Cheung Part 8

Question 1

what is the most common elbow fracture

Answer 1

supracondylar fracture of the humerus

Question 2

supracondylar humerus fracture affects who and what symptoms are seen

Answer 2

2-12 year olds

fall off trampoline, elbow deformity, pain

Question 3

what exam and tests are important when dealing with a supracondylar humerus fracture

Answer 3

neurovascular exam important
X-rays show supracondylar fracture
postive posterior SAIL SIGN

Question 4

what are the symptom and exam results seen in rickets

Answer 4

pain in legs

bowed legs

Question 5

what is seen on an X-ray of rickets

Answer 5

looser lines (osteoid seam)
widened growth plates

Question 6

what lab results are seen in rickets

Answer 6

low normal serum Ca

Phos is low

Question 7

what is the treatment of rickets

Answer 7

nutritional supplementation

treat underlying cause

Question 8

the hypertrophic zone in rickets is what size

Answer 8

large

Question 9

the sun produces what in the vitamin D pathway

Answer 9

7-dehydrocholesterol

Question 10

7-dehydrocholesterol becomes what in the vitamin D pathway

Answer 10

cholecalciferol (vitamin D3)

Question 11

what happens to cholecalciferol (vitamin D3) in the liver

Answer 11

becomes 25-hydroxyvitamin D3

Question 12

what happens to 25-hydroxyvitamin D3 in the kidney

Answer 12

1,25-dihydroxyvitamin D3

Question 13

as one goes from epiphysis to metaphysis in the growth plate what happens

Answer 13

germinal zone (nearest epiphysis)
proliferative zone
zone of maturation
hypertrophic zone
bone (metaphysis)

Question 14

what is the most common bone broken in non-accidental trauma

Answer 14

humerus (then femur)

Question 15

metaphyseal corner fractures are commonly seen in what

Answer 15

child abuse

Question 16

what are risk factors for child abuse

Answer 16

low income
first born
premature
stepchildren
handicapped
single parent
drug use
unemployed parents
abused parents

Question 17

what types of injury should one suspect child abuse

Answer 17

spiral fractures
posterior rib fractures
metaphyseal corner fractures

Question 18

what is the Salter Harris classification of bone fractures

Answer 18

type I: through growth plate
type II: growth plate and metaphysis
type III: growth plate and articular epiphysis
type IV: growth plate meta and epiphysis
type V: crush injury damaging growth plate

Question 19

what is acute joint effusion

Answer 19

monoarticular or oligoarticular
systemic symptoms: JIA, Lyme, Septic
Sometimes painless

Question 20

what is cerebral palsy

Answer 20

permanent, non-progressive brain injury in permpartum period

Question 21

what is seen in cerebral pals

Answer 21

upper motor neurons issue with spasticity
hemiplegia
diplegia

Question 22

when should one be suspicious of cerebral palsy

Answer 22

patient with delayed motor development
history of prematurity
prolonged NICU stay
toe walking

Question 23

the hypertrophic zone in growth place of achondroplasia is what

Answer 23

narrow

Question 24

musculoskeletal issues in achondroplasia typically arise where

Answer 24

spine

Question 25

marfan syndrome is due to what

Answer 25

fibrillin mutation

defect in collagen I osteoblasts

Question 26

what is seen in marfan syndrome

Answer 26

caved chest
really long fingers and narrow bones
hypermobile thumb

Question 27

what is the treatment for osteogenesis imperfecta

Answer 27

bisphosphonates

surgery

Question 28

what are the symptoms of osteogenesis imperfecta

Answer 28

blue sclerae
macrocephaly
hearing loss
poor dentition
kyphoscoliosis
fracture
growth retardation