patient management approachs peds

Question 1

History

Answer 1

1. Age/Sex/Race
2. CC
3. Perinatal Hx
   
   1. Pregnancy, presentation, delivery method, and apgars
4. Developmental Hx
   
   1. growth ht/wt, milestones
5. PSHX, PMHX, Meds, Allergies
6. Family Hx
7. O nset
8. P osition
9. Q uality/Quantity
10. R adiation
11. S ymptoms associated
    
    1. Neurologic
    2. Mechanical
    3. Constitutional
    4. Local
12. T iming
13. AA
14. Social Hx (EtOH, tobacco), Travel Hx
15. Handedness, Sports
16. ADLs
17. ROS

Question 2

Physical Exam

Answer 2

1. General
2. JAB
3. Look
   
   1. Gait
   2. S welling
   3. E rythema
   4. A trophy
   5. D eformity
   6. S kin changes
      
      1. Midline lesions
      2. Skin lesions
4. Feel
5. Move
6. NV Exam
7. Special Tests

Question 3

Imaging

Answer 3

• Xrays, other modalities

Question 4

Diagnosis or DDx

Answer 4

1. DDx
   
   1. V ascular
   2. I infection
   3. N eoplasm / Neurogenic
   4. D ysplasias / Developmental
   5. I nflammatory
   6. C ongenital
   7. A utoimmune
   8. T rauma
   9. E ndocrine
2. Concerns (AVN risk, infection, etc.)

Question 5

Acute Rx and work-up

Answer 5

• Reduce/splint/traction, ER tests/consults, admit, further imaging, plan OR for trauma

Question 6

Treatment plan

Answer 6

1. Goals
2. Non-operative Rx (options, follow-up)
3. Operative
   
   1. Discuss options
   2. Plan OR – consult specialist PRN
4. Consent
5. Outcome
6. Risks (immediate, late, pathology-specific)
7. Pre-op
   
   1. labs (x-match), tests (ECG, CXR), old OR reports, consults
8. Intraoperative
   
   1. patient, surgery, implants, adjuncts (teams, consultants, special equipment), table, flouro, monitoring

Question 7

Technique

Answer 7

1. Position, ABX
2. Incision, approach, fixation

Question 8

8. Post-op

Answer 8

1. NV exam, compartment check
2. Xrays
3. Immobilization
4. Weight Bearing Status, Physio

Question 9

9. Disposition and Follow-up

Answer 9

F/U plan

Question 10

10. Complications

Answer 10

1. List potential complications
2. Prevention
3. Treatment

Question 11

Paeds
Disease

Answer 11

1. History
   
   1. Age/Sex/Race
   2. CC
   3. Perinatal Hx
      
      1. Pregnancy, presentation, delivery method, and apgars
   4. Developmental Hx
      
      1. growth ht/wt, milestones
   5. PSHX, PMHX, Meds, Allergies
   6. Family Hx
   7. O nset
   8. P osition
   9. Q uality/Quantity
   10. R adiation
   11. S ymptoms associated
       
       1. Neurologic
       2. Mechanical
       3. Constitutional
       4. Local
   12. T iming
   13. AA
   14. Social Hx (EtOH, tobacco), Travel Hx
   15. Handedness, Sports
   16. ADLs
   17. ROS
2. Physical Exam
   
   1. General
   2. JAB
   3. Look
      
      1. Gait
      2. S welling
      3. E rythema
      4. A trophy
      5. D eformity
      6. S kin changes
         
         1. Midline lesions
         2. Skin lesions
   4. Feel
   5. Move
   6. NV Exam
   7. Special Tests
3. Imaging
   
   1. Xrays, other modalities
4. Diagnosis or DDx
   
   1. DDx
      
      1. V ascular
      2. I infection
      3. N eoplasm / Neurogenic
      4. D ysplasias / Developmental
      5. I nflammatory
      6. C ongenital
      7. A utoimmune
      8. T rauma
      9. E ndocrine
   2. Concerns (AVN risk, infection, etc.)
5. Acute Rx and work-up
   
   1. Reduce/splint/traction, ER tests/consults, admit, further imaging, plan OR for trauma
6. Treatment plan
   
   1. Goals
   2. Non-operative Rx (options, follow-up)
   3. Operative
      
      1. Discuss options
      2. Plan OR – consult specialist PRN
   4. Consent
   5. Outcome
   6. Risks (immediate, late, pathology specific)
   7. Pre-op
      
      1. labs (x-match), tests (ECG, CXR), old OR reports, consults
   8. Post the case
      
      1. patient, surgery, implants, adjuncts (teams, consultants, special equipment), table, flouro, monitoring
7. Technique
   
   1. Position, ABX
   2. Incision, approach, fixation
8. Post-op
   
   1. NV exam, compartment check
   2. Xrays
   3. Immobilization
   4. Weight Bearing Status, Physio
9. Disposition and Follow-up
   
   1. F/U plan
10. Complications
    
    1. List potential complications
    2. Prevention
    3. Treatment