Pediatrics Flashcards

1
Q

What is this injury and what does it represent?

A

Pediatric corner fractures of distal femur.

Represents NAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are fractures highly suspicious for child abuse?

A

Corner fx
Distal humerus transphyseal fx
Posterior rib fx
Fractures in various stages of healing
Long bone fx in non ambulatory patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What region of the physis do Physeal fractures occur?

A

Hypertrophic zone (zone of provisional calcification)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indications for Physeal bar excision?

A

>2cm growth remaining
<50% Physeal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What view do you use to measure medial epicondyle displacement?

A

Humeral axial view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risks of ORIF proximal radius fractures?

A

Loss ROM
AVN
Synostosis

Try and close reduce if possible, this is needed when >30-45 deg angulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment algorithm for ped femur fracture?

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs of compartment syndrome in kids?

A

Agitation
Anxiety
Analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complication of tibial tubercle fracture?

A

Compartment syndrome (injury to recurrent anterior tibial artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Complications of tibial spine fracture?

A

Stiffness
Late anterior instability (60%)

*intermeniscal ligament and medial meniscus can get entrapped and often block reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Cozen’s phenomenon?

A

Late valgus deformity if tibia that occurs ~6 months after proximal tibia fracture. This usually self corrects. But if present beyond 2 years after injury then can consider osteotomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pediatric HALO pin configuration?

A

6-8 pins at 2-4 in-lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Spine flexion distraction injuries typically involve the ——- region and 50% have this associated injury?

A

Thoracolumbar

Intra-abdominal injury

* Management is extension bracing for stable bony injuries or operative stabilization if ligamentous injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Joints with intra-articular metaphysis that are prone to septic joint…

A

SHEA

Shoulder
Hip
Elbow
Ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

First line test for Lyme disease?

A

ELISA and then if this is positive next order Western Blot test

Treatment:
- >8 years Doxycycline
- <8 years Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MRI finding consistent with cerebral palsy?

A

Periventricular leukomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mechanism of action for Botox?

A

Inhibits presynaptic release of acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Equinovarus foot is caused by…

A

overpull of posterior tibialis +/- Achilles tendon

Common in spastic hemiplegic CP patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Myelodysplasia serum marker

A

Maternal serum alpha-fetoprotein

*risk factors: low folic acid, valorous acid, carbamazepine, maternal hyperthermia, maternal insulin dependent diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Inheritance pattern of Duchennes muscular dystrophy and Becker muscular dystrophy?

A

X-linked recessive (males affected)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What Cobb angle do you fuse scoliosis in muscular dystrophy ?

A

When cobb reaches >20-25 deg because risk of loss of pulmonary function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Area of the spinal cord affected by polio?

A

Anterior horn

(Loss of motor but intact sensation)

*treatment is sub exhaustion exercise to prevent further loss of motor cell function

23
Q

Posteromedial tibial bowing

24
Q

Anteromedial tibial bowing is associated with…

A

Fibular hemimelia/ PFFD/ longitudinal deficiency

Sonic hedge hog gene

Associated with ball and socket ankle and equinovalgis foot

25
Anterolateral tibial bowing is associated with…
Pseudoartbrosis of the tibia (neurofibromatosis)
26
Clubfoot correction order
CAVE Cavus Adductus Varus Equinus *deficient tibialis anterior artery, possible LLD
27
Fibular deficiency is associated with…
Limb length discrepancy Limb malalignment (valgus) ACL absence Ball and socket ankle joint Tarsal coalition
28
Most common segments involved with a brachial plexus injury?
C5-6 (Erb Palsy - waiter tip deformity)
29
Birth brachial plexopathy can result in these changes of the glenohumeral joint due to persistent muscular imbalances?
Posterior humeral subluxation Glenoid retroversion humeral head flattening Glenohumeral joint incongruity
30
What is the curve pattern in adolescent idiopathic scoliosis?
Right thoracic scoliosis with hypokyphosis
31
Diagnosing physiologic knee varus, blount’s disease, and rickets (both diet and hypophosphotemic rickets)…
32
AIS Bracing with open triradiate cartilage is effective if the brace is worn a minimum of ___ hours per day
18
33
Risk factors for hip dysplasia?
First born Female sex Breach Family history DDH
34
Risk factors for failure of Pavlik harness treatment for DDH?
Femoral nerve palsy during treatment Irreducibility (ortalolani negative) Treatment after 7 weeks of age Right sided dislocation Graf type IV grade at presentation
35
Infantile scoliosis is more likely to progress when it meets these criteria?
RVAD >20 deg Cobb angle >25
36
For Pediatric hip dislocations what is the best treatment and post reduction imaging modality?
Closed gentle reduction in the OR with paralysis. Postreduction MRI to ensure to entrapped cartilage (CT not helpful because much of hip is not yet ossified)
37
Intra-articular tibial tubercle fractures are at risking if entrapping this structure?
Lateral mensiscus
38
Direction of physeal closure of the tibial tubercle?
Posterior to anterior and medial to lateral
39
Blocks to reduction for displaced pediatric tibial spine fractures?
Intermeniscal ligament Medial meniscus
40
For distal tibia phsyeal fractures, the Risk of growth arrest in kids increases if…
The postreduction gap is >3mm
41
Pattern of distal tibia phsyeal closure
central > medial > lateral
42
Halo pins used in Peds Number Lbs
6-8 pins at 2-4 in-lbs
43
Kocher criteria? Which of the criteria is the best predictor of infection?
NWB Fever >38.5 ESR >40 WBC >12K Fever am
44
Brain MRI finding for cerebral palsy?
Periventricular leukomalacia
45
Duchenne and Becker muscular dystrophy have this inheritance pattern?
X linked recessive
46
Scoliosis is primarily a ____ deformity
Rotational
47
AIS etiology?
Multifactorial
48
This reading on a scoliometer warrants referral?
7 deg or more (equates to 21 deg Cobb)
49
Typical AIS curve pattern?
RIGHT thoracic curve with hypokyphosis
50
Factors affecting AIS curve progression?
Age Skeletal maturity Risser 0-1 Sanders Peak growth velocity Occurs prior to menarche Occurs prior to Risser 1 Curve >20 deg
51
MRI indications for scoliosis in presumed AIS?
Left thoracic curve Pain Rapidly progressing scoliosis Atypical kyphosis of thoracic curve Juvenile onset (before age 10) Neurologic signs or symptoms Congenital abnormalities
52
When do you prophylacticallynpin the contralateral hip for SCFE?
Endocrine abnormalities Open triradiate cartilage
53
Familial Vit D resistant hypophosphotemia is associated with these lab findings?
Low serum phosphate Elevated urinary phosphate