Miller's Peds Flashcards
86% of elbow ROM returns when after SCH CRPP
3 mos
what can happen if submuscular plate is not removed after healed in femur fracture ORIF
genu valgum
age when dens physis closes in kids
6 yo
Abx for Lyme
> 8 yo doxy
< 8 yo Amoxicillin
consider this bug if kid not responding to IV abx for diskitis
TB
treatment for chronic recurrent mulitfocal osteomyelitis
NSAIDs
most likely cause of osteomyelitis in kid with sickle cell
Staph a is #1
- but this is the group we can see salmonella
earliest XR finding for kid with discitis
loss of lumbar lordosis
procedure for stiff knee gait in CP kid
hamstring lengthening and rectus transfer
Surgical procedures for CP with equinovarus foot
Split PT to peroneals with overactive PT
Splint TA to cuboid with overactive TA
Myelodysplasia kid
- level that they can walk
L4
maternal finding assoc with sacral agenesis
diabetes
scoliosis degree when you want to fuse in Duchenes
> 20-25
Findings in Fascioscapulohumeral Muscular Dystrophy
normal CK
scapular winging
can’t whistle
Foot deformity in Freidrich Ataxia
cavus
pathology of Freidrich ataxia
degeneration of spinocerebellar and posterior columns of spinal cord
GAA repeat
Friedrichs ataxia
Cause of death in Friedrichs Ataxia
cardiomyopathy
Dysphagia
excessive sweating
postural hypotension
Riley Day Syndrome
occurs in Ashkenazi Jews
Pathology of myasthenia gravis
Ab against Ach receptors
treatment options for myasthenia gravis
thymectomy
steroids
Ach-esterase inhibitors (pyridostigmine)
plasmapheresis (to remove the Ab)
newly developed unilateral external rotation in a kid
- what should you consider the cause
SCFE
Treatment for tarsal coalition
- talocal
- talonavic
talocal
< 50% -> resection + fat interposition
> 50% -> fusion
Calnavic
resection with fat interposition
overlapping 5th toe treatments
observation as this usually resolves
Tenotomy + dorsal capsulotomy if doesn’t and is bothersome
congenital curly toe treatment
observation or flexor tendon tenotomy if bothersome after a few years
PITX1 mutation assoc with
Clubfoot
Adam’s forwadr bend test measurement that warrants referral
7 degrees
AIS MRI indications
Left Thoracic curve pain apical kyphosis rapid curve progression neurological signs congenital anomalies
Risk factors for curve progression after maturity
Thoracic curve > 50
lumbar curve > 30
will progress 1-2 degrees/year
Level that determines CTLSO vs TLSO
Apex T7 and higher -> CTLSO (Milwaukee)
Apex T8 and lower -> TLSO
when to perform anterior AND posterior for AIS
< 10 yo
curve > 75 (he said maybe)
Delayed infection (9-12 mos) in AIS s/p fusion
remove implant
ABX
Alveoli continue to multiply until what age
8 yo
spinal deformity with highest risk of neurological injury with progress
Congenital Kyphosis
That with atlanto-axial instability
Downs
RA
Grisel’s
how to treat pseudosubluxation of C spine in kid
NTD
Most important risk factor for DDH
Breech
If done, what is the purpose of femoral osteotomy for DDH during closed reduction
prevent AVN
treat sever anterversion
When to leave DDH alone
bilateral over 6 yo
unilateral over 8yo
Lateral pillar classification is not valid until what phase of the disease
end of fragmentation
Defect in what gene leads to longitudinal femoral def
Sonic Hedge Hog gene
Common knee finding with congenital short femur
absent ACL
treatment for congenital patellar dislocation
lateral release + some type of realignmen
Mucopolysaccharidoses have what type of dwarfism
proportionate
What genes/molecule influences limb bud to form
Homeobox
Sonic Hedgehog
When are primary centers of ossification present
all present at birth
Abnormalities affectein the primary center of ossification
Long femorl def
Cleidopcranial dysplasi
Apert’s
Congenital disease with high incidence of coxa vara
Cleidocranial dysplasia
Dysplasia affecting the secondary ossification centers
MEd
SED congenita
SED tarda
Diastrophic dysplasia
What disease do you think of if they show you hips with appearance of bilateral Perthes (they will be symmetric)
MED
COL2A1 mutation
Spondyloepiphyseal Dysplasia
abnormal type II collagen casugin intracelluyliuar procollagen inclusions
Major workup necessary for kid with spondyloepiphyseal dysplasia
C spine films as they can have atlanto-axial instability (odontoid hypoplasia) which may require fusion
portion of msk system not affected in MED
spine (which does occur in SED)
cervical spine finding with diastrophic dysplasia
cervical kyphosis which may cause quadraplegia
Area in growth plate with FGFR-3 mutation
prolierative zone
causes and QUANTITATIVE defect
if asked a treatment for mucopolysaccharidosis
bone marrow transplant
osteochondroma that occurs in the epiphysis
- cause?
Trevor’s Disease (Dysplasia epiphysealis hemimelica)
- defect in groove of ranvier
area of physis leading to osteochondroma
groove of ranvier
glycine substitution on procollagen
- disease
- ramification
OI
- this leads to abnormal cross linking
Medication given to kid with OI
IV pamidronate
Path of Scurvy
low Vit C -> prevents conversion of proline to hydroxyproline
common treatment for osteopetrosis
bone marrow transplant
When asked hemihypertrophy-> think ?
Neurofibromatosis
When to fusion Downs C1/2
sx’s or ADI < 10mm
Accessory calcaneal ossification
- other ortho condutions to check
Larsen’s
- cervi al kyphosis
- dislocated joints
Shoulder motion most likely to be limited in Sprengles
shoulder abduction
thumb present but no radius
thrombocytopenia absent radius
abnormal ligament in Madelung’s
Vicker’s ligament - abnormal palmar ligament that tethers the lunate to the radius
When do you fit a prosthesis in a kid
age 6 when they start sitting
