maneuvers (to diagnose disorders) & some Peds general questions Flashcards
This maneuver is positive in De Quervain’s tenosynovitis
Finkelstein’s test
These maneuvers are positive if ACL of knee is damaged. The knee may also be unstable.
anterior drawer maneuver and Lachman maneuver
This maneuver is positive in meniscus injuries of the knee
McMurray’s sign
Diagnosing bacterial meningitis:
_______ sign is for nuchal rigidity. Patient supine. Raise head and flex chin toward chest.
Brudzinski
Brudzinski sign for bacterial meningitis:
Positive result if patient automatically _______ ______ ____
bends both hips
Diagnosing bacterial meningitis:
_______ sign is for the hip. Patient supine. Flex patient’s hips and knees in a right angle, then slowly straighten/extend the leg. Positive result is when the patient complains of pain during extension or resisting.
Kernig’s
Signs to diagnose appendicitis:
RLQ pain with passive leg extension:
RLQ pain with internal rotation of right hip:
Firm deep palpation of the LLQ will cause severe pain on the RLQ:
Pelvic/abdominal pain when patient drops heels to floor:
Psoas
Obturator
Rovsing’s
Markle (heel jar) test
Abrupt cessation of inspiration caused by hooking fingers on the right costal margin and pressing down firmly - used to diagnose cholecystitis:
Murphy’s sign
Periumbilical bruising/discoloration is called ________ sign and is an indication of acute _________.
Cullen’s
pancreatitis
Bruising on the flank area is called _________’s sign and is an indication of acute pancreatitis.
Grey-Turner’s sign
The test used to assess for meniscus injury of the knee by hearing a “CLICK”, either heard and/or palpated, is the _____ test.
McMurray
*** The _____ tests look for knee instability
Drawer
The ________ test is for the ACL only, and is a more sensitive test than the Drawer sign
Lachman
This test is used to diagnose torn/laxity of the MCL of the knee: _________
Patient is supine with legs straight, and medial stress is applied to the knee.
Valgus stress test
THINK - “valGUM - knees stick together (medial) like with GUM”
***The ______ test is used to diagnose DeQuervain’s Tenosynovitis/Tendonitis. Tell the patient to make a fist by holding the thumb against the palm, then cover it with the other 4 fingers. Applying ulnar deviation causes pain (positive).
Finkelstein
Test for median nerve problem/carpal tunnel syndrome in which the wrist is in full flexion for 60 seconds:
Phalen test/maneuver
***Test for median nerve problem/carpal tunnel syndrome in which the anterior wrist is briskly tapped:
Tinel’s test -
THINK “Tinel - Tap” - T and T
Name the sign:
Patient is supine. Use one hand to press two metatarsal heads together while applying pressure on the area pf pain by using the other hand. A positive sign is where the pain is reproduced and you may hear a click.
Mulder’s sign (for Morton’s neuroma)
Name this test:
Instruct patient to stand with feet together and arms on the side with eyes open. Then instruct patient to close eyes. Watch for swaying and loss of balance.
Romberg test
Name this pediatric maneuver:
Flex both hips with thighs at 90 degrees together (adduction)
Push the hip posteriorly which will cause abnormal hip to dislocate.
Palpate as femoral head slips out of socket. Confirm with the other test.
Barlow’s test/maneuver
Perform Barlow’s test first, before doing the Ortolani test.
Remember, B comes before O.
Name this pediatric maneuver:
- Examine one hip at a time. Flex the infant’s hip and knees 90 degrees
- Place your index and middle fingers along the greater trochanter of the femur (outer thigh) and place your thumb on top of the knees and the inner thigh.
- Gently abduct hips while pulling it anteriorly. You may feel the unstable hip and or hear an ***AUDIBLE “CLUNK” SOUND as the unstable hip slips back into the acetabulum after being displaced.
Ortolani Test/maneuver
Remember - “O”rtolani - “O” - rotate the hip in an “O” (Circle)
Acute diarrhea in kids:
Antibiotics should not be used routinely for well-appearing children with acute bloody diarrhea unless a ____ ______ has been isolated. Antibiotic therapy may be a risk factor for the development of hemolytic uremic syndrome.
specific pathogen
Signs of dehydration in an infant/child: \_\_\_\_\_\_ fontanelles (\_\_\_\_ spot) Sunken eyes Parched dry lip sand mouth Fewer tears when crying Tachycardia, tachypnea Lethargy/sleepiness Reduced skin turgor Voiding less often (< \_\_\_ wet diapers/day)
Sunken; soft
6
infant dehydration:
***____ ____ is an important indicator - > ___%.
weight loss; 10%
Name this pediatric condition:
Transfer of eggs from fingers touching the perianal area and then fomites. Causes perianal itching, vaginitis, excoriations.
Enterobiasis (pinworms)
Enterobiasis (pinworms):
**Labs to diagnose include the _____ _____ test in the **____ _______.
Scotch tape
EARLY MORNING
Enterobiasis (pinworms):
Treatment is with ______ or _____. Treat the entire household.
Antiminth; Mebenzadole
What is the most common genetic abnormality in African Americans (1 in 12)?
All newborns in US are screened.
sickle cell
What is the “gold standard” test for sickle cell disease?
hemoglobin electrophoresis (Hgb S)
Acute enlargement of the spleen in sickle cell disease:
called acute splenic _________.
Sequestration
G6PD is a genetic defect in an enzyme that protects ______ from oxidative injury. It is an x-linked recessive trait that is more common among _________,
_________, and ______ descent.
RBCs
Mediterranean
African; Asian
All of the following statements are true about G6PD anemia except:
1 An X-linked recessive trait that is more common among Mediterranean, African, and Asian descent
2 It is a type of hemolytic anemia
3 Sulfa drugs and fava beans can cause hemolysis
4 A genetic disorder that can cause sickling when RBCs are exposed to hypoxic conditions
4 A genetic disorder that can cause sickling when RBCs are exposed to hypoxic conditions
Peds:
Child abuse:
Are health care workers required by law to report any suspicion of abuse/neglect?
Almost ___% are below age one and preschool
***What type of presentation should elicit suspicion of child abuse in the clinical setting?
YES
50%
*** A controlling type of adult who doesn’t want to be interviewed
Risk factors for child abuse:
Financial problems/low income family
Parent was a victim of abuse, _____ age, ____ parent, divorced
Low level of education
young; single
***Indicators of child abuse: Retinal/conjuncitval hemorrhages Burns w/location and pattern Bruises Spiral fractures Rib and skull fractures ***NOT an indication of child abuse: \_\_\_\_ \_\_\_\_\_
vaginal infection
Child abuse:
A delay in obtaining _______ _____ coupled with an inconsistent ______ is a RED FLAG
medical care
history
ADHD: More common in _____
ADD: More common in _______.
Treatment is with ______ or ______.
boys
girls
Ritalin; Adderall
Peds:
Take adderall (amphetamine) when?
Do not give when?
In the morning before school starts
At night b/c it can cause insomnia
Non-amphetamine treatment for ADD/ADHD is: ________.
It has an increased risk of suicidal thoughts or actions in children and teenagers.
Strattera
Strattera:
Avoid in ______ patients.
anorexic
Lead toxicity starts at _____ mcg/dl, but no safe level or nontoxic blood lead levels exist.
5
Lead poisoning affects _____ synthesis in the bone marrow, leading to microcytic anemia.
The source with the highest level of lead is _____ ___.
heme
paint chips
Lead level ___ or higher - CDC recommends chelation.
Most serious complications are acute encephalopathy, seizures, coma
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