes common)
- Direct inoculation (puncture)
What are the three routes of aquisition of osteomyelitis?
- hematogenous
- contiguous focus
- vascular insufficiency
What is the most common bacterial cause of osteomyelitis?
S. aureus
How do we treat acute osteomyelitis?
- blood culture
- vancomycin
How do we treat acute osteomyelitis?
- blood culture
- vancomycin
How do we treat a hospitalized but stable patient with osteomyelitis?
- blood culture
- aspirate pus
- vancomycin initially
- Nafcillin or clindamycin if susceptible
A 13-year-old presents 2 weeks after jumping from a fence, landing on a nail which punctured his tennis shoe and lodged in his foot. After appropriate surgical drainage, what is the usual duration of antibiotic therapy?
A. 5 to 7 days
B. 1 to 2 weeks
C. 3 to 4 weeks
D. 6 weeks
B. 1 to 2 weeks
What is the most common organsism that causes septic arthritis?
S. aureus
