Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peds > OITE Review > Flashcards

OITE Review Flashcards

1
Q

MRI indications scoli (5)

A 
L thoracic curve
Pain
Neuro sx - asym abdominal reflex, hyper-reflexia
Rapid progression
Apical kyphosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What factor is most predictive of predicting AIS progression?

A

Age = skeletal maturity

Risser sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most correlative XR finding for AIS progression?

A

Tanner whitehouse = hand XR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bracing rules for AIS

A

<25 = nothing
<40 + skeletally mature = watch
Immature < 40 = brace (reduce risk surg 50% if bracing done at least 12hrs per day, compliance is MOST important factor for det prog to surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If very skeletally immature and must fusion spine, do you do post or ant approach?

A

Ant to prevent crank shaft phenom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Delayed infx bugs (2) for AIS vs acute

A

P.acnes & S.epi (NOT aureus!!!)

Acute = aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Curve & age for infantile idiopathic scoli

A

LEFT thoracic

Age = <3yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the measurement for infantile IS?

A

RVAD > 20 = high risk progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treat infantile IS

A

Body cast
RVAD>35 - MRI +/- growing rod (less effective the longer is in)
Don’t fuse b/c get alveolar aka pulm insuff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which type of scoli is highest risk of neural axis involvement

A

Juvenile = 3-10yo

Think arnold chiari malform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What deform is the worst outcome for congenital scoli

A 
Failure formation vs segmentation vs mixed
Worst prog = 
1. Uni lat var 
\+ 
CL hemi vert 
100% risk progression
GET MRI****
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which spine deform has highest risk neurologic compromise from surgery?

A

Congenital kyphosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DMD inheritence

A

XL recessive - more common BOYS

  • High creatine kinase
  • Gower’s sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a pars stress frx called? Most sensitive test?

A

Spondy-lo-lysis

SPECT = single proton…. = most sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What level is most common spondy in kids?

A

L5-S1

- HAMSTRING tightness on exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most important determinant of pain and non-union for spondy (how they’ll do once they get it)

A

Slip angle >45 deg

VS PI - dets if you will get a spondy at all

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How measure pelvic incidence

A

total of sacral slope + pelvic tilt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Scheurmann’s kyphosis

A

Idiopathic kyphosis - usual brace

Normal kyphosis in T spine 20-50deg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Klippel Feil

A

= abnormal cervical segmentation (AA fusion)
Sprengel’s deform on right - scapula is up with limited ROM
Deafness (the other one that isn’t paget)
Webbed neck
Trt = conservative, NO CONTACT SPORTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

AA instability

A

Down’s
JRA
Treat if >5mm EXCEPT Downs > 10mm b/c lig lax at baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common level for pseudo sublux

A

C2/3 - don’t have to do anything about it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Association w/ C1/2 rotary sublux

A

Think after retrophayngeal infx/URI

SCM spasm on SAME SIDE as chin (aka actue torticollis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Association for sacral agenesis

A

Maternal diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What disease has palpable SCM mass - treat and what to r/o

A

Cong muscular torticollis
PT + stretching
R/o DDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

RF DDH

A

Breech
Female (left side most common)
First born

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Packaging disorders associated with DDH

A

Torticollis - SCM away from chin

Metatarsus adductus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When does O&B not helpful - what test do you use

A

6mo

Galeazzi test - does one leg look shorter than other when knees flexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

2 US findings for DDH

A 
Alpha angle > 60 = normal
Less means the tab is SHALLOW = bad
(in adults alpha bigger is bad)
Beta angle > 55
Image
- White line = ilium
- Muscle is LATERAL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When can you get XR for DDH

A

> 4mo - FH starts to ossify

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is normal AI and CEA

A

AI < 25 = normal

CEA < 25 = ABnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are 4 things that might prevent hip reduction

A

Inverted labrum vs limbus
Lig teres
IP tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How treat stable vs unstable sublux hip?

A 
Stable = watch
Unstable = Pavlik
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How treat dislocated or dislocate-able hip?

A

Non-reduce -> OR

Reduce -> Pavlik

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Palvik - ant vs post strap roles & 2 comp of Pavlik

A

Ant strap - stop flexion (less than 90)
Too much - fem nerve palsy
Post strap - stop aBduction
Other comp = AVN (post sup retinacular art)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is Pavlik disease?

A

Post acetabular wear - why check every week via US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Who can’t you use Pavlik?

