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Leeds MBCHB Year 4 Peads > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

Medical term for growth plate

A

Epiphyseal plates

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2
Q

What are epiphyseal plates made of

A

Hyaline cartilage

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3
Q

Structure of growth plates and location

A

Hyaline cartilage between epiphysis and metaphysis

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4
Q

Greenstick fracture type

A

Only one side of the bone

Common in children as more cancellous bone than cortical bone

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5
Q

Buckle fracture type

A

Two bones pushed together and bulging

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6
Q

Transverse fracture type

A

Straight across

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7
Q

Oblique fracture type

A

Straight across bone but at an angle

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8
Q

Segmental fracture type

A

Two brakes in long bone leaving a segment in between

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9
Q

A fracture across a growth plate is called

A

Salter Haris fracture

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10
Q

Comminuted fracture type

A

Lots of pieces

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11
Q

Mnemonic to remember growth plate fractures

A

SALTR

Straight across, above, below, through, cRush

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12
Q

How many types of Salter Harris fractures are there

A

5 using SALTR mnemonic

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13
Q

Growth plate fracture splitting the epiphysis type

A

4 Salter Harris

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14
Q

3 causes of hip pain 0-4 years

A

Septic arthritis
DDH
Transient sinovitis

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15
Q

3 cause of hip pain 5-10 years

A

Septic arthritis
Transient sinovitis
Perthes disease

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16
Q

3 causes of hip pain in 10-16 year olds

A

Septic arthritis
Slipped upper femoral epiphysis (SUFE)
Juvenile idiopathic arthritis

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17
Q

Should codeine be used in children

A

No as big metabolic differences so hard to calculate therapeutic dose

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18
Q

Most common cause of septic arthritis

A

Staph aureus

Neisserua gonorrhoea in sexually active teenagers

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19
Q

Common age for transient synovitis

A

3-10 years

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20
Q

Joint pain + fever likely dx?

A

Septic arthritis

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21
Q

What is transient synovitis associated with preceding the condition

A

URTI a couple of weeks before

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22
Q

Transient synovitis management

A

Simple analgesia
Safety net - A&E if develop a fever

Review in 48 hours and 7/7

Symptoms usually resolve in 1-2 weeks

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23
Q

Age of presentation for Perthes disease

A

4-12 years

5-8 years most common

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24
Q

Pathophysiology in Perthes disease

A

Acascular necrosis of femoral head

Likely due to repeated mechanical stress

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25
Main complication of Perthes disease
Early osteoarthritis after revascularistion healing process leading to total hip replacement in 5%
26
4 symptoms/ signs or Perthes disease
Pain in hip/groin Limp Restricted hip movements referred pain to knee NO TRAUMA
27
How to differentiate between Perthes disease and SUFE
Perthes disease = no trauma | SUFE = mild trauma triggers pain
28
Diagnostic test in Perthes disease
X-ray but can be normal
29
Management of perthes disease
Bed rest, traction, crutches, analgesia | ?surgery if realignment is needed
30
Age of presentation SUFE
8-15 years | OBEASE BOYS
31
Typical history of SUFE
Obese boy going through growth spirt with minor trauma Hip/ groin/ knee pain RESTRICTED INTERNAL ROTATION
32
Clinical examination of SUFE
Rest in external rotation Pain and limited movement on internal rotation
33
Investigation for SUFE
X RAY
34
Management of SUFE
Surgery to return femoral head to correct position
35
Where does oesteomylitis typically occur
Mataphyisis (m=middle) of long bones
36
Most common infective organism in osteomyelitis
Staph aureus
37
6 key risk factors for osteomyelitis
``` HIV, immunocompromised Orthopaedic surgery Open bone fracture Sickle cells TB ```
38
Investigations for osteomyelitis
Xray first line MRI best Blood tests show increased WCC CRP ESR Cultures / biopsy
39
Oestosarcoma most common site and age
Femur 10-20 years
40
Osteosarcoma key symptoms
Persistent bone pain that IS WORSE AT NIGHT - may wake them up from sleep Swelling, restricted joint movements, mass
41
How should a child with unexplained bone pain or swelling be managed
urgent x ray within 48 hours
42
X ray appearance of osteosarcoma
Poorly defined lesion with a 'fluffy' appearance | "sun-burst" appearance lateral from inflammation/ irritation
43
key blood test in osteosarcoma
Raised ALP
44
What is talipes?
Fixed abnormal ankle position
45
Two types of talipes
Talipes equinovarus - plantar flexion and supernates | Talipes calcaneovalgus - dorsi flexion and pronation
46
How are Talipes treated
Ponseti method
47
What is the ponseti method and which condition does it treat
Talipes Manipulation of foot and cast applied Tenotomy is performed to release tension
48
What is positional talipes
Form of talipes that does not require cast as foot can move into normal position
49
3 key risk factors for DDH
Breach (any point after 36 weeks, or birth) 1st degree family history Multiple pregnancy
50
Which babies get a hip USS at 4-6 weeks
FH of DDH Breach at any point after 36 weeks (even if corrected) Breach at birth
51
Which babies get a hip USS at 4-6 weeks
FH of DDH Breach at any point after 36 weeks (even if corrected) Breach at birth
52
Two key clinical tests for DDH
Ortolani test - baby on back, abduct hip to try dislocate anteriorly Barlow test - knees at 90 degrees, down ward pressure applied
53
Treatment of DDH
Pavlik harness if baby less than 6 months (hip flexed and abducted) Surgery if after 6 months
54
Name of osteomalacia in children
Rickets disease
55
Cause of Ricketts
Vitamin D or calcium deficiency
56
Genetic form of rickets
Hereditary hypophosphataemic rickets X- linked low levels of phosphate in blood
57
Three types of organ dysfunction that causes low vitamin D
Kidney disease GI malabsorption Parathyroids :)
58
What Is needed for phosphate absorption
Vitamin D (also helps absorb calcium(
59
Rickets blood results
Ca low PO4 low ALP high PTH high VIT D LOW
60
What baby diets are at a higher risk of rickets
Breast fed instead of bottle as not fortified with vitamin D
61
Achondrasplasia meaning
Disproportionate short stature
62
Genetic cause of achondroplasia
FGFR3 gene on chromosome 4 AD inheritance Homozygous inheritance is fatal
63
Effect on skull of achondroplasia
Disproportionate skull Foramen magnum stenosis
64
Non skeletal associations with achondroplasia
Recurrent otitis media Slope apnoea Hydrocephalus/ cervicial cord compression (foramen magnum stenosis)
65
Life expectancy in achondroplasia
Normal Normal development and intelligence too
66
Joint part effected in Osgood Schlatter
Tibial tuberosity where petella ligament inserts
67
Osgood Schalters physiology
Physical stress -> inflammation of tibial epiphyseal plate (e=end) -> multiple small avulsion fractures where patella ligament pulls away tiny pieces of bone
68
Avulsion fracture type
Tendon pulls away a piece of bone
69
Oesteogenesis imperfecta pathophysiology
Genetic mutation -> abonormal collagen formation
70
Key symptoms of OI
``` Hypermobility BLUE/ GREY SCLERA Short stature and triangular face Deafness from early adulthood Dental and bone malformation ```
71
Osteogenesis imperfecta management
Bisphosphates to increase BD | VIT d supplementation

Leeds MBCHB Year 4 Peads (21 decks)

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