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EOR - Pediatrics > Orthopedics/Rheumatology > Flashcards

Orthopedics/Rheumatology Flashcards

1
Q

insidious onset of a dull ache or throbbing localized to the groin, lateral hip, or buttocks

A

avascular necrosis of proximal femur

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2
Q

3 rf for avascular necrosis of the femur

A

trauma
steroids
SSA

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3
Q

in peds, AVN is called

A

legg-calve perthes dz

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4
Q

what is this showing

A

AVN of femur

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5
Q

gs dx for AVN

A

MRI

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6
Q

2 XR findings of AVN

A

effusion
joint space widening

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7
Q

tx for AVN

A

conservative vs joint replacement

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8
Q

4 mo F w. asymmetric thigh creases - LUE is shorter than the right and legs externally rotated

A

congenital hip dysplasia

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9
Q

what is this showing

A

hip dysplasia

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10
Q

2 XR findings of hip dysplasia

A

superiorly displaced femur
hypolastic acetabulum

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11
Q

congenital hip dysplasia is malignment of the

A

acetabulum and femoral head

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12
Q

3 PE findings of hip dypslasia

A

legs of unequal lengths
asymmetric skin folds
limping/waddling gait

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13
Q

screening for hip dysplasia

A

hip exam at every WCC until 2 yo

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14
Q

PE tests for hip dysplasia

A

barlow
ortolani

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15
Q

adduction of the hip while holding the knee straight to assess for popping of the femoral head out of the socket

A

barlow maneuver -> hip dysplasia

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16
Q

flexion of the hip at 90 degrees with gentle abduction -> relocation of hip
performed after barlow maneuver

A

ortolani maneuver

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17
Q

what imaging is useful to assess the position of the femoral head and structure of acetabulum

A

US

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18
Q

_ is contraindicated for hip dysplasia until 4 months old

A

XR

due to radiolucency of femoral head

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19
Q

tx of hip dysplasia based on age

A

< 6 mos: pavlik harness (abduction bracing)
6-15 mos: hip spica cast
15-24 mos: ORIF followed by hip spica cast

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20
Q

what type of harness is this

A

pavlik -> abduction bracing

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21
Q

what type of harness is this

A

hip spica cast

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22
Q

group of rheumatic dz’s that begin at or before 16 yo

A

juvenile rheumatoid arthritis (JIA)

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23
Q

3 types of JIA

A

oligoarticular -> mc
polyarticular
systemic (still dz)

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24
Q

oligoarticular JIA mc affects _ and involves </= _ joints during the first 6 mos of the dz

A

girls
4

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25
Q

polyarticular JIA affects >/= _ joints at onset,
and is divided into (2)

A

> /= 5 joints

RF (-) vs RF (+)

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26
Q

_ are typically RF negative w. polyarticular JIA, and have a better prognosis

A

girls

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27
Q

describe pattern of arthritis w. polyarticular JIA (2)

A

symmetric
small joints

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28
Q

what symptoms are associated w. systemic JIA (5)

A

prolonged fever
iridocyclitis
generalized LAD
splenomegaly
unexplained rash

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29
Q

what is iridocyclitis

A

inflammation of the iris and ciliary body

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30
Q

dx for systemic JIA is clinical - what should the work up include (3)

A

RF
ANA
HLA-B27

31
Q

tx for systemic JIA (3)

A

NSAIDs
steroid injxns
MTX

32
Q

3 pediatric osteo cancers to know

A

osteosarcoma
ewing’s sarcoma
osteochondroma

33
Q

what age group do you think of w. osteosarcoma

A

10-14 yo

34
Q

describe pain w. osteosarcoma

A

progressively worsening night time bone/joint pain with swelling

35
Q

what is this showing

A

sun ray/burst
hair on end appearance

osteosarcoma

36
Q

mc site of metastasis for osteosarcoma

A

lung

37
Q

PE findings of ewing’s sarcoma (4)

A

fever
palpable mass
swelling
ttp

38
Q

what is this showing

A

lytic lesion
onion peel appearance of periosteum

ewing’s sarcoma

39
Q

tx for ewing’s sarcoma

A

chemo
surgery
xrt

40
Q

osteosarcoma mimics _
ewing’s sarcoma mimics _

A

osteosarcoma: growing pains
ewing’s sarcoma: infxn

41
Q

age group mc affected by osteochondroma

A

10-20 yo males

42
Q

benign chondrogenic lesion derived from cartilage

A

osteochondroma

43
Q

mc benign bone tumor

A

osteochondroma

44
Q

what is this showing

A

pedunculated stalk -> osteochondroma

45
Q

what is this showing

A

lesion on the bone -> osteochondroma

46
Q

tx for osteochondroma

A

resection vs obs

47
Q

presentation of nursemaid elbow (4)

A

holding elbow flexed and pronated
ttp of lateral elbow
loss of pronation/supination
limited flexion/extension

48
Q

moi for nursemaid elbow

A

sudden pull on extended, pronated forearm -> dislocation of elbow joint

ex swinging kid by the arm or pulling, tugging on uncooperative child

49
Q

nursemaid elbow is _ subluxation

A

radial head

50
Q

what is this showing

A

radial head subluxation (nursemaid elbow)

51
Q

tx for nursemaid elbow

A

supination-flexion

make sure kid uses arm before d/c’ing

52
Q

inflammation of patellar ligament where it inserts on the tibial tuberosity -> painful swelling below knee

A

osgood schlatter dz

53
Q

typical presentation of osgood schlatter (3)

A

9-14 yo - growth spurt
tenderness over tibial tubercle
involved w. sports that require running

54
Q

2 PE findings of osgood schlater

A

pain w. resisted knee extension
prominent tibial tuberosity

55
Q

XR is not necessary for osgood schlater dx, but what would you see if severe

A

fragmentation of tibial tuberosity

56
Q

tx for osgood schlater

A

reduce PA
ice
PT
NSAIDs
last line: surgery

57
Q

indication for surgery for osgood schlater

A

closed growth plates

58
Q

what test is this

A

Adams forward bend

59
Q

what is this showing

A

scoliosis

60
Q

clinical definition of scoliosis

A

lateral spine curvature w. cobb angle >/= 10

61
Q

PE finding of scoliosis

A

asymmetry in scapular height w. adams forward bend

62
Q

scoliosis is more likely to progress and require tx in girls or boys

A

girls

63
Q

3 indications for MRI w. scoliosis

A

atypical curve pattern
rapid progression
neuro sx (ex reflex abnl)

64
Q

complication of scoliosis

A

decreased pulmonary fxn

spirometry shows restrictive pattern

65
Q

tx for scoliosis based on degree of curvature

A

10-15: monitor q 6-12 mo, +/- XR
15-20: serial AP XR q 3-4 mo
20-40 degrees: conservative (PT/bracing)
> 40: surgery

66
Q

obese male, limp, knee pain w. external rotation

A

slipped capital femoral epiphysis

67
Q

head of femur slips off neck of femur inferiorly and posteriorly

A

slipped capital femoral epiphysis (SCFE)

68
Q

4 PE findings of SCFE

A

-pain in hip/groin/thigh/ipsilateral knee w.o trauma
-antalgic waddling
-externally rotated leg
-drehmann sign

69
Q

what is drehmann sign

A

while in supine position, hip externally rotates and abducts w. passive hip flexion -> SCFE

70
Q

what PA is associated w. SCFE

A

jumping

71
Q

dx for SCFE

A

XR for all:
AP
PLUS
frog leg lateral

72
Q

3 XR findings of SCFE

A

widening of joint space
decrease in epiphyseal height
steel sign

73
Q

what is this showing

A

steel sign: double density from superimposition of epiphysis and metaphysis -> SCFE

74
Q

tx for SCFE (2)

A

surgical fix w. screw for all
+/- contralatearl prophylactic screw fix

EOR - Pediatrics (15 decks)

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