Brainscape's Knowledge GenomeTM

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


See full index

Pediatric Clerkship > Ortho & Neuro > Flashcards

Ortho & Neuro Flashcards

1
Q

Kid w/ limp–MCC

A

trauma

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

Kid w/ limp–18mo F w/ asymmetric gluteal folds on exam

A

Developmental Hip Dysplasia

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

Developmental Hip Dysplasia–RF?

A

first born female, +FH, breech position

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

Developmental Hip Dysplasia–Dx; Tx

A

clunk on Barlow, US hip if unsure (pelvis ossifies at 4-6 mo so xray no good); Pavilk harness or sx

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

Kid w/ limp–5 y/o M initially w/ painless limp now has pain in his thigh

A

Legg-Calve’-Perthes Disease. (avascular necrosis).

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

Kid w/ limp–5 y/o M initially w/ a cold 1wk ago now presents w/ a limp & effusion in the hip. X-rays are normal and ESR is 35 (↑), T = 99.8, WBCs = 10K

A

Transient Synovitis

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

Transient Synovitis–tx

A

bed rest for 1 wk + NSAIDs

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

Kid w/ limp–14 y/o lanky M w/ nagging knee pain and

decreased ROM of the hip on exam

A

SCFE. Remember they’re not always fat!

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

SCFE–tx

A

Surgically close and pin the epiphysis to avoid osteonecrosis

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

Kid w/ limp–14 y/o basketball player has knee pain and swelling of tibial tubercle

A

Osgood-Schlatter. Overuse injury from jumping

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

Dx–12 y/o F w/ 2 wk hx daily fevers to 102 and a salmon colored evanescent rash on her trunk, thighs and shoulders. Left knee and right knee are swollen.

A

JRA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

JRA–good prognostic factor

A

+ANA

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

JRA–bad prognostic factor

A

+RF, also polyarticular and older age @ onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

JRA–Tx

A

1st line=NSAIDs, 2nd line=MXT, 3rd line=steroids

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

Dx–2y/o F w/ a 2 wk hx daily fevers to 102 and desquamating rash on perineum. Swollen hands and feet, conjunctivitis and unilateral swollen cervical lymph node.

A

Kawasaki

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

Kawasaki–lab findings

A

↑plts (wk2-3), ↑ urine WBC, ↑LFTs, ↑CSF protein

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

Kawasaki–best first test

A

2D echo and EKG. Repeat the Echo after 2-3wks of tx

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

Kawasaki–tx

A

Acute = IVIG + high dose aspirin; then aspirin + warfarin

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

Kawasaki–most serious sequellae

A

coronary artery aneurysm or MI

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

Dx–If F. More common if hx of retinoblastoma or previous radiation. “Onion skinning” on xray. (layers of periosteal development)

A

Ewing Sarcoma

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

Ewing Sarcoma–tx

A

rads +/- sx

22
Q

Dx–If >10, more likely. M>F. See “sunburst” and “Codman’s triangle” on xray

A

Osteogenic sarcoma

23
Q

Osteogenic sarcoma–tx

A

chemo +/- sx

24
Q

Dx–More diffuse bone pain in a patient w/ petechiae, pallor and increased infections

A

Bone cancer; Don’t forget bone pain can be presenting sx for leukemia

25
Q

Hydrocephalus–Anytime you see a meningocele or myelomeningocele, do a ____

A

CT (looking for hydrocephalus, Arnold Chiari II)

26
Q

Anytime you see an infant with a head circumference >95th %, consider _____; sxs

A

hydrocephalus; bulging fontanelle, ↑DTRs, HA, vomiting.

27
Q

Hydrocephalus–Noncommunicating

A

Stenosis of CA, tumor/malformation near 4th ventricle

28
Q

Hydrocephalus–Communicating

A

SAH, pneumoncoccal/TB meningitis, leukemia

29
Q

Dx–Infant with increasing head size, prominent occiput, cerebellar ataxia and delayed motor development.

A

Dandy-Walker malformation

30
Q

Dandy-Walker–what do you see on CT/MRI?

A

Cystic expansion of 4th ventricle. Can see Agenesis of cerebellar vermis.

31
Q

Dx–1 y/o develops a fever to 102.4. Four hours later, the parents bring her in after she has a 3-4 minute tonic-clonic seizure

A

febrile seizure (6mo-6yo)

32
Q

Febrile seizure–next step

A

Give acetamenophen. NO ↑risk for epilepsy

33
Q

Dx–8 yo M gets in trouble in school because he is always “staring into space”. Episodes last seconds, have lip smacking, and he goes right about his business after they are done

A

Absence seizure

34
Q

Absence seizure–EEG finding

A

Hz spike and wave discharge

35
Q

Absence seizure–tx

A

ethosuxamide or valproic acid

36
Q

Dx–6mo w/ multiple symmetric contraction episodes of neck, trunk and extremities that occur in spells

A

Infantile spasms (can be associated w/ tuberous sclerosis)

37
Q

Infantile spasms–EEG finding

A

Hypsarrhythmia = asynchronous, chaotic, bilateral

38
Q

Infantile spasms–tx

A

1st line = ACTH; 2nd line = prednisone

39
Q

Dx–8y/o w/ difficulty w/ balance while walking, no DTRs, bilateral Babinski and “explosive, dysarthric speech”

A

Friedrich Ataxia (AR, trinucleotide repeat)

40
Q

Friedrich Ataxia–MCC death

A

HOCM –> CHF

41
Q

Dx–2y/o w/ gait disturbance, loss of intellectual fxn, nystagmus and optic atrophy. Cresyl violet w/ metachromatic staining

A

Metachromic leukodystrophy (AR)

42
Q

Metachromic leukodystrophy –deficiency of _____ and accumulation of _____

A

arylsulfatase A; cerebroside sulfate

43
Q

Dx–12y/o w/ decreased school performance, behavior changes, ataxia, spasticity, hyperpigmentation, ↑K, ↓Na, acidosis

A

Adrenoleukodystrophy (XLR)

44
Q

Adrenoleukodystrophy–prognosis

A

death in 10 years

45
Q

Dx–9mo who had previously been reaching milestones starts to lag. Seizures, hypotonia,
cherry red macula

A

Tay Sachs (XLR)

46
Q

Tay Sachs–deficiency of ____; accumulation of _____

A

hexosaminidase A; GM2

47
Q

Dx–3mo infant lays in the “frog-leg” position,

A

SMA 1 = Werdnig Hoffman

48
Q

Werdnig Hoffman–prognosis

A

most die before 2yo

49
Q

Dx–6y/o is brought in 2/2 “clumsiness” and freq falls. Lower leg w/ dec muscle bulk and appears “stork- like”. Multiple sm injuries on hands/feet. Pes cavus and claw hand

A

Marie-Charcot-Tooth Disease

50
Q

Marie-Charcot-Tooth Disease–dx

A

Decreased motor/sensory nerve vel, sural nerve bx. *CPK is normal

51
Q

Marie-Charcot-Tooth Disease–Tx

A

Stablize ankles w/ surgical fusion. Usually normal lifespan and most remain ambulatory.

Pediatric Clerkship (5 decks)

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