A

NM kids - Pavlik works on your muscles to keep hip in place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What do you do for kids with DDH who are walking

A

Surg: open reduction // osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the 6 pelvic osteotomies for DDH

A 
Salter 
Pemberton
Triple
Dega - CP young kid
Shelf - salvage 
Chiari - salvage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What do you if a young kid fails Pavlik?

A

Give 3 wks
Abduction brace
If that fails, closed reduction casting + hip arthrogram to check reduction

40
Q

What is Legg Calve Perthes

A

Idiopathic AVN
4-8yo boys
Associated with ADHD, protein C and S def, and thrombophilia

41
Q

What is the classification for LCP

A

Pillar - LATERAL physis
>50% of the femoral head = BAD -> probs needs surg
Young and lower Pillar classification = better outcomes

42
Q

Who gets SCFE

A

Fat boy with knee pain

43
Q

What zone is SCFE affect vs atypical SCFE

A 
Hypertrophic zone (same as SH frx)
Atypical = primary spongiosa
44
Q

What is a stable SCFE

A

Anything the kid was walking on no matter how bad the XR looks

45
Q

How do you fix SCFE surgically?

A

IN SITU - dont reduce anything
Screw fixation
Unstable = HIGH risk AVN

46
Q

What is atypical SCFE

A 
<10yo
Do an endocrine work up - won't be fat
- Hypo thyroid
- Renal osteodystrophy
THESE are the kids you prophylactically do the other size
47
Q

Where is your screw start point for SCFE?

A

Center through the physeal line
>5 threads through the physis
Start point not directly lateral - might need to start slightly anterior
If screw head is medial to the inter troch line can get labral tears

48
Q

Who do you do bilateral SCFE screws on?

A

Endocrine abnormalities

Tri-rad cart open aka v young

49
Q

LE physis grown

A

3 9 6 5

50
Q

What are the rules for distal femur vs prox tibial for limb length discrep

A

Distal femur: 0.9cm/yr
Prox tibia: 0.6 cm/yr
Girls grow until 14 // boys 16

51
Q

Treat limb length discrp

A

<2cm = shoe lift
2.5cm - 4 = epiphysiodesis
4+ cm - lengthening

52
Q

Volkman law

A

Tension accelerates growth

53
Q

14 yo boy, complete growth arrest at distal femoral physis - what is the predicted leg length discrp

A

2yrs left to grow x .9cm = 2cm

54
Q

What association x2/ treat op vs non-op for congenital knee dislocation

A

Larsen syndrome
And ipsi hip dislocation - have to treat knee first b/c can’t put a Pavlik on dislocated knee
Trt: close reduction and splinting in FLEXION
IF can’t get 30 deg flexion after 3mo casting -> surg

55
Q

What does O vs B positive test mean?

A

Ortolani + = reducible

Barlow + = dislocatable

56
Q

Gene for long femoral deficiency

A

SHH - longitudinal growth

57
Q

Mutation for pseudoachondroplasia

A

COMP (collagen)- AD - normal faces, cervical instability

58
Q

Mutation for diastrophic dysplasia

A

Sulfate transport protein, AR, “cauliflower ears, club foot + achondroplasia”, kyphoscoli - urgent treatment for kyphosis b/c high rates neurologic involvement

59
Q

What is multiple epiphyseal dysplasia presentation

A

Bilateral Perthes (NEVER bilat w/ Perthes) -> next step skeletal survey to r/o MED

60
Q

Presentation for Poland syndrome

A

Symbrachydactyly

UniL chest wall hypoplasia

61
Q

Alpert syndrome mutation and presentation

A

AD - FGFR2

Complex syndactyly - its either this or Poland

62
Q

What is the mutation and chromosome and region of cartilage for achon

A

AD - FGFR3
Chr 4
Proliferative zone

63
Q

Most common cause rickets in US

A

hypophos X-linked R

64
Q

What are the labs for rickets + treatment

A

Normal Ca, low PO4, high alk phos

Treat with vit D and phos

65
Q

Common presentations of OI

A

Olecranon frx

Basilar invagination

66
Q

Treat med + surg for OI

A

IV pamidronate (bisphos - x osteoclasts)
Osteotomies w/ IM implants (not plating)
Scoli - FUSE them

67
Q

Mutation and chromosome for osteopetrosis

A

Chr 11 AR - no carbonic anhydrase - bad osteoclasts

68
Q

NF mutation and presentation

A 
Chr 17 (17 letters in NF) - neurofibromin 
Smooth cafe au lait 
Ant lat bowing
Tibia pseud-arthrosis 
Neuro sx - malignant neuro sheath tumors
69
Q

Rough cafe au lait

A

McCune Alright

Cafe au lait - fibrous dysplasia - precocious puberty

70
Q

Marfans mutation, presentation

A 
Ch 15 - fibrilin - AD
Superior lens dislocation
TGF-beta -> heart and lungs
Dural ectasia -> need to fuse not brace
Hip stuff
71
Q

How is the ADI to fuse a Down’s kid

A

> 10 (higher than normal b/c baseline lig lax)

72
Q

Kid w/ multiple joint dislocations - disease + mutation

A

Larsens - filamin B mutations

Cervical kyphosis

73
Q

What is a Sprengel’s deformity

A

Scapula doesn’t descend - don’t confuse with scoli
Don’t nee to treat
KF disease

74
Q

What must you do for total radius gone but have a thumb

A

MUST do CBC peripheral smear and cardiac work up - kid could die

75
Q

What is CI to centralizing the ulna for radial def conditions

A

No elbow flexion - without this no point in centralizing

76
Q

Diseases if missing a thumb and key question

A 
Key question - CMC stable?
unstable - amp the thumb, move the index finger over and make it into a thumb
Holt Oram - cardiac US
Fanconi - chromosomal breakage analysis
TAR - CBC and peripheral blood smear
77
Q

What is a Madelung deformity

A

Volar-ulnar issues cause distal radius malformation
Tear drop of the radius on lateral XR
SHOX gene mutations

78
Q

Do you need to do anything about a prox rad-ulnar synostosis?

A

Nope

79
Q

How treat thumb duplication

A

Keep ulnar thumb for UCL

1-3: fuse the digit

80
Q

Poor prognosis for brachial plexus

A

No biceps after 6mo
- More ulnar to biceps, median to brachialis
Horner’s
Pregang - no sympa, no rhomboids, C spine muscular weak, positive histamine test

81
Q

What is the risk of SH 2 vs SH 3/4

A

SH 2 - physeal bar, look on MRI

SH 3/4 - growth arrest

82
Q

Kids both bone

A

Short arm cast!!!!

Unless you have a supracondylar - fix at the same time

83
Q

When do you un-reduce a supracondylar

A

Lose perfusion in the hand

84
Q

When does ROM return to normal for supracondylars

A

6mo after - no formal PT needed

85
Q

What is the 2 biggest problems with lat condyle frx

A

Inadequate reduction of periosteum -> loss ROM
Do NOT to post-lat approach b/c AVN -> cubitus valgus -> tardy ulnar nerve palsy (later in life post-lat rotatory instab)

86
Q

What degrees do you need to fix a ped radial head and neck frx

A

> 6mo

87
Q

Which kids who have a Chance frx what is the other injury you need to look for

A

Intra-ab (seat belt sign)

88
Q

Open or closed for peds hip fractures?

A

OPEN b/c MUST get anatomic reduction

89
Q

Rules for SPICA

A

Do not apply short leg first then rest - higher risk compartment syndrome
Avoid 90-90 - femoral n palsy
Cast wedging - if your femur fracture falls into varus, this will put them into valgus

90
Q

How treat femoral shaft fractures by age

A

0-6mo Palvik
6mo-5yrs Spica
>5yo stable - flexible nail (>85% canal filled)
>5yo unstable - plate
>5yo + >100lbs = rigid nail - MUST do GT start very lateral (MFCA becomes dom BS after 4yo, before was lig teres)

91
Q

What is trapped that is fucking with your tibial eminence reduction

A

Ant horn med men

92
Q

What deformity is worst and seen in peds tibia fractures

A

Valgus - prox metaphysis b/c med growth plate grows faster than lateral - self correcting

93
Q

What is a Tillaux frx

A

AITFL avulsion
SH 3 of distal tibia
MUST get CT
ORIF >2mm displaced

94
Q

What is a triplane frx

A

SH 4 frx - SER
Tillaus + physis + metaphysis
AP looks like SH3
Lat looks like SH 2

95
Q

Treat transient synovitis

A

Hx viral illness with normal ESR/CRP

Trt NSAIDS -> doesn’t improve MRI

96
Q

What is the involucrum vs sequestrum

A

NEW bone vs DEAD bone (debride this)

97
Q

What are the RF for DVT after osteomyelitis

A

MRSA
CRP >6
>8yo

Peds (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions