Exam 2; Rheum/ortho, neuro, and cardio

Question 1

all newborns have ________ degree hip and knee flexion contractures

Answer 1

20-30 degree

Question 2

Contractures return neutral by

Answer 2

4-6 months

Question 3

what is a +Galeazzi’s sign? And what is it associated with

Answer 3

= asymmetrical skin folds/femoral shortening
Associated with DDH (developmental dysplasia of the hip)

Question 4

What is the Barlow’s test? And what is it associated with?

Answer 4

• Bring it in and back
• tells if the pt can subluxate the hip
  Associated with DDH (developmental dysplasia of the hip)

Question 5

What is Ortolani test? and what is it associated with?

Answer 5

• Open and up
• Reduce a dislocated hip
  Associated with DDH (developmental dysplasia of the hip)

Question 6

pts 6 mo or less with suspected DDH (developmental dysplasia of the hip) can have what done?

Answer 6

ultrasound

Question 7

pts greater than 6 mo with suspected DDH (developmental dysplasia of the hip) can have what done?

Answer 7

AP X-ray in 20-30 degrees of hip flexion

Question 8

Tx of DDH (developmental dysplasia of the hip) in a pt LESS than 4 weeks (newborn)

Answer 8

monitor

Question 9

Tx of DDH (developmental dysplasia of the hip) in a pt <6 months

Answer 9

• Pavlick if reducible
• closed reduction if not

Question 10

Tx of DDH (developmental dysplasia of the hip) in a pt >6 months

Answer 10

• Traction and closed reduction or surgery for an open reduction

Question 11

Tx of DDH (developmental dysplasia of the hip) in a pt >18 months

Answer 11

ORIF - Open reduction fixed procedure

Question 12

The most common cause of limping in young children is (3-8yo) is

Answer 12

Transient monoarticular synovitis (TMS)

Question 13

A subchondral radiolucent fracture line (aka caffey sign) on x ray indicates

Answer 13

Legg-Calve-Perthes dz (LCPD)

Question 14

Klein’s lines on X ray indicates

Answer 14

Slipped Capital Femoral Epiphysis (SCFE)

Question 15

Bony enlargement of the tibial tuberosity on x-ray is

Answer 15

Osgood-schlatter disease

Question 16

Painless lump with normal ROM and fluid collection in a normally occurring bursa behind the knee is likely a

Answer 16

Baker’s cyst

Question 17

A Baker’s cyst can be dx via

Answer 17

Ultrasound

Question 18

Tx of a baker’s cyst includes

Answer 18

(self limited)
Aspirate or surgical excision

Question 19

what is the most common benign bone tumor in children?

Answer 19

Osteochondroma

Question 20

what benign bone tumor in children presents as a pain free mass?

Answer 20

Osteochondroma

Question 21

Pain and tenderness in addition to onion skin layering indicates what bone cancer?

Answer 21

Ewing sarcoma

Question 22

An aggressive form of bone cancer that presents are pain in a long bone is

Answer 22

Osteosarcoma

Question 23

Sudden, brief loss of consciousness associated with loss of postural tone from which recovery is spontaneous is known as

Answer 23

Syncope

Question 24

two of the most common heart anomalies causing sudden cardiac arrest are

Answer 24

• Hypertrophic cardiomyopathy (HCM) and
• Anomalous origin of the coronary artery

Question 25

A vibratory or still’s murmur is heard the loudest/best when the patient is in what position? When does the murmur diminish?

Answer 25

Loudest when the pt is supine
(DIMINISHES with inspiration OR sitting)

Question 26

A venous hum is heard the loudest/best in what position? When does the murmur diminish?

Answer 26

Loudest when the pt is Sitting
(DIMINISHES if the pt turns their neck, lays supine, or compresses the jugular vein)

Question 27

What is the hallmark of transposition?

Answer 27

• Aorta arises from the RV
• Pulmonary artery arises from the LV

Question 28

If CXR reveals an egg on a string appearance, this may indicate what condition?

Answer 28

Transposition of the Great Vessels

Question 29

2 or more generalized seizures (at least 24 hrs apart)

Answer 29

Epilepsy

Question 30

a seizure that arises from both hemispheres of the brain simultaneously is a

Answer 30

Generalized seizure

Question 31

a seizure that arises from ONE region of the cortex is a

Answer 31

Focal seizure

Question 32

seizures occurring at a rate that does NOT permit consciousness to be regained in the intervals between the seizures is known as

Answer 32

Status Epileptics

Question 33

In the initial management of status epileptics what med can be given and what are the doses?

Answer 33

Benzodiazepines “zepam”
- Lorazepam 0.1 mg/kg IV or IO, MAX 4mg
- Diazepam 0.2 mg/kg IV or IO, MAX 10mg

Question 34

If after administration and initial management of status epileptics you would

Answer 34

Give a second dose of benzodiazepine

Question 35

If the seizures continue in status epileptics even after TWO doses of benzodiazepine you would administer

Answer 35

First dose of anti-seizure medication:
- Fosphenytoin 20 mg/kg IV or IO; MAX 1500 mg

Question 36

50% of febrile seizures occur at ages

Answer 36

1-2 yrs

Question 37

MC disorder of childhood is

Answer 37

Febrile seizures

Question 38

1st line meds for a pt with Tourette syndrome includes

Answer 38

Clonidine or Guanfacine