Peds Shelf Texas last 1/3 Flashcards

1
Q

Most common cause kid w/ a limp?

A

Trauma

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2
Q

18month old F
Asymmetric gluteal folds
Clunk on barlow: adduct thigh, push posterior on knee to try to push hip out of socket

A

Development hip dysplasia

Tx: Pavlik harness, surgery

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3
Q

5yo painless limp initially

Now pain in knee or thigh

A

Leg-Calve’-Prethes Disease

- avascular necrosis

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4
Q
5yo cold 1 wk ago
Now limp + effusion in hip
Xrays normal
ESR 35 (elevated)
WBCs = 10k
A

Transient synovitis

- bed rest 1 wk NSAIDs

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5
Q

14yo lanky M w/ nagging knee pain

Decreased ROM of hip on exam

A

SCFE: often overweight

Tx: surgically close + pin the epiphysis to avoid osteonecrosis

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6
Q

14yo basketball/volleyball player knee pain + swelling of tibial tubercle

A

Osgood-Schlatter

- overuse from jumping

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7
Q

12yo F 2wk hx daily fevers to 102 + salmon colored evanescent rash on trunk, thighs, shoulders
Left and right knee swollen

A

Juvenile rheumatoid arthritis

Tx: NSAIDs = 1st line
2nd line = methotrexate
3rd line = steroids

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8
Q

2yo F w/ 2wk hx daily fevers to 102, desquamating rash on perineum.
Swollen hands/feet, conjunctivitis, unilateral swollen cervical LN

A

Kawasaki

Tx: IVIG + high dose Aspirin

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9
Q

Good/bad prognostic factor for JRA?

A

ANA - good

RF - bad

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10
Q

Best first test when Kawasaki is suspected?

A

2D echo + EKG

Then repeat echo after 2-3 wks of treatment

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11
Q

Most serious sequellae from Kawasaki?

A

Coronary aneurysm

MI

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12
Q

Onion skinning on Xray

A

Ewing Sarcoma
- if < 10yo more likely

Onion skinning = layers of perosteal development

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13
Q

Treat Ewing Sarcoma?

A

Rads +/- surgery

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14
Q

Sunburst or codman’s triangle on Xray

A

Osteogenic sarcoma

- if > 10yo more likely

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15
Q

Treat Osteogenic sarcoma?

A

Chemo +/- surgery

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16
Q

Bone pain can be presenting sx for?

A

Leukemia

17
Q

How approach meningocele or myelomeningocele?

A

Head CT looking for hydrocephalus

Arnold-chiari II

18
Q

Infant w/ head circumference > 95th %

A

Hydrocephalus

  • also consider bulging fontanelle
  • increased DTR’s
  • HA
  • vomiting
19
Q

This AM 1yo fever to 102.4
4 hours later has 3-4 minute tonic-clonic seizure
Dx? Tx?

A

Febrile seizure

Tx: acetaminophen

(no increased risk of epilepsy)

20
Q

Common EEG finding in kid w/ absence seizure?

Tx?

A

3hz spike and wave discharge

Tx: Ethosuxamide / valproic acid

21
Q

6mo old w/ multiple symmetric contraction episodes of neck, trunk, extremities that occur in spells

A

Infantile spasms

Tx: ACTH
Prednisone is 2nd line