part 1

Question 1

Severe infection of bone, bone marrow, and surrounding soft tissue.

Answer 1

osteomyelitis

Question 2

What is the most common microorganism that causes osteomyelitis?

Answer 2

staph. aureus

- but can be caused by a variety of organisms

Question 3

What is the etiology of osteomyelitis?

Answer 3

-indirect (hematogenous) or direct entry

Question 4

What is the pathophysiology of osteomyelitis?

Answer 4

• microorganisms grow—>
• increases pressure in bone —>
• ischemia and vascular compromise —>
• infection spreads through bone —>
• cortex devascularization and necrosis

Question 5

What are the clinical manifestations of acute osteomyelitis maning infection of <1 month in duration?

Answer 5

Local manifestations:
-constant bone pain that worsens with activity, unrelieved by rest
Systemic manifestations:
fever, night sweats, chills, nausea, decreased WBC and malaise

Question 6

What are the long term and rare complications of osteomyelitis?

Answer 6

septicemia
septic arthritis
pathologic fractures
amyloidosis

Question 7

What are the diagnostic studies associated with osteomyelitis?

Answer 7

• bone or soft tissue biopsy
• blood and/or wound cultures
• WBC count
• erythrocyte sedimentation rate (ESR)
• c reactive protein
• X-rays/MRI/CT scans
• bone scans

Question 8

What is the treatment for osteomyelitis?

Answer 8

• aggressive prolonged IV antibiotics therapy (4-6 weeks or longer)
• culture or bone biopsy to determine antibiotic
• surgical debridement and decompression

Question 9

What is the care for chronic osteomyelitis?

Answer 9

• surgical removal
• extended use of antibiotics
• impregnated antibiotic beads
• intermittent or constant antibiotic irrigation of bone
• casts or braces
• negative pressure or hyperbaric wound therapy
• removal of prosthetic devices
• amputation: if bone destruction is extensive

Question 10

Who is at risk for osteomyelitis?

Answer 10

• immunocompromised pt’s
• diabetics
• pt’s with prosthetics
• pt’s with vascular insufficiencies