paeds

Question 1

inheritance osteogenesis imperfecta

Answer 1

autosomal dominant (type 1) // recessive type 2 = death

Question 2

mutation osteogenesis imperfecta

Answer 2

type 1 collagen

Question 3

symptoms osteogenesis imperfecta

Answer 3

childhood, fractures, blue sclera, short stature, deafness

Question 4

invx osteogenesis imperfecta

Answer 4

ca, phosphate, PTH, ALP

Question 5

what is langerhans cell histiocytosis

Answer 5

abnormal proliferation of histocytes

Question 6

symptoms langerhans cell histiocytosis

Answer 6

bone pain in skull or femur, nodules, otitid media or mastoiditis

Question 7

xray langerhans cell histiocytosis

Answer 7

punched out legions

Question 8

what is normal varus/ valgus alingment at birth

Answer 8

varus

Question 9

what is normal varus/ valgus alignment as a toddler

Answer 9

valgus

Question 10

what structural variant causes intoeing

Answer 10

femoral anteversion

Question 11

what test can used to determine if flat feet are pathological or not

Answer 11

jack’s test –> dorsiflexion of big toe forms an arch

Question 12

what is curly toes

Answer 12

overlapping and curling of toes

Question 13

what is developmental dysplasia of the hip (DDH)

Answer 13

dislocation or subluxation of femur head from acetabulum

Question 14

RF DDH

Answer 14

girls, first born, breech, down syndrome, oligohydramnios, left leg

Question 15

complications DDH

Answer 15

fake acetabulum forms –> severe OA at young age –> THR

Question 16

symptoms DDH

Answer 16

short limb, asymmetric groin fold

Question 17

when is DDH screened for

Answer 17

USS for firs degree relative with hip problems, breech at 36 weeks

Question 18

invx DDH

Answer 18

barlow –> ortolani test // USS // XRAY 4-6 months

Question 19

mx DDH

Answer 19

palvik harness, surgery if 18 months+

Question 20

what is transient synovitis of the hip + what usually causes it

Answer 20

inflammation of synovium joint usually after URTI

Question 21

symptoms transient synovitis of the hip

Answer 21

limp, pain weight bearing, low grade fever

Question 22

invx transient synovitis of the hip

Answer 22

Xray, hip aspiration, normal CRP, MRI (diagnosis of exclusion)

Question 23

what is a red flag in transient synovitis of the hip

Answer 23

fever –> specialist input

Question 24

which age group get transient synovitis

Answer 24

2-10 girls

Question 25

what is perthes disease

Answer 25

flattened femoral head --> avascular necrosis

Question 26

staging for perthes disease

Answer 26

catterall

Question 27

complications perthes

Answer 27

lack of blood supply --> necrosis --> fracture --> remodelling --> OA

Question 28

who gets perthes

Answer 28

boys 4-9

Question 29

symptoms perthes

Answer 29

hip pain and limb worse on exercise // stiffness and atrophy // loss of internal rotation and abduction

Question 30

invx perthes

Answer 30

Xray + MRI

Question 31

mx perthes

Answer 31

cast or braces --> surgery (usually conservative mx)

Question 32

what is slipped upper femoral epiphysis (SUFE)

Answer 32

displacement of femoral head posteriorly

Question 33

who gets SUFE

Answer 33

overweight boys 10-15, hypothyroid and renal disease

Question 34

symptoms SUFE

Answer 34

loss of internal rotatin, pain in groin, pain and limp

Question 35

invx SUFE

Answer 35

lateral Xray

Question 36

mx SUFE

Answer 36

urgent surgery to pin femoral head

Question 37

what is juvenile idiopathic arthritis

Answer 37

arthritis at <16 in 4 or less joints - usually medium sized joints

Question 38

which antibodu can be assoc with juveline idiopathic arthritis

Answer 38

ANA

Question 39

what is systemic juveline idiopathic arthritis also know as

Answer 39

stills disease

Question 40

symptoms systemic juveline idiopathic arthritis

Answer 40

pyrexia, rash, lymph, arthritis, uveitis

Question 41

what is clubfoot assoc with (6)

Answer 41

males, spina bifida, cerebral palsy, edwards (T18), oligohydramnios, breech

Question 42

mx clubfoot

Answer 42

ponseti casting --> change cast every 5-6 months

Question 43

what surgery is required for full correction of clubfoot

Answer 43

achilles tendonotomy

Question 44

secondary causes of scoliosis

Answer 44

neuromuscular disease, skeletal dysplasia,tumour

Question 45

invx for scoliosis

Answer 45

xray or MRI (if severe pain)

Question 46

mx scoliosis

Answer 46

casts, braces --> surgical rod stabilisation

Question 47

what classification is used for growth plate fractures

Answer 47

salter harris: I fracture through physis only --> II physis and metaphysis --> III + IVE metaphysis + epihysis to include joint --> V crush fracture