LIMPING CHILD Flashcards
A male child 2-12 years old with pain that has just started. Last week he had a cold with grey stuff on his tongue now he has a mild fever
transcient synovitis
Child is febrile and looks unwell and has a limp
septic athritis
child has developed a limp which appears to be painless for more than 6 weeks there is leg length discrepancy and systemically macular rash
juvenile idiopathic arthritis
how does developmental displasia present
detected in nenonates 6 times more common in girls
A 4 year old with gradual onset knee pain and limp sometimes radiates to buttock and thigh and is worse with acitiity. Appeared after a cold a month ago.
legg perthes disease - can be transcient synovitits but this goes away in 2 weeks
10-16 year old boyr with a bit of a big belly that have a limp with pain in groin thigh and knee. onset is gradual but can be acute and very painful on x ray there is a frog leg lateral displacement of femoral head
slipped upper femoral epiphysis
Mnagment for JIA
- NSAIDS
- STEROIDS
- DMARDs
4.
MANAGMENT for slipped femoral epiphysis
surgical fixation
management with perthes disease
alagesia if mild
plaster or surgery to secure femoral head
DDH TREATMENT
- < 6 months pavlik harness - effective if started early
2. > 6 months surgery
Describe barlows and ortholini?
ortholini leg elevated and abducted and brlrlows leg depressed and adducted to dislocate
Acute lymphoid leukaemia presentation and signs
ANT
anaemia - lethargy pallor
neutropenia - frequent or severe infections
thrombocytopenia - easily bruising petechiae
hepatosplenomegaly
bruising
symptoms of anaemia
Thrombotic thrombocytopenia purpura is common in what age adn how does it present
30-50 year olds
neuro and renal symptoms
Idiopathic thrombocytopenia purpura how does it present
petechiae due to bleeding
low platelets seen ONLY
dic how does it caused
by burns/trauma or sepsis
sequalea of measles
pneumonia then much later on subacute sclerosising panencephalitis
sequalea of mumps
pancreatitis and infertility
Kosher criteria what is it used for and what does it contain
used for identifyin septic artheritis and it contains
- fever
- inability to weight bear
- raised ESR
The two types of innocent murmus and how they present
Both are due to the turbulence of the blood flow in the heart - noise heart makes as blood flows through it.
- venous hum - continuous blowing noise heard below the clavicles
- Stills murmur - low pitches sound at the LLSE
signs of malrotation
management
treatment
exophthalmus congenital diaphragmatic hernia and intrinsic duodenal atresia
volvulus and bile stained vom
Diagnosis - upper go contrast and USS
Rx- laparotomy if volvulus and ladds is risk of reoccurrence
Kawasaki
crash burn c- conjunctivitis r - rash a - adenopathy cervical s- strawberry tongue h- hands and feet swollen and peeling
burn - high fever that doesnt respond to antipyretics
what renal disease is associated beckwith wiedermann syndrome
wilms tumour
GIrl is urinating more she feeling tired and skinny likely underlying cause is ….
diabetes causes this but the diabetes can be caused by cystic fibrosis so answer is CF
girl 12 years old consentual sex with 17 year old whats the first thing you should do
disclose to relevent authority cause she is underage it is a doctors to do so and you cannot expect the child to disclose herself or
thyroglossal cyst presentation
ant triangle where thyroid is
aneichoic on USS echogenicity would suggest infection
brachial cyst
ant to SCM near angle of mandible
unless infected it has a similar consistency to water and anechoic on USS
WAHT IS A dermoid cyst and where
in the midline suprahyoid are heterogenous and contain calcium and fat on imaging
thyroid gland tumours are they rare in chilren
yep rare
lymphatic malformations
cause:
post, to SCM and result form occlusion of lymphatic channels
cause: painless fluid filled lesions from age 2 closely linked to surrounding structures and removal is difficult
hyperanchoic on USS
INFANTILE HAEMANGIOMA
ANY triangle in neck
grow rapidly then regress
x ray mass lesion with calcified phleboliths
involution occurs the fat ocntent of lesions increase
lymphadenopathy
generalised is secondary to infection and can be any triangle
less than 3 months treatment for meningitis
IV amoxicillin and IV cefotaxime
