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Peds > peds67 > Flashcards

peds67 Flashcards

1
Q

management of osteomyelitis

A

antibiotics for 6 weeks; when ESR goes down, can start oral abx; surgery to drain abscess if fever and swelling for >48 hours

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2
Q

complications of osteomyelitis

A

spread of infection; chronic osteomyelitis; pathologic fracture; angular deformity or limb length discrepancy

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3
Q

in-toeing

A

most is normal and corrects with growth

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4