Ortho + Endo Flashcards
MC fx in kids, due to trauma to humerus
Supracondylar fx
**check radial pulse since brachial artery can be injured
Toddler fx:
nondisplaced spiral fx of distal tibia in infants; (Tx splint immobilization)
Nursemaid elbow:
pulling on hand → subluxation of radial head from annular ligament → kid holds arm in a pronated position
(reduce with supination motion)
Called Blount disease if kid >2 y/o
genu varum (bowlegs) **ortho consult
Metatarsus adductus =
tx?
forefoot pointing inwards
t1 = reassurance t2 = orthosis or correctuve shoes t3= surgical (doesn't correct w mvmt)
Clubfoot = increased risk of associated…
spina bifida
avascular necrosis of femoral head =
presentation?
Legg-Calve-Perthes disease
painless limp in a boy <10 y/o (requires ortho c/s)
painful limp in a fat boy?
slipped capital femoral epiphysis
*dx with XR
Osgood-Schlatter disease =
overuse injury of quads and patellar tendon → traction apophysitis of tibial tuberosity ( = localized pain/swelling)
*tx = RICE + NSAIDs
uneven gluteal folds and “snapping hips” during physical exam in a newborn
congenital hip dysplasia
*dx via US
dx of osteomyelitis?
bone scan (X-ray can be false-neg for 3 days)
fever + localized joint pain + limited ROM =
dx/tx?
septic arthritis
dx= aspiration
tx = drainage + IV nafcillin
Osteogenesis imperfecta:
inheritance?
abnormality?
AD
type 1 collagen
Osteosarcoma XR shows…
Ewing sarcoma XR shows…
Codman’s triangle and sunburst appearance
“onion skin”
Patellofemoral syndrome =
tx?
chronic anterior knee pain, worse w/ exercise or prolonged sitting
Tx strengthening exercises
Sick euthyroid syndrome: pathophys?
↑bodily stress (trauma, starvation, etc.) causes ↑cortisol, which blocks TSH →
- ↓T4/T3
- normal TSH
- ↑rT3 (deiodinase 3 activated by stress)
Cushing syndrome: dx?
ACTH/cortisol levels + dexamethasone suppression test (pituitary Cushing can be suppressed)
Hyperaldosteronism lab abn?
↑Na, ↓K, ↓H (HTN, metabolic alkalosis)
Addison syndrome:
hormone abn?
presenttion?
tx?
↓cortisol/↓aldosterone
fatigue, hypoglycemia, HTN, hyperpigmentation, weight loss
Tx prednisone + fludrocortisone replacement
Congenital adrenal hyperplasia: abn hormones? presentation? dx? tx?
∆21α-hydroxylase → ↓aldosterone/↓sex hormones
↓Na, ↑K, ↑H (metabolic acidosis), hirsutism, virilization
Dx ↑17-OHP
tx hydrocortisone + fludrocortisone replacement
Tx Nephrogenic DI vs Central DI?
nephrogenic = DDAVP
central = hctz
Hypercalcemia sx: s
- stones (kidney, GB)
- bones (pain, osteitis fibrosa cystica)
- groans (PUD, pancreatitis)
- psychic overtones
Hypocalcemia sx: n
euromuscular irritability (tingling, tetany) prolonged QT arrhythmias
Hypercalcemia s/p fracture is due to…
dx?
tx?
extensive bone resorption
Dx urine calcium:creatinine ratio >0.2
Tx hydration, calcitonin if severe
Nutritional rickets: electrolyte abn?
normal Ca, ↓P → decreased bone mineralization
X-linked hypophosphatemic rickets:
genetic abn?
lab abn?
presentation?
XD ∆PHEX (renal phosphate resorption gene)
↑urinary P, ↓serum P
decreased bone mineralization resistant to vitamin D supplements
Pseudohypoparathyroidism:
cause?
electrolyte abn?
presentation?
renal tubules unresponsive to PTH →
↓Ca, ↑P, ↑PTH
hypOcalcemia sx + 4th/5th finger bradydactyly (knuckle-knuckle-dimple-dimple sign)
Hypoparathyroidism: electrolyte abn?
lack of PTH → ↓Ca, ↑P, ↓PTH
hypOcalcemia sx
1° hyperparathyroidism: electrolyte abn?
excessive PTH → ↑Ca, ↓P, ↑PTH (hypercalcemia sx)
