Exam 2; Rheum/ortho, neuro, and cardio Flashcards
all newborns have ________ degree hip and knee flexion contractures
20-30 degree
Contractures return neutral by
4-6 months
what is a +Galeazzi’s sign? And what is it associated with
= asymmetrical skin folds/femoral shortening
Associated with DDH (developmental dysplasia of the hip)
What is the Barlow’s test? And what is it associated with?
- Bring it in and back
- tells if the pt can subluxate the hip
Associated with DDH (developmental dysplasia of the hip)
What is Ortolani test? and what is it associated with?
- Open and up
- Reduce a dislocated hip
Associated with DDH (developmental dysplasia of the hip)
pts 6 mo or less with suspected DDH (developmental dysplasia of the hip) can have what done?
ultrasound
pts greater than 6 mo with suspected DDH (developmental dysplasia of the hip) can have what done?
AP X-ray in 20-30 degrees of hip flexion
Tx of DDH (developmental dysplasia of the hip) in a pt LESS than 4 weeks (newborn)
monitor
Tx of DDH (developmental dysplasia of the hip) in a pt <6 months
- Pavlick if reducible
- closed reduction if not
Tx of DDH (developmental dysplasia of the hip) in a pt >6 months
- Traction and closed reduction or surgery for an open reduction
Tx of DDH (developmental dysplasia of the hip) in a pt >18 months
ORIF - Open reduction fixed procedure
The most common cause of limping in young children is (3-8yo) is
Transient monoarticular synovitis (TMS)
A subchondral radiolucent fracture line (aka caffey sign) on x ray indicates
Legg-Calve-Perthes dz (LCPD)
Klein’s lines on X ray indicates
Slipped Capital Femoral Epiphysis (SCFE)
Bony enlargement of the tibial tuberosity on x-ray is
Osgood-schlatter disease
Painless lump with normal ROM and fluid collection in a normally occurring bursa behind the knee is likely a
Baker’s cyst
A Baker’s cyst can be dx via
Ultrasound
Tx of a baker’s cyst includes
(self limited)
Aspirate or surgical excision
what is the most common benign bone tumor in children?
Osteochondroma
what benign bone tumor in children presents as a pain free mass?
Osteochondroma
Pain and tenderness in addition to onion skin layering indicates what bone cancer?
Ewing sarcoma
An aggressive form of bone cancer that presents are pain in a long bone is
Osteosarcoma
Sudden, brief loss of consciousness associated with loss of postural tone from which recovery is spontaneous is known as
Syncope
two of the most common heart anomalies causing sudden cardiac arrest are
- Hypertrophic cardiomyopathy (HCM) and
- Anomalous origin of the coronary artery
A vibratory or still’s murmur is heard the loudest/best when the patient is in what position? When does the murmur diminish?
Loudest when the pt is supine
(DIMINISHES with inspiration OR sitting)
A venous hum is heard the loudest/best in what position? When does the murmur diminish?
Loudest when the pt is Sitting
(DIMINISHES if the pt turns their neck, lays supine, or compresses the jugular vein)
What is the hallmark of transposition?
- Aorta arises from the RV
- Pulmonary artery arises from the LV
If CXR reveals an egg on a string appearance, this may indicate what condition?
Transposition of the Great Vessels
2 or more generalized seizures (at least 24 hrs apart)
Epilepsy
a seizure that arises from both hemispheres of the brain simultaneously is a
Generalized seizure
a seizure that arises from ONE region of the cortex is a
Focal seizure
seizures occurring at a rate that does NOT permit consciousness to be regained in the intervals between the seizures is known as
Status Epileptics
In the initial management of status epileptics what med can be given and what are the doses?
Benzodiazepines “zepam”
- Lorazepam 0.1 mg/kg IV or IO, MAX 4mg
- Diazepam 0.2 mg/kg IV or IO, MAX 10mg
If after administration and initial management of status epileptics you would
Give a second dose of benzodiazepine
If the seizures continue in status epileptics even after TWO doses of benzodiazepine you would administer
First dose of anti-seizure medication:
- Fosphenytoin 20 mg/kg IV or IO; MAX 1500 mg
50% of febrile seizures occur at ages
1-2 yrs
MC disorder of childhood is
Febrile seizures
1st line meds for a pt with Tourette syndrome includes
Clonidine or Guanfacine
