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Ravi Board/OITE Prep > PEDS OITE > Flashcards

PEDS OITE Flashcards

1
Q

ortho sx of CMT (PMP 22)

A

on c-some 17p12; look for areflexia, hammer toes, hip dysplasia, cavocarus - slowing of peroneal, ulnar, and median nerves

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2
Q

inhertiance for duchenne

A

x-link recessive

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3
Q

hemophilia inheritance

A

both A and B are x-linked recessive

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4
Q

nerve injury with flex vs ext SCH frx

A

flexion - ulnar; extension - AIN - typically neuropraxia- resolves by 6-12 wks

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5
Q

most important prognostif factor in peds radial neck frx

A

PRIMARY angulation - goal is < 30 deg after closed reduction

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6
Q

osteopetrosis genetics

A

proton pump mutations > chloride channel CLCN 7 gene > Carbonic anhydrase - 3 types - malignant infantile(AR); intermediate (AR); benign type 2 (AD)

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7
Q

osteopetrosis assoc with

A

coxa vara, osteomyeltiis, CN palsies; appendicular fractures

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8
Q

pre-op planning before resection tarsal coalition

A

get CT of subtalar

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9
Q

sx of beckwith wiedemann

A

exopthalmos; macroglossia; hemi hypertrophy; neonatal hypoglycemia; viseromegaly and abd wall defects

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10
Q

cancer risk of beckwith wiedemann

A

wilms tumor or hepatoblastoma - get routine US until age 7

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11
Q

conditions with hemihypertrophy of body

A

NF; proteus; Klippel-Trenaunay; beckwith wiedemann

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12
Q

prox humerus fractures neer 3 and 4

A

in older kids > 12years - consider closed reduction and pinning

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13
Q

neer peds prox hum classification

A

grade 1 < 5mm displacement; grade 2 < 33% of physis ; grade 3 is 33%-67%; 4 is most

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14
Q

tib tubercle frx extending into joint needs

A

might needs arthroscopy to rule out or fix meniscus tear

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15
Q

SED vs MED genes

A

SED is collagen type 2 defects; MED is COMP defect

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16
Q

fibrillin gene defect causes

A

marfan

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17
Q

glucocerebrosidase defect causes

A

Gauchers

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18
Q

involucurm vs sequestrum

A

sequestrum is INSIDE; involucrum envelopes

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19
Q

peds pre-ganglionic injury

A

hits long thoracic (wing scapula); rhomboids (Dorsal scapular n); cuff ( suprascapular nerve); lat dorsi (thoracodorsal n); horners (sympathetic chain) and elevated hemidiaphragm

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20
Q

tx of pre ganglioninc nerve injury in infants

A

nerve transver using med/ulnar nerve by 3 months

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21
Q

significance of 3 rib pencilling

A

means curve progression in NF scoliosis

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22
Q

tx of PAINLESS lateral condyle NON-union

A

insitu ORIF with bone graft

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23
Q

AL bowing assoc with

A

NF and congen pseudoarthrosis of tibia

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24
Q

anterior tibia bowing

A

normal at birth or assoc with fib hemimelia

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25
Q

posteromedial tibial bowing assoc with

A

calcaneovalgus foot

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26
Q

LE growth rates

A

4mm; 9mm; 6mm; 5mm prox femur to distal tibia

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27
Q

pelvic osteotomy for INcongruent hips after maturity

A

chiari;

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28
Q

what condition presents as fixed rocker bottom

A

Congen vertical talus - needs surg to reduce talonavicular and talocalc joints

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29
Q

how to distinguish CVT from others

A

put foot in plantar flexion; if talonavicular line up with 1st ray it is NOT CVT

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30
Q

anteromedial bowing seen with

A

osteogenesis imperfecta

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31
Q

muscle imbalance in CMT

A

Peroneus longus over powers the Tib Ant

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32
Q

tx of LCP group B

A

if < 8 no treatment; If > 8 femoral or pelvic osteotomy - no role for core decompression

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33
Q

congenital LLD and long term length

A

LLD will increase slowly until maturity

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34
Q

type 1 Hypersensitivity

A

IgE mediated; mast cells; anaphylaxis

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35
Q

type 4 HSN

A

cell mediated via T-helper cells; uses macrophage or Eosinophils

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36
Q

physeal bridge with angular deformity

A

if < 50% and angle > 10-20 degrees do both osteotomy and bridge excision

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37
Q

genetics of diastrophic dyspasia

A

auto recessive DTDST gene

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38
Q

order of distal tibia physis closure

A

central, anteromedial, posteromedial, lateral

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39
Q

tillaux vs triplane

A

tillaux is salter 3 and in older kids; triplane is salter 4 in younger kids

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40
Q

myleomeningocele levels

A

L3 or ABOVE - confined to wheel chair; high risk of hip dislocation but might be house hold ambulator; L4 - has quad function and can ambulate; L5 has GOOD prognosis;

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41
Q

tarsal coalition assoc with what injury

A

recurrent ankle sprains

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42
Q

external tibial torsion normals

A

normal is 25 deg (0-40) use transmalleolar axis and knee condyles axises

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43
Q

main complication of intercondylar eminence frx fixation

A

arthrofibrosis and stiffness

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44
Q

chance of recover with total brachial plexus and horners

A

less than 10%

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45
Q

genetics of NF 1

A

auto dominant on c-some 17

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46
Q

multiple vs single pin fixation in SCFE

A

use just one pin; multi pin has higher rate of osteonecrosi

47
Q

mc complication for hip spica under 5 for femur frx

A

loss of reduction

48
Q

best value of teloradiograph

A

single shot xray of both legs - best for angular deformity

49
Q

cervical fusion for downs

A

ONLY if myelopathic signs or symptoms

50
Q

best candidiate for split post tib transfer

A

ages 4-7; flexible cavovarus and SPASTIC hemiplegia

51
Q

galactocerebrosidase deficiecny

A

Krabbe

52
Q

sphingomyelinase deficiency

A

Niemann-pick

53
Q

alpha galactosidase

A

Fabrys

54
Q

Hexosaminidase A deficiecny

A

Tay-sachs

55
Q

acute vs chornic scfe

A

before or after 3 weeks

56
Q

synovectomy for severe hemophelia

A

to reduce recurrent hemarthrosis, does not improve ROM or eventual hemophilic arthropathy

57
Q

where does scfe fail in growth plate

A

hypertrophic zone (unless renal osteodystrophy - then secondary spongiosa)

58
Q

prognositic factor CP kids to walk

A

able to sit by age 2

59
Q

chronic bisphos use for OI shows

A

lots of parallel lines in metaphysis

60
Q

when to remove elastic nails from femur

A

6-12 months

61
Q

tx of blounts

A

brace until age 3, or if failure with 12 months bracing or > 4years then prox tib osteotomies

62
Q

Friedrichs ataxia

A

auto recessive repeat of GAA - areflexia; babinski; and ataxia - caused by spinocerebellar degeneration - typically starts from age 7-15 progressive; fatal by 50

63
Q

peds fem neck frx classification

A

delbet 1-4 - transphyseal, transcervical, cervicotrochanteric and intertrochanteric

64
Q

tx of peds fem neck

A

type 1-3 if under age 3 gets smooth wires; 4-10 gets 4.5-6.5 screws ; 6.5-7.3 screw if >10; all type 4 gets DHS

65
Q

when does posteromedial bowing resolve

A

age 5-7

66
Q

effect of SCFE on limb

A

limb shortening; decreased hip flexion and internal rotation

67
Q

tx of periosteal sleeve avulsion in patella

A

tension band fixation - do not excise the fragment - big cartilage piece

68
Q

duchenne inhertiance

A

x linked recessive

69
Q

CMT inheritance

A

auto dominant

70
Q

worst spot for SCFE pin

A

anterosuperior

71
Q

rugger jersey spine seen with

A

osteopetrosis (Auto recessive)

72
Q

basilar invagiation sx

A

myelopathic symptoms

73
Q

basilar invagiation seen with

A

osteogenesis; Klippel-Feil syndrome, occipitocervical synostosis, achondroplasia, osteogenesis imperfecta, Morquio syndrome, and spondyloepiphyseal dysplasia.

74
Q

what other work up does JIA need

A

optho eval with slit lamp for anterior uveitis - can lead to blindness

75
Q

child abuse rank on mortalit cause

A

2nd most commona cause

76
Q

excess abduction in pavlik causes

A

AVN fem head

77
Q

cast index

A

sagittal over AP; should be less than .7

78
Q

clubfoot peroneals

A

weak - tib ant over powers and causes the dynamic supination gait

79
Q

patella sleeve fracture fixation

A

ORIF - with suture fixation

80
Q

peak age of onset of JIA

A

2-4 years

81
Q

NF genetics

A

autodominant; NF 1

82
Q

tx of SMA 2 subluxing hips

A

Observation - unlikely to walk; they ALL get scoliosis;

83
Q

tx of hallux valgus in CP

A

fusion

84
Q

which injury is a/w highes risk of peds Mand M

A

spine fracture

85
Q

when to fuse scoliosis for Duchenne

A

when curve of TL spine is at 20-30 deg

86
Q

posteromedial tibial bowing assoc with

A

LLD

87
Q

TC coalition leads to what foot type

A

pes planus

88
Q

axis deviation in femoral lenghtening

A

if using frame - no change in mech axis; if using growing nail - lateral axis deviation occurs

89
Q

femoral head blood supply by age

A

2-4 years its LFCX and ligamentum; 4+ its MFCX

90
Q

tx of peds curly toe

A

if symptomatic do flexor tenotomy after age 3; before then just do obs

91
Q

tx of AL bowing in NF-1

A

if pseudoarthrosis - surgery; if no fracture - total contact clamshell orthosis

92
Q

contractures of knee tx

A

if 20 or less - obs; 20-40 hamstrings release and post-op stretches;

93
Q

arthrogyropsis natural course

A

NOT progressive

94
Q

morquio syndrome features

A

accumulation of Keratin sulfate by age 2 ; waddling gait; genu valgum; thoracic kyphosis; cloudy cornea; NORMAL IQ; C1-2 instability

95
Q

Klippel Feli features

A

low hairline; webbed neck; limited c-spine motion due to fused segments

96
Q

risk factors of AVN in peds fem neck

A

fracture displacement, age of over 10

97
Q

dural ectasia is a/w

A

marfan, ehlers danlos, NF 1 and Anky spondy

98
Q

poterior leaf spring orthosis used for

A

absent heel strike and excess plantar flexion/limited DF in swing

99
Q

what orthosis for crouch gait

A

floor reation AFO; or KAFO for those who are minimally ambulatory

100
Q

triple arthrodeiss contraindicated in what age

A

10-12 for coalition bc fusion would limit foot growth

101
Q

what is the ostetomy to treat a healed scfe

A

flexion; int rot; and valgus - imhauser - goal is to fix the retroversion;

102
Q

measuring q agle

A

ASIS to center of knee vs mechanical axis

103
Q

how does botox work

A

blocks presynapse release of AcH

104
Q

pyridostigmine fxn

A

increased Ach levels by BLOCK Ach-esterase

105
Q

when to fuse to pelvis in DMD

A

if curve over 40 or greater than 10 deg of pelvic obliquity

106
Q

hemi vs diplegia

A

hemi is one side and arm is MORE affected than leg; di is both and legs rae more affected

107
Q

lysosomal vs lipid storage disorders

A

Hunters, Hurler are muccoPS; and Gauchers is LIPID

108
Q

genetics of CMT

A

Auto dominant; but can be recessive or x-linked

109
Q

what other bony issues assoc with CMT

A

acetb dyspasia

110
Q

when does acetab teardrop show up on kids

A

18 months

111
Q

tear drop in dysplasia hips

A

v-shaped, wider top part usually means worse outcome bc thicker tab floor

112
Q

ortolani test

A

already out

113
Q

distal femur frx in peds

A

non displaced - cast; SH 1/2 CRPP; 3/4 - OR PP

114
Q

hindfoot parallelism indicates

A

club foot

Ravi Board/OITE Prep (9 decks)

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