Orthopedics

Question 1

Limping Child

Answer 1

LIMPSS
Legg-Calve-Perthes Disease
Infection
Malignancies
Pain from trauma/drama
S(CFE)
Somewhere else lieth the truth

Question 2

Leg-Calve-Perthes

Answer 2

avascular necrosis femoral head
Age 3-12 (6)
boys>girls
xr (frog leg lateral)
MRI gold standard
NSAIDS and ortho referral

Question 3

Kocher Criteria

Answer 3

Refusal to bear weight
Fever>101.5 (38.6)
WBC>12k
ESR>40

Question 4

most common pathogen septic joint

Answer 4

S. Aureus

Question 5

Slipped capital femoral epiphysis

Answer 5

overweight tween boys

2nd most missed fracture (c/o knee pain)

Question 6

Klein’s line

Answer 6

SCFE - line along superior border of femoral neck that should intersect the lateral aspect of the femoral head. In SCFE the head slides medially and the line will not touch femoral head

Question 7

Osgood-Schlatter’s Disease

Answer 7

micro trauma to tibial tuberosity resulting in partial avulsion of tibial tuberosity and separation of bone

Question 8

Gamekeeper’s thumb

Answer 8

injury to UCL (ulnar collateral ligament)

Question 9

felon incision

Answer 9

ulnar side of 2, 3, 4 and radial side of thumb and 5

Question 10

Fight bites

Answer 10

Strep species

IV ABX - Unasyn…ADMIT

Question 11

Barton Fracture

Answer 11

like colles or smith but involves the joint

Question 12

best view for acetabular fracture

Answer 12

judet view xr,

Question 13

first sign of compartment syndrome

Answer 13

pain with passive extension, paresthesia

Question 14

most common fractured tarsal bone

Answer 14

calcaneal

Question 15

bohler’s fracture

Answer 15

angle in calcaneus should be >20%…less equals compression fracture

Question 16

RA with acute onset stridor and throat pain

Answer 16

cricoarytenoid dislocation

Question 17

RA and feels like head might fall off

Answer 17

AA instability

Question 18

Involvement of DIP

Answer 18

OA…NOT RA…only PIP

Question 19

Reiter’s Syndrome

Answer 19

HLA-B27 - can’t see, pee, climb tree

Question 20

elbow aspiration

Answer 20

lateral approach…avoid ulnar nerve

Question 21

Gout

Answer 21

needle shaped crystals NEGATIVE bifringence

Question 22

pseudogout

Answer 22

calcium pyrophosphate crystals…usually in knee
thomboid shaped crystals , weekly bifringence
Pseudo begins with P. P for positive

Question 23

most common primary bone tumor in kids

Answer 23

osteosarcoma..usually in distal femur

Question 24

colchicine side effects

Answer 24

nausea, vomiting, GI upset

Question 25

juvenile dermatomyositis

Answer 25

``` inflammatory autoimmune myopathy GIRLS 5-10 years old PROXIMAL muscle weakness atropy is late finding associated with heliotrope rash Gottron's papules STEROIDS! ```

Question 26

most common complication of anklylosing spondylitis

Answer 26

anterior uveitis

Question 27

most common electrolyte abnormality in rhabdo

Answer 27

hypocalcemia | potassium and phosphate are HIGH

Question 28

rhabdo UA

Answer 28

BLOOD BUT NO RBCS

Question 29

boutonniere deformity

Answer 29

forced flexion of PIP