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Clin Med II - Exam 2 > Knott - Peds > Flashcards

Knott - Peds Flashcards

1
Q

approach to peds ortho

A
  1. age
  2. context
  3. hx
  4. pe
  5. imaging → xray, US, CT, MRI
  6. referral → ED/ortho
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2
Q

what are 3 types of ortho infxns

A
  1. transient (toxic) synovitis
  2. septic arthritis
  3. osteomyelitis
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3
Q

mc location for transient synovitis

A

hip

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4
Q

what do you think when you see a non toxic, post viral infxn pediatric pt w. an antalgic gait and his hip abducted and externally rotated

A

transient synovitis

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5
Q

a pt w. septic arthritis will appear

A

ill

fever

irritable

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6
Q

septic arthritis is almost always caused by

A

staph

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7
Q

osteomyelitis commonly affects the

A

long (tubular) bones

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8
Q

what do you think when you see periosteum elevation of a long bone

A

osteomyelitis

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9
Q

mc place for osteoid osteoma

A

le → proximal femur

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10
Q

benign bone lesions progress

A

slowly

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11
Q

what are the benign bone lesions

A
  1. osteoid osteoma
  2. osteoblastoma
  3. osteochondroma
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12
Q

malignant bone lesions are characterized by

A

lots of pain → kids waking up screaming at night

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13
Q

an osteoma is a

A

non malignant bone lesion

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14
Q

what do you think when you see small radiolucent nidus

< 1 - 1.5 cm

A

osteoid osteoma

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15
Q

what is the mc place for an osteoblastoma

A

posterior column of the spine

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16
Q

what do you think when you see non-malignant bone lesion larger than osteoid osteoma

A

osteoblastoma

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17
Q

what are the 3 mc place for osteochondroma

A

distal femur

around knee

proximal humerus

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18
Q

what do you think when you see a cartilage-capped bony spur on the external surface of a bone

A

osteochondroma

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19
Q

what creates a cauliflower appearance on xray

A

osteochondroma

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20
Q

what are the malignant bone lesions

A
  1. osteosarcoma
  2. ewing’s sarcoma
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21
Q

what is the mc location for osteosarcomas

A

femur

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22
Q

what is the mc primary malignant bone lesion in kids

A

osteosarcoma

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23
Q

osteosarcoma often occurs

A

post trauma

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24
Q

what do you think when you see a pt w. localized pain for several months that waxes and wanes with normal labs except for elevated alk phos and LDH

A

osteosarcoma

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25
Q

what does this xray make you think - sunburst, codman’s triangle

A

osteosarcoma

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26
Q

what is the mc location for ewing’s sarcoma

A

long bones of extremities →

  1. femur
  2. tib/fib
  3. humerus
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27
Q

what does this xray make you think - moth eaten, permeative appearance; codman’s triangle; onion peel; periosteal elevation

A

ewing’s sarcoma

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28
Q

what are 6 considerations in evaluation of pediatric fx

A
  1. age
  2. MOI
  3. anatomic location
  4. soft tissue involvement → open vs closed
  5. key PE
  6. xrays
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29
Q

what is the most metabolically active portion of the bone

A

metaphysis

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30
Q

what portion of the bone is the most prone to fx

A

metaphysis

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31
Q

be able to label this pic

A
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32
Q

4 types of peds fx

A
  1. buckle
  2. plastic deformation → bowing
  3. greenstick
  4. physeal
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33
Q

what is the mc pediatric fx

A

buckle

34
Q

buckle fx is caused by what type of injury

A

FOOSH

35
Q

mc location for buckle fx

A

ulna/radius

36
Q

what is the mc location for a bowing fx

A

ulna

radius

37
Q

what is this fx called

A

bowing fx

38
Q

what is this fx

A

greenstick → bone is bent w. fx line, but fx does not extend completely thru bone

39
Q

salter harris fx’s involve the

A

growth plate → physeal fx

40
Q

salter harris types III-V usually require __

dt risk of __

A

ortho referral

stunted growth

41
Q

what might you be concerned about w. a toddler fx

A

child abuse

42
Q

what is the mc location for a toddler fx

A

femur

tib/fib

43
Q

what is the mc elbow injury/elbow fx in kids

A

supracondylar fx

44
Q

supracondylar is a ___ injury

A

do not miss!

