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Pediatrics Module > Peds Rheum/Ortho > Flashcards

Peds Rheum/Ortho Flashcards

1
Q

4 criteria of Juvenile idiopathic arthritis (JIA)

A

1) onset 6mon - 16yo
2) arthritis 1+ joints (edema, warmth, inflam, tender, limited ROM) x 6 wks
3) sx’s present 6 months
4) Can’t be explained by vasculitis, neoplasm, infection, CT disorder

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2
Q

Most common JIA

A

Oligo JIA

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3
Q

What should be monitored in children with JIA?

A

eyes; slit lamp exam q 6 months for increased risk of iritis and uveitis

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4
Q

Difference between oligo and polyarticular JIA

A

oligo 1-4 joints and poly 5+

RF always neg in oligo but can be pos or neg in poly

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5
Q

5 yo with asymmetric arthritis for 6 months plus plaques on extensor surfaces and nail pitting

A

psoriatic JIA

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6
Q

young child with limp and found to have swollen knee joint which is warm and tender. Positive ANA

A

Oligo JIA

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7
Q

Rheumatic condition in children with +HLA B-27

A

enthesitis JIA

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8
Q

How are JIAs treated?

A

1st line: NSAIDs
Methotrexate
Steroids (intra-articular or systemic)
DMARDs (rheumatic sx’s)

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9
Q

+ skin PE of psoriasis rash

A

Auspitz sign = bleeding when scale removed

Koebner phenomena = increased rxtn at site of trauma

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10
Q

Juvenile arthritis + salmon colored rash associated with fever spikes

A

systemic onset JIA

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11
Q

Diagnostic criteria of fevers for systemic onset JIA

A
  • fever spikes once per day for at least 2 weeks
  • fevers accompanied by salmon colored rash which fades as fever goes away
  • no signs of infection
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12
Q

JIA that doesn’t fit any category criteria called ______.

A

undifferentiated

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13
Q

Systemic Lupus Erythematosis (SLE) diagnostic criteria

A

4/11 criteria; mneumonic “SOAP Brain MD”

Serositis
Oral Ulcers (painless)
Arthritis/Arthralgia
Photosensitivity

Blood (Hematologic) Disorder
Renal Abnormality
ANA
Immunologic Disorder (Serologies)
Neurologic Disorders
Malar Rash ("butterfly")
Discoid Rash ("coin")
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14
Q

How is SLE ruled out?

A

(-) ANA

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15
Q

SLE treatment

A

Symptomatic: sunscreen, avoid cold, NSAIDs, anti-HTN, aspirin (for thrombosis)

Disease-specific: steroids, Belimumab, hydroxychloroquine

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16
Q

How is neonatal lupus acquired?

A

maternal antibodies (anti-Ro and anti-La) to neonate

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17
Q

Common manifestations of NLE

A

rash, cytopenias, hepatomegaly

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18
Q

Earliest sign of heart block in due to NLE? How is this treated?

A

fetal tachycardia

give steroids antenatal ASAP; pacemaker in infancy

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19
Q

Drugs that induce lupus

A

seizure meds (phenytoin, carbamazepine)
psych meds
isoniazid
minocycline

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20
Q

Dx of drug-induced lupus

A

+ anti-histone antibodies

+ ANCA

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21
Q

Diagnostic criteria of Kawasaki

A

1) high fever (+101) x +5 days
2) 4 of following: bilat non-exudative conjunctivitis, mucous membrane involvement (beefy red throat, strawberry tongue, cracked lips), non-vesicular rash, extremity change, cervical lymphadenopathy

22
Q

Exception to using aspirin in children

A

Kawaskai Disease

23
Q

Kawasaki disease tx

A

ADMIT
Cardiac Echo ASAP
IVIG and high dose aspirin

24
Q

Major complication of Kawasaki disease

A

coronary artery aneurysm; need ECHO done

25
Q

Newborn 2-4 wks old who favors head to one side and has restricted ROM of one sternocleidomastoid.

A

congenital muscular Torticollis

26
Q

Tests to dx Developmental Hip Dysplasia

A

+ Barlow = hips add and push down
+ Ortolani = hips up and out
Galeazzi sign = knees uneven; lower knee with DHD

27
Q

Possible Hip Dysplasia can be U/S at _____ age and XR at ______ age.

A

4-6 wks

2 months

28
Q

Developmental Hip Dysplasia treatment

A

Pavlik harness if < 6 mon
Reduce/traction if > 6 mon
Surgery + 2 yo

29
Q

Athletic 6 yo boy with insidious onset painless limp. XR shows sclerotic femoral head and widened metaphysis. Likely dx? Tx?

A

Legg-Calve Perthes Disease

tx: self-resolves; traction; progress to arthritis 50-60 yo

30
Q

XR shows “ice cream falling off cone.” What is dx? What is typical patient epidemiology?

A

dx: SCFE (slipped capital femoral epiphysis)

typically heavyset 12 yo boy with knee/groin pain

31
Q

SCFE treatment

A

surgical screws

32
Q

Describe transient synovitis of hip cause and presentation

A
  • caused by viral infection

- hip with mild effusion and no erythema or warmth

33
Q

What should be r/o in transient synovitis of hip?

A

septic hip (red, hot)

34
Q

TX of Transient synovitis of hip

A

NSAIDs

resolves in 48-72 hrs

35
Q

DX and TX of septic arthritis

A

dx: high ESR, fever, sudden onset, ill-appearing
tx: emergency I&D and IV abx

36
Q

How to treat Nursemaid’s Elbow?

A

reduction: supination-flexion technique to move radial head back in place

37
Q

How is scoliosis treatment decided?

A

Risser index (maturation of pelvis; 0-5): 0-3 brace

Cobbs angle: < 20 observe, > 20 refer

38
Q

bow legged is called ______ and knock-kneed is called ______. Which is more common?

A 
genu varum (common at birth)
genu valgum
39
Q

When do genu varum and genu valgum tyypically resolve?

A

genu varum - 3 yo
genu valgum - 7 yo

  • if not refer
40
Q

In toeing treatment

A

brace foot/ankle
no W sitting
self-corrects

41
Q

Toe walking normal if how old?

A

< 3 yo

42
Q

Neuromuscular conditions with scoliosis

A

cerebral palsy, muscular dystrophy

43
Q

Signs of what disorders may include a clubfoot?

A

spina bifida, DDH

44
Q

Salter Harris Fractures

A 
Type I: Straight across
Type II: Above
Type III: Lower
Type IV: Two or Through
Type V: cERush
45
Q

compression fracture at distal radius

A

Buckle fx (Torus)

46
Q

Toddler’s fracture

A

spiral fracture of tibia; common 9 months to 3 yrs old when learning to walk

47
Q

Jone’s fracture vs Dancer’s fracture

A

Jones: stress fx at base of 5th metatarsal

Dancer: avulsion fx where ligament pulls off part of 5th metatarsal base

48
Q

Management of clavicle fracture

A

I: sling and pain control

Refer if II, III, open fracture, or tenting of skin

49
Q

Boxer fracture

A

fracture of 5th metacarpal from punching wall

50
Q

Buckle fracture treatment

A

splint

cast not recommended

Pediatrics Module (15 decks)

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