Osteomyelitis in the Diabetic Foot


1. Osteomyelitis of the foot in diabetic patients is typically encountered in the following:

a. patients with rheumatoid arthritis
b. patients who have Charcot foot
c. patients who undergo foot surgery
d. patients with a long history of diabetes mellitus who have an ulceration on their foot

2. All of the following are types of osteomyelitis except

a. Degenerative
b. Hematogenous
c. Contiguous
d. Chronic

3. In a patient diagnosed with diabetic foot osteomyelitis the following should be addressed first:

a. the etiology
b. the neurologic status of the patient
c. blood tests
d. the vascular status of the patient

4. The highest risk of incurring osteomyelitis after foot surgery occurs as a result of the following:

a. Smoking cigarettes
b. Office Surgery
c. Multiple bone procedures
d. Implant surgery

5. Contiguous osteomyelitis happens as a result of all of the following except

a. toenail surgery combined with bone surgery
b. open fractures
c. implant surgery
d. Hepatitis C

6. Osteomyelitis with peripheral vascular disease is most commonly associated with the following:

a. Thickened toenails
b. Hammertoe deformity
c. Tinea Pedis
d. Gangrene

7. Osteomyelitis of the foot in the diabetic patient is related to all of the following complications of diabetes except:

a. Neuropathy
b. Immunopathy
c. Angiopathy
d. Nephropathy

8. The strict definition of osteomyelitis is meant to describe one of the following

a. bacterial infection of a sinus tract
b. infection of bone and marrow
c. infection of just the periosteum
d. infection of just the bony cortex

9. Osteomyelitis is a common complication of foot ulcerations occurring in as many as:

a. 10% of patients with ulcerations
b. 15% of patients with ulcerations
c. 25% of patients with ulcerations
d. 50% of patients with ulcerations

10. Osteomyelitis in the foot of the diabetic patient most likely mimics the x-ray changes of the following:

a. Gouty arthritis
b. Psoriasis
c. Scleroderma
d. Charcot deformity

11. The most useful blood test in diagnosing osteomyelitis is:

a. ESR
b. WBC
c. CBC with a differential
d. PSA

12. The definitive diagnosis for diabetic foot osteomyelitis is achieved through the following testing procedure:

a. X-ray evaluation
b. Thermographic testing
c. Blood cultures
d. Bone biopsy and culture

13. A bone biopsy in infected bone will show all of the following except:

a. hypertrophic erythrocytes
b. necrosis
c. leucocyte infiltration
d. chronic inflammatory cells

14. In osteomyelitis, beginning evidence of bone changes on X-ray are usually seen within the following time period:

a. 21 days
b. 30 days
c. 5 days
d. 10 days

15. Which of the following statements are not true?:

a. involucrum is new bone formation
b. involucrum is formed by the periosteum
c. sequestrum are healed bone fragments
d. cloaca are defects in the involucrum

16. X-ray changes begin to be visible when the following has occurred:

a. 30-70% of the bone has been absorbed
b. uniform destruction of the cortex
c. calicification occurs in the medullary canal
d. remodeling of involucrum

17. The most common cause of non-infectious bone lesions in the foot of the diabetic patient is:

a. rhematoid nodules
b. gouty tophi
c. regional osteoporosis
d. neuropathic osteoarthropathy

18. All of the following are true statements regarding imaging techniques except:

a. Multiplanar Tomography shows internal detail of bone with high resolution
b. Increase in the density of the marrow cavity in early osteomyelitis can be detected with Computerized Tomography
c. Radionuclide bone scanning reflects osteoblastic activity as well as vascularity
d. Gallium 67 citrate is the current radioactive material of choice

19. All of the following are true statements regarding Magnetic Resonance Imaging except:

a. MRI was found to be more effective than plain radiography or bone scan in detecting bone infection
b. MRI can help differentiate between soft tissue infection and bone infection
c. MRI can help differentiate between Charcot deformity and osteomyelitis
d. MRI is used often to differentiate healed osteomyelitis from surrounding active disease

20. The most common pathogen found in osteomyelitis of the diabetic foot is:

a. S. Aureus
b. Pseudomonas Aeroginosa
c. S. Epidermis
d. Enterococcus

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