45
Q

what do you think when you see a pt w. elbow pain and guarding and no ROM

A

supracondylar fx

46
Q

what does the fat pad sign on a peds elbow xray make you think of

A

supracondylar fx

47
Q

what peds pt population usually has clavicle fx

A

adolescents

athletes

48
Q

where do boxers fx occur

A

fx of head/neck of 5th metacarpal

49
Q

what is a nat

A

non accidental trauma

50
Q

what are 6 nat injuries that might make you suspicious for child abuse if the hx is inconsistent w. injury

A
  1. long bone fx in non ambulatory pt
  2. rib fx
  3. sternum, scapula, spinous process, vertebral body fx
  4. multiple fx in various stages of healing
  5. digital fx in < 3 yo
  6. complex skull fx in < 18 months
51
Q

when does the posterior fontanelle close

A

2 months

52
Q

when does the anterior lateral fontanelle close

A

3 months

53
Q

when does the posterior lateral fontanelle close

A

one year

54
Q

when does the anterior fontanelle close

A

2 years

55
Q

what is the etiology of torticollis

A

sternocleidomastoid m

56
Q

in what pt population is back pain concerning

A

young kids

57
Q

what is the mc scoliosis location

A

thoracic region →

r thoracic

l lumbar

58
Q

what are 2 values to evaluate scoliosis

A

cobb angle

risser score

59
Q

what does the risser score measure

A

iliac ossification/skeletal maturity

60
Q

older kids have a lower risk for progression of

A

scoliosis

61
Q

what pt population do you think of with spondylolysis and spondylolisthesis

A

gymnasts

divers

62
Q

fx of posterior arch in lower lumbar spine and scotty dog sign on xray should make you think of

A

spondylolysis and spondylisthesis

63
Q

asymmetric thigh folds and a positive barlow and ortolani should make you think of

A

developmental hip dysplasia

64
Q

what is the imaging choice for hip dysplasia dx in kids 4-6 weeks old

A

US

65
Q

what is the diagnostic imaging of choice for developmental hip dysplasia f kids are > 4-6 weeks old

A

xray

66
Q

what do you think of when you see an overweight AA middle schooler w. pain and no hx of trauma

A

slipper capital femoral epiphysis

67
Q

what is this xray showing - widened epiphyseal plate, bloomberg’s sign, off-centered Klein’s sign

A

slipped capital femoral epiphysis

68
Q

what LE condition might affect a skinny younger kid after trauma or infxn

A

legg-calve-perthes dz

69
Q

what is legg-calve-perthes dz

A

osteonecrosis of femoral head

70
Q

babies are born with with leg formation

A

fenuvarus → bow legged

71
Q

what are indications for referral with genu valgum

A
  1. >8 cm btw medial malleoli
  2. progressive knock-knees after 4-5 yo
  3. unilateral or assymetric
  4. associated w. short stature
  5. hx metabolic dz or joint swelling/infxn
72
Q

what are indications for referral with genu varus

A
  1. >6 cm btw femoral condyles
  2. progressive bowing
  3. persistent bowing >3yo
  4. unilateral or asymmetric
  5. short stature
  6. hx of concern
73
Q

when would you measure thigh-foot angle

A

tibial torsion

74
Q

what is the mc congenital foot deformity

A

metatarsus adductus

75
Q

what is the tx for clubfoot (talipes equinovarus)

A

early serial casting

76
Q

what is the mc reason for bone pain in adolescents

A

sever’s apophysitis → osgood schlatter’s of the ankle

77
Q

what is the most common location for osteochondrosis dessicans (OCD) -

A

complication of osgood schlatter’s

knee

78
Q

what condition might you see in little leaguers

A

lateral epicondylitis

79
Q

how many times should you try to reduce a nursemaid’s elbow before xraying

A

2

80
Q

how do you reduce a nursemaid’s elbow

A

supinate and flex

Clin Med II - Exam 2 (14 decks)

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