NUR 2162- UPDATED 2024//2025
WITH QUESTIONS AND ACCURATE
ANSWERS
Osteomyelitis, what is the primary organism responsible for? - CORRECT ANSWER
Infection in the bone cause usually by bacteria- Staphylococcus aureus. Can be caused
by other ones too: Haemophilus influenzae, Salmonella and gram-negative bacteria.
There are two types: Hematogenous (travels through the blood) and contiguous
(spreads on adjacent bones by open fractures/wounds etc)
Can be caused by diabetes, metabolic vascular disease, smoking, alcohol, advanced
age, immunocompromised patients
Hematogenous: Travels into the blood from ear, sinus, cutaneous, and dental infections.
Usually happens in the pelvis, spine, and small bones
Pelvic infections are more likely to result in vertebral osteomyelitis.
Vaginal, uterine, ovarian, bladder, and intestinal infections are more likely to result in
iliac or sacral osteomyelitis.
Process of inflammation: - CORRECT ANSWER ◦An invading pathogen provokes an
inflammatory response.
◦The invading pathogen may set up colonies and create a substance called biofilm.
◦The biofilm adheres to surfaces and creates a film which contributes to antibiotic
resistance (the medications are unable to penetrate the biofilm or very little is able to
make it through - it acts like a shield)
◦The biofilm also promotes osteoclast activity while impeding osteoblast activity further
promoting inflammation.
◦As inflammation progresses, the vasculature becomes leaky and more fluid and
leukocytes enter the space.
◦The exudate extends into the metaphysis and small metaphyseal openings, weakening
the periosteum and leading to pathological fractures
Signs and symptoms:
◦Fever (systemic inflammatory response)
◦Malaise (systemic inflammatory response)
◦Anorexia (systemic inflammatory response)
◦Weight loss
◦Pain (localized inflammatory response)
◦Swelling and exudate (in contiguous osteomyelitis) (localized inflammatory response)
Treatments: Antibiotic treatment (6-8 weeks), bone biopsy, debridement of infected
bone
Tests and diagnostics: XR, CT, MRI, WBC Count, SPECT, PECT, CRP
Osteosarcoma - CORRECT ANSWER Cancer in bones
, Most common diagnosed primary tumor
May contain fibrinoid & chondroid tissues
Contains osteoid produced by anaplastic stromal cells
These osteioids get deposited in thick masses which they can infiltrate normal
Mostly in metaphysis of long bones
Pain and enlarged mass
Can spread to lungs
Is diagnosed with CT, MRI for metastasis and general bone biopsy
Alkaline phosphatase and Lactate dehydrogenase levels
In general, chemotherapy is limited as medications cannot pass through bones.
Pathophysiology of cystocele, enterocele, rectocele - CORRECT ANSWER Cystocele:
Type of Pelvic prolapse- Anterior one
Stabilizing the connective tissue between bladder and vagina and putting bladder back
into the place.
Decreased estrogen levels can cause this such as menopause.
Multiple births
Enterocele:
Type of pelvic prolapse- A vagina vault happening at apex of the vagina
Involved bladder, rectum or/and small bowel
Goal is to put all the organs back into place.
Rectocele:
Posterior form
Involves rectum
Goal: Stabilize the connective tissue between rectum and vagina
Types of fluid compartments. - CORRECT ANSWER Intracellular (fluid in the cells) ⅔ of
the bodies fluid
Extracellular (fluid outside the cells)
Intravascular (fluid in the blood vessels)
Interstitial (fluid that surrounds the cells)
Transcellular (i.e. CSF, pericardial fluid, synovial fluids)
What type of fluid compartment is blood plasma? - CORRECT ANSWER Extracellular
compartment
Pleural effusion - CORRECT ANSWER Abnormal accumulation of fluid in the pleural
space (between lung and chest wall).
If pleural effusion is present, the affected lung fields are dull to percussion and breath
sounds are absent. A pleural friction rub may also be present.
With a large pleural effusion that is compressing lung tissue and causing alveolar
collapse, treatment may include thoracentesis, removal of the fluid by needle aspiration,
or insertion of a chest tube
What respiratory condition is caused by decreased PaCO2? - CORRECT ANSWER
hyperventilation, respiratory acidosis ?
WITH QUESTIONS AND ACCURATE
ANSWERS
Osteomyelitis, what is the primary organism responsible for? - CORRECT ANSWER
Infection in the bone cause usually by bacteria- Staphylococcus aureus. Can be caused
by other ones too: Haemophilus influenzae, Salmonella and gram-negative bacteria.
There are two types: Hematogenous (travels through the blood) and contiguous
(spreads on adjacent bones by open fractures/wounds etc)
Can be caused by diabetes, metabolic vascular disease, smoking, alcohol, advanced
age, immunocompromised patients
Hematogenous: Travels into the blood from ear, sinus, cutaneous, and dental infections.
Usually happens in the pelvis, spine, and small bones
Pelvic infections are more likely to result in vertebral osteomyelitis.
Vaginal, uterine, ovarian, bladder, and intestinal infections are more likely to result in
iliac or sacral osteomyelitis.
Process of inflammation: - CORRECT ANSWER ◦An invading pathogen provokes an
inflammatory response.
◦The invading pathogen may set up colonies and create a substance called biofilm.
◦The biofilm adheres to surfaces and creates a film which contributes to antibiotic
resistance (the medications are unable to penetrate the biofilm or very little is able to
make it through - it acts like a shield)
◦The biofilm also promotes osteoclast activity while impeding osteoblast activity further
promoting inflammation.
◦As inflammation progresses, the vasculature becomes leaky and more fluid and
leukocytes enter the space.
◦The exudate extends into the metaphysis and small metaphyseal openings, weakening
the periosteum and leading to pathological fractures
Signs and symptoms:
◦Fever (systemic inflammatory response)
◦Malaise (systemic inflammatory response)
◦Anorexia (systemic inflammatory response)
◦Weight loss
◦Pain (localized inflammatory response)
◦Swelling and exudate (in contiguous osteomyelitis) (localized inflammatory response)
Treatments: Antibiotic treatment (6-8 weeks), bone biopsy, debridement of infected
bone
Tests and diagnostics: XR, CT, MRI, WBC Count, SPECT, PECT, CRP
Osteosarcoma - CORRECT ANSWER Cancer in bones
, Most common diagnosed primary tumor
May contain fibrinoid & chondroid tissues
Contains osteoid produced by anaplastic stromal cells
These osteioids get deposited in thick masses which they can infiltrate normal
Mostly in metaphysis of long bones
Pain and enlarged mass
Can spread to lungs
Is diagnosed with CT, MRI for metastasis and general bone biopsy
Alkaline phosphatase and Lactate dehydrogenase levels
In general, chemotherapy is limited as medications cannot pass through bones.
Pathophysiology of cystocele, enterocele, rectocele - CORRECT ANSWER Cystocele:
Type of Pelvic prolapse- Anterior one
Stabilizing the connective tissue between bladder and vagina and putting bladder back
into the place.
Decreased estrogen levels can cause this such as menopause.
Multiple births
Enterocele:
Type of pelvic prolapse- A vagina vault happening at apex of the vagina
Involved bladder, rectum or/and small bowel
Goal is to put all the organs back into place.
Rectocele:
Posterior form
Involves rectum
Goal: Stabilize the connective tissue between rectum and vagina
Types of fluid compartments. - CORRECT ANSWER Intracellular (fluid in the cells) ⅔ of
the bodies fluid
Extracellular (fluid outside the cells)
Intravascular (fluid in the blood vessels)
Interstitial (fluid that surrounds the cells)
Transcellular (i.e. CSF, pericardial fluid, synovial fluids)
What type of fluid compartment is blood plasma? - CORRECT ANSWER Extracellular
compartment
Pleural effusion - CORRECT ANSWER Abnormal accumulation of fluid in the pleural
space (between lung and chest wall).
If pleural effusion is present, the affected lung fields are dull to percussion and breath
sounds are absent. A pleural friction rub may also be present.
With a large pleural effusion that is compressing lung tissue and causing alveolar
collapse, treatment may include thoracentesis, removal of the fluid by needle aspiration,
or insertion of a chest tube
What respiratory condition is caused by decreased PaCO2? - CORRECT ANSWER
hyperventilation, respiratory acidosis ?
