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Surgery > MSK - Peds > Flashcards

MSK - Peds Flashcards

1
Q

What does thalidomide consumption by the mother lead to in a fetus? How?

A

Phocomelia

interrupts blood flow, causes limb not to grow

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2
Q

What is the difference between aplasia and hypoplasia?

A

Aplaisa - limb/fingers/toe does not form

Hypoplasia - smaller limb

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3
Q

What is congenital amputation?

A

Loss of limb/no growth of limb, usually due to lack of blood supply

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4
Q

What is Streeter’s dysplasia?

A

Constricting bands in utero sac cause amputations of fetal limbs

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5
Q

What is Sprengle’s deformity? What extra bone may develop as a result? When is surgery performed?

A

Congenital elevation of scapula
Omovetebral bone
3-8 years old

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6
Q

What congenital absence can cause hypermobility of shoulders?

A

Absence of clavicle

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7
Q

What results from congenital radial-ulnar synostosis? What actions are restricted?

A

Failure of radius and ulna to separate

Inability to supinate/pronate

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8
Q

What deformity of the elbow is caused by congenital dislocation of the radial head?

A

Varus deformity

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9
Q

What upper extremity fracture is most common in children?

A

Clavicle

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10
Q

How many pitches per game and season are recommended for 9-10, 11-12, and 13-14

A

9-10: 50 per game, 2000 per year
11-12: 75 per game, 3000 per year (100 per week)
13-14: 75 per game, 3000 per year (125 per week)

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11
Q

What is nurse maid’s elbow? What ligament is involved? How do children present? How is it reduced?

A

Subluxation of radial head
Annular ligament
Pronated, slightly flexed
Supinate and flex elbow

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12
Q

How are non-displaced supracondylar humerus fractures treated? How are displaced supracondylar humerus fractures treated? What is a major complication of untreated supracondylar fractures?

A

Posterior splint, check hourly for 24 hours
Closed reduction with percutanous pinning or ORIF
Volkmann’s contracture

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13
Q

Are sprains common in children?

A

No

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14
Q

What is the weakest area of the physis?

A

Hypertrophic zone

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15
Q

What is the tibial eminence? What are 4 types of fractures? How are they treated?

A

Bony attachment of ACL
Type 1 - non-displaced - immobilize in extension
Type 2 - intact posterior hinge - reduce, immobilize
Type 3 - completely displaced - ORIF
Type 4 - Completely displaced, rotated, comminuted - ORIF

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16
Q

How are femur fractures treated in children <6 months, >6 months, or >11 years?

A

<6 months - Pavlik harness
6months-5years - spica casting
>11 years - flexible IM nails, antegrade nail, or ex-fix

17
Q

What are patella sleeve fractures? How are non-displaced treated? Displaced?

A

Cartilage sleeve separated from patella
Non-displaced - cast
Displaced - ORIF

18
Q

What lower leg fractures are common from bumper injuries? Children on slide with parents? How are they treated?

A

Tibia/fibula shaft fracture
Non-displaced spiral toddler fracture
Cast usually

19
Q

What type of Salter-Harris fracture is a triplane fracture? After x-rays, what must be ordered to evaluate it? How is it treated if displacement is greater than 2mm?

A

Salter-Harris IV
CT
ORIF if greater than 2mm displacement

20
Q

What area of long bones is most susceptible to osteomyelitis in children? What does it spread through? What is ordered to evaluate it?

A

Metaphysis of long bones
Spreads through Haversian canals
MRI w/ contrast

21
Q

What is the Kocher Criteria? What is it used to evaluate?

A 
WBC >12000
Inability to bear weight
Fever > 101.3
ESR >40mm/h
Septic Hip in children
22
Q

What mimics septic hip in children? What is it related to? What lab value is different? Are children able to bear weight? How is it treated

A 
Transient synovitis of hip
Related to viral infections
CRP<20
Able to bear weight, restricted abduction
NSAIDs and observation
23
Q

What three factors put you at greatest risk for development dysplasia of hip?

A

First-born, female, breech

24
Q

What is Hilgenreiner’s line? What is perkin’s line? What should be seen in the inferomedial quadrant? If not, what is this an indication for?

A

H - Through triradiate cartilage
P - Perpendicular to H at lateral edge of acetabulum
Epiphysis shoulder be seen in inferomedial quadrant
Developmental Dysplasia of hip

25
Q

What are the 5 timelines for treatment of development dysplasia?

A

<6 months - Pavlik harness 23 hrs per day
6-18 months - Closed reduction, spica casting
18months - 2 years - open reduction and spica casting
2-4 years - open reduction, femoral osteotomy
4+ years - open reduction, pelvic osteotomy

26
Q

What is Shenton’s line? What is an abnormal finding? Indicative of?

A

Arc along medial femoral neck and superior margin of obturator foramen
Discontinuous arc
Developmental dysplasia of hip

27
Q

What is Legg-Calve-Perthe disease? How is usually treated? What is it associated with? If it is collapsed, how is it treated?

A

AVE of proximal femoral epiphysis
Self-limiting
Coagulopathy
Operative

28
Q

What is the most common disorder affecting adolescent hips? Where is pain usually seen? What zone does it occur in? How does Klein’s line help assess it? How is it treated?

A

Slipped Capital Femoral Epiphysis (SCFE)
Knee
Hypertrophic zone
Tangent line of greater trochanter should go through epiphyseal head
Percutaneous screw (in situ - w/o reduction)

29
Q

What tumor is Hemihypertrophy associated with? How is it monitored

A

Wilm’s tumor - renal neuroblastoma (nephroblastoma)

Serial ultrasounds will 7

30
Q

Where is a popliteal cyst usually found?

A

Between semimembranosis and medial head of gastroc

31
Q

Is bipartite patella normal? How is it treated? If painful?

A

Yes
Observation
Excision

32
Q

What is Blout’s disease? Who is at risk? How is it treated under 3 years? Over 3 years? What angle is used to assess severity?

A

Progressive genu varum - proximal tibial bowing
Early walkers
Bracing if under 3 years
Surgery if over 3 years
Drennan angle - >16 degrees - 95% change of progression, <10 degrees 95% chance of resolution

33
Q

What is the most common birth defect?

A

Club foot

34
Q

What is the Coleman block test? What is it used to evaluate?

A

Block under lateral foot will correct hindfoot varus if flexible
Cavovarus (elevated arch)

35
Q

What is the difference between Kohler’s, Iselin’s, and Sever’s disease? How are they treated?

A

Kohler’s - AVN of navicular
Iselin’s - traction apophysitis of 5th metatarsal
Sever’s disease - overuse injury to calcaneal apophysitis
Non-op, rest, NSAIDs

36
Q

What are the treatments for tarsal coalition and flexible pes planovalgus?

A

Tarsal coalition - observation, immobilization with casing, potential surgery
Flexible pes planovalgus - non-op initially, surgery (achillese lengthening or calcaneal osteotomy) for causes that don’t resolve

37
Q

What is the difference between Kohler’s, Iselin’s, and Sever’s disease? How are they treated?

A

Kohler’s - AVN of navicular

38
Q

Where is syndactyly of toes most common?

A

Between 2nd and 3rd toes

39
Q

What is the non-progressive upper motor neuron disease, onset prior to age 2?

A

Cerebral palsy

Surgery (10 decks)

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