Pediatric Part 2 Flashcards
What are the 3 left to right shunts?
ASD
VSD
PDA
What will be heard when an ASD is present?
Fixed split S2
What will be heard when a VSD is present?
Harsh holosystolic murmur at left sternal border
The smaller a VSD, the ____ the sound of the murmur
Louder
With VSDs, what are the treatment options?
Observe
Surgery if symptomatic
What is heard with a PDA?
Continuous machine-like/multiphase murmur
How do you close the PDA?
Indomethacin
How do you keep the PDA open?
Prostaglandins
What does the PDA connect?
Aorta and Pulmonary artery
Right to Left shunts will present with?
Cyanosis
Transposition of great vessels often occurs in mothers with what condition diagnosed before pregnancy?
Diabetes
What are the 4 components of Tetralogy of Fallot?
VSD
Overriding Aorta
Pulmonic Stenosis
RV hypertrophy
What will be seen on CXR with Tetralogy of Fallot?
Boot shaped heart
With certain Right to Left shunts, what should remain open to ensure survival?
PDA – give prostaglandins
Why can Developmental Dysplasia of the Hip be present anatomically?
Acetabulum is not deep enough yet
If a newborn has clunky hips (barlow-ortolani) what is the treatment?
Harness
What is Legg-Calve-Perthes Disease and in who?
AVN of the femoral head
= Boys < 10 years old
Symptom of Legg-Calve- Perthes Disease?
PainLESS limp
Treatment for Perthe’s Disease?
Non-weight bearing
– Body will remodel the dead bone with time
What is SCFE and in who?
Femoral head slips through the growth plate from the femoral neck
= OBESE boys > 10 years old
Symptom of SCFE?
Painful limp
What specific X-ray should be done for SCFE?
Frog-leg X-ray
Treatment for SCFE?
Surgery
How will Septic Arthritis present?
Acute, painful joint where a child refuses to put weight on it + FEVER
How will Transient Tenosynovitis present?
Acute, painful joint where a child refuses to put weight on it following a viral illness
What lab changes are present with Septic Arthritis only?
HIGH WBC, ESR, CRP
What will the Arthrocentesis show with Septic Arthritis?
Cell count > 50K
Treatment for Septic Arthritis?
Drainage and ABx
Treatment for Transient Tenosynovitis?
NSAIDs/time because it will heal on its own
Are there systemic signs with Transient Tenosynovitis?
NO
Another name for Osgood-Schlatter’s Disease?
Tibial Tuberosity Apophysitis
Describe how Osgood-Schlatter’s Disease occurs?
Tendons attach to the tibial tubercle which is attached to the apophysis that connects to the tibia
– Overuse causes the apophysis to become inflamed
What is unique about the Apophysis compared to other growth plates?
It does NOT fuse until after age 18!
– The rest are much earlier than that
Treatment for Osgood-Schlatter’s Disease?
Rest or play through the pain
When will the pain most often occur with Osgood-Schlatter’s?
AFTER overuse of leg muscles
Ewing’s Sarcoma is a neuroendocrine tumor with what translocation?
11;22
How will Ewing’s Sarcoma present?
Local pain, swelling + fever, weight loss, cytopenias
What will be seen on X-ray with Ewing’s Sarcoma?
Onion skinning
What 2 conditions can lead to Osteosarcoma?
RB gene mutation
Pagets disease of bone
How will an Osteosarcoma present?
Local pain and swelling ONLY
What 2 things can be seen on X-ray with an Osteosarcoma?
- Sunburst lytic lesion
- Codman’s triangle
What is unique about the pain with an Osteoid Osteoma?
Relieved by NSAIDs or aspirin
What will be seen on X-ray with an Osteoid Osteoma?
Central lucency + cortical thickening
Treatment for Osteoid Osteoma?
NSAIDs/Aspirin and time
What 3 diagnostics are needed for Ewing’s and Osteosarcoma?
X-ray
MRI
Core needle biopsy
