Pediatrics

Question 1

What physeal zone does Gaucher’s disease affect?

Answer 1

Reserve zone

Question 2

What physeal zone does achondroplasia affect?

Answer 2

Proliferative zone

Question 3

What physeal zone does MHE affect?

Answer 3

Proliferative zone

Question 4

What physeal zone is the location of chondrocyte maturation?

Answer 4

Hypertrophic zone

Question 5

What are the physeal zones?

Answer 5

Reserve, proliferative, hypertrophic, primary spongiosa, secondary spongiosa

Question 6

What physeal zone is responsible for chondrocyte hypertrophy?

Answer 6

hypertrophic zone

Question 7

What zone is responsible for chondrocyte maturation?

Answer 7

Hypertrophic zone

Question 8

Which physeal zone has the highest extracellular matrix production?

Answer 8

Proliferative zone

Question 9

Which physeal zone has a large amount on chondrocyte growth?

Answer 9

Hypertrophic zone - specifically the degenerative zone; 5x the growth of chondrocytes

Question 10

What physeal zone is affected by SCFE?

Answer 10

Hypertrophic zone

Question 11

What physeal zone is affected by Rickets?

Answer 11

Hypertrophic zone (provisional calcification zone)

Question 12

Which physeal zone does enchondromas affect?

Answer 12

Hypertrophic zone

Question 13

What physeal zone is affected by mucopolysaccharide disease?

Answer 13

hypertrophic zone

Question 14

Fractures most commonly occur through which physeal zone?

Answer 14

zone of provisional calcification (hypertrophic zone)

Question 15

Which zone is affected in a metaphyseal corner fracture?

Answer 15

Primary spongiosa

Question 16

Which zone is affected in renal SCFE?

Answer 16

Secondary spongiosa

Question 17

What are the indications for bar resection?

Answer 17

<50% of physis affected; >2 cm or >2 years of growth remaining

Question 18

Physeal fracture separations most commonly happen through which zone of the physics?

Answer 18

Hypertrophic zone; specifically zone of provisional calcification

Question 19

What is the sequence of closure of the distal tibial physis?

Answer 19

central, posterior, medial then anterolateral

Question 20

What is the weakest part of the growth plate?

Answer 20

Hypertrophic zone

Question 21

In children, a diagnosis of osteomyelitis with concomitant deep venous thrombosis (DVT) has a high association with which causative organism?

Answer 21

MRSA; other risk factors children >8, CRP >6, need for surgical intervention

Question 22

In Erb’s palsy, what changes at the shoulder can be expected?

Answer 22

internal rotation contracture, glenoid retroversion, posterior shoulder subluxation and humeral head flattening

Question 23

What is the normal/average acetabular index?

Answer 23

27.5 deg

Question 24

An acetabular index above what degrees is indicative of hip dysplasia?

Answer 24

> 35 deg

Question 25

What levels are most commonly affected in a pediatric brachial plexus palsy?

Answer 25

C5-6 levels (Erb-Duchenne palsy)

Question 26

What muscles are most commonly affected in an Erb-Duchenne palsy?

Answer 26

Deltoid and biceps (C5), wrist and finger extensors (C6)

Question 27

What is a normal α angle on pediatric hip US?

Answer 27

> 60 deg

Question 28

Absent clavicles is found in what genetic disorder?

Answer 28

Cleidocranial dysplasia

Question 29

In DDH, what degree of abduction increases the risk for AVN?

Answer 29

> 60 deg of hip abduction increases the rate of AVN; if >60 deg is needed for hip reduction, open reduction should be performed

Question 30

What is the innervation of the rhomboids?

Answer 30

dorsal scapular nerve