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ABOS Part 1 > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

What is this injury and what does it represent?

A

Pediatric corner fractures of distal femur.

Represents NAT

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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

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3
Q

What region of the physis do Physeal fractures occur?

A

Hypertrophic zone (zone of provisional calcification)

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4
Q

Indications for Physeal bar excision?

A

>2cm growth remaining
<50% Physeal involvement

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5
Q

What view do you use to measure medial epicondyle displacement?

A

Humeral axial view

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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

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7
Q

Treatment algorithm for ped femur fracture?

A

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8
Q

Signs of compartment syndrome in kids?

A

Agitation
Anxiety
Analgesics

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9
Q

Complication of tibial tubercle fracture?

A

Compartment syndrome (injury to recurrent anterior tibial artery)

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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

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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.

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12
Q

Pediatric HALO pin configuration?

A

6-8 pins at 2-4 in-lbs

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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

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14
Q

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

A

SHEA

Shoulder
Hip
Elbow
Ankle

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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

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16
Q

MRI finding consistent with cerebral palsy?

A

Periventricular leukomalacia

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17
Q

Mechanism of action for Botox?

A

Inhibits presynaptic release of acetylcholine

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18
Q

Equinovarus foot is caused by…

A

overpull of posterior tibialis +/- Achilles tendon

Common in spastic hemiplegic CP patients

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19
Q

Myelodysplasia serum marker

A

Maternal serum alpha-fetoprotein

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

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20
Q

Inheritance pattern of Duchennes muscular dystrophy and Becker muscular dystrophy?

A

X-linked recessive (males affected)

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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

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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

A

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
Q

Anterolateral tibial bowing is associated with…

A

Pseudoartbrosis of the tibia (neurofibromatosis)

26
Q

Clubfoot correction order

A

CAVE

Cavus
Adductus
Varus
Equinus

*deficient tibialis anterior artery, possible LLD

27
Q

Fibular deficiency is associated with…

A

Limb length discrepancy
Limb malalignment (valgus)
ACL absence
Ball and socket ankle joint
Tarsal coalition

28
Q

Most common segments involved with a brachial plexus injury?

A

C5-6 (Erb Palsy - waiter tip deformity)

29
Q

Birth brachial plexopathy can result in these changes of the glenohumeral joint due to persistent muscular imbalances?

A

Posterior humeral subluxation
Glenoid retroversion
humeral head flattening
Glenohumeral joint incongruity

30
Q

What is the curve pattern in adolescent idiopathic scoliosis?

A

Right thoracic scoliosis with hypokyphosis

31
Q

Diagnosing physiologic knee varus, blount’s disease, and rickets (both diet and hypophosphotemic rickets)…

A

32
Q

AIS Bracing with open triradiate cartilage is effective if the brace is worn a minimum of ___ hours per day

A

18

33
Q

Risk factors for hip dysplasia?

A

First born
Female sex
Breach
Family history DDH

34
Q

Risk factors for failure of Pavlik harness treatment for DDH?

A

Femoral nerve palsy during treatment
Irreducibility (ortalolani negative)
Treatment after 7 weeks of age
Right sided dislocation
Graf type IV grade at presentation

35
Q

Infantile scoliosis is more likely to progress when it meets these criteria?

A

RVAD >20 deg
Cobb angle >25

36
Q

For Pediatric hip dislocations what is the best treatment and post reduction imaging modality?

A

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
Q

Intra-articular tibial tubercle fractures are at risking if entrapping this structure?

A

Lateral mensiscus

38
Q

Direction of physeal closure of the tibial tubercle?

A

Posterior to anterior and medial to lateral

39
Q

Blocks to reduction for displaced pediatric tibial spine fractures?

A

Intermeniscal ligament
Medial meniscus

40
Q

For distal tibia phsyeal fractures, the Risk of growth arrest in kids increases if…

A

The postreduction gap is >3mm

41
Q

Pattern of distal tibia phsyeal closure

A

central > medial > lateral

42
Q

Halo pins used in Peds
Number
Lbs

A

6-8 pins at 2-4 in-lbs

43
Q

Kocher criteria?
Which of the criteria is the best predictor of infection?

A

NWB
Fever >38.5
ESR >40
WBC >12K

Fever am

44
Q

Brain MRI finding for cerebral palsy?

A

Periventricular leukomalacia

45
Q

Duchenne and Becker muscular dystrophy have this inheritance pattern?

A

X linked recessive

46
Q

Scoliosis is primarily a ____ deformity

A

Rotational

47
Q

AIS etiology?

A

Multifactorial

48
Q

This reading on a scoliometer warrants referral?

A

7 deg or more (equates to 21 deg Cobb)

49
Q

Typical AIS curve pattern?

A

RIGHT thoracic curve with hypokyphosis

50
Q

Factors affecting AIS curve progression?

A

Age
Skeletal maturity
Risser 0-1
Sanders
Peak growth velocity
Occurs prior to menarche
Occurs prior to Risser 1
Curve >20 deg

51
Q

MRI indications for scoliosis in presumed AIS?

A

Left thoracic curve
Pain
Rapidly progressing scoliosis
Atypical kyphosis of thoracic curve
Juvenile onset (before age 10)
Neurologic signs or symptoms
Congenital abnormalities

52
Q

When do you prophylacticallynpin the contralateral hip for SCFE?

A

Endocrine abnormalities
Open triradiate cartilage

53
Q

Familial Vit D resistant hypophosphotemia is associated with these lab findings?

A

Low serum phosphate
Elevated urinary phosphate

ABOS Part 1 (11 decks)

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