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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
Q

Main complication of Perthes disease

A

Early osteoarthritis after revascularistion healing process leading to total hip replacement in 5%

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26
Q

4 symptoms/ signs or Perthes disease

A

Pain in hip/groin
Limp
Restricted hip movements
referred pain to knee

NO TRAUMA

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27
Q

How to differentiate between Perthes disease and SUFE

A

Perthes disease = no trauma

SUFE = mild trauma triggers pain

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28
Q

Diagnostic test in Perthes disease

A

X-ray but can be normal

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29
Q

Management of perthes disease

A

Bed rest, traction, crutches, analgesia

?surgery if realignment is needed

30
Q

Age of presentation SUFE

A

8-15 years

OBEASE BOYS

31
Q

Typical history of SUFE

A

Obese boy going through growth spirt with minor trauma

Hip/ groin/ knee pain

RESTRICTED INTERNAL ROTATION

32
Q

Clinical examination of SUFE

A

Rest in external rotation

Pain and limited movement on internal rotation

33
Q

Investigation for SUFE

A

X RAY

34
Q

Management of SUFE

A

Surgery to return femoral head to correct position

35
Q

Where does oesteomylitis typically occur

A

Mataphyisis (m=middle) of long bones

36
Q

Most common infective organism in osteomyelitis

A

Staph aureus

37
Q

6 key risk factors for osteomyelitis

A 
HIV, immunocompromised
Orthopaedic surgery
Open bone fracture
Sickle cells
TB
38
Q

Investigations for osteomyelitis

A

Xray first line
MRI best

Blood tests show increased WCC CRP ESR

Cultures / biopsy

39
Q

Oestosarcoma most common site and age

A

Femur

10-20 years

40
Q

Osteosarcoma key symptoms

A

Persistent bone pain that IS WORSE AT NIGHT - may wake them up from sleep

Swelling, restricted joint movements, mass

41
Q

How should a child with unexplained bone pain or swelling be managed

A

urgent x ray within 48 hours

42
Q

X ray appearance of osteosarcoma

A

Poorly defined lesion with a ‘fluffy’ appearance

“sun-burst” appearance lateral from inflammation/ irritation

43
Q

key blood test in osteosarcoma

A

Raised ALP

44
Q

What is talipes?

A

Fixed abnormal ankle position

45
Q

Two types of talipes

A

Talipes equinovarus - plantar flexion and supernates

Talipes calcaneovalgus - dorsi flexion and pronation

46
Q

How are Talipes treated

A

Ponseti method

47
Q

What is the ponseti method and which condition does it treat

A

Talipes

Manipulation of foot and cast applied

Tenotomy is performed to release tension

48
Q

What is positional talipes

A

Form of talipes that does not require cast as foot can move into normal position

49
Q

3 key risk factors for DDH

A

Breach (any point after 36 weeks, or birth)
1st degree family history
Multiple pregnancy

50
Q

Which babies get a hip USS at 4-6 weeks

A

FH of DDH
Breach at any point after 36 weeks (even if corrected)
Breach at birth

51
Q

Which babies get a hip USS at 4-6 weeks

A

FH of DDH
Breach at any point after 36 weeks (even if corrected)
Breach at birth

52
Q

Two key clinical tests for DDH

A

Ortolani test - baby on back, abduct hip to try dislocate anteriorly

Barlow test - knees at 90 degrees, down ward pressure applied

53
Q

Treatment of DDH

A

Pavlik harness if baby less than 6 months (hip flexed and abducted)

Surgery if after 6 months

54
Q

Name of osteomalacia in children

A

Rickets disease

55
Q

Cause of Ricketts

A

Vitamin D or calcium deficiency

56
Q

Genetic form of rickets

A

Hereditary hypophosphataemic rickets

X- linked low levels of phosphate in blood

57
Q

Three types of organ dysfunction that causes low vitamin D

A

Kidney disease
GI malabsorption
Parathyroids :)

58
Q

What Is needed for phosphate absorption

A

Vitamin D (also helps absorb calcium(

59
Q

Rickets blood results

A

Ca low
PO4 low
ALP high
PTH high

VIT D LOW

60
Q

What baby diets are at a higher risk of rickets

A

Breast fed instead of bottle as not fortified with vitamin D

61
Q

Achondrasplasia meaning

A

Disproportionate short stature

62
Q

Genetic cause of achondroplasia

A

FGFR3 gene on chromosome 4

AD inheritance

Homozygous inheritance is fatal

63
Q

Effect on skull of achondroplasia

A

Disproportionate skull

Foramen magnum stenosis

64
Q

Non skeletal associations with achondroplasia

A

Recurrent otitis media
Slope apnoea
Hydrocephalus/ cervicial cord compression (foramen magnum stenosis)

65
Q

Life expectancy in achondroplasia

A

Normal

Normal development and intelligence too

66
Q

Joint part effected in Osgood Schlatter

A

Tibial tuberosity where petella ligament inserts

67
Q

Osgood Schalters physiology

A

Physical stress -> inflammation of tibial epiphyseal plate (e=end) -> multiple small avulsion fractures where patella ligament pulls away tiny pieces of bone

68
Q

Avulsion fracture type

A

Tendon pulls away a piece of bone

69
Q

Oesteogenesis imperfecta pathophysiology

A

Genetic mutation -> abonormal collagen formation

70
Q

Key symptoms of OI

A 
Hypermobility
BLUE/ GREY SCLERA
Short stature and triangular face
Deafness from early adulthood
Dental and bone malformation
71
Q

Osteogenesis imperfecta management

A

Bisphosphates to increase BD

VIT d supplementation

Leeds MBCHB Year 4 Peads (21 decks)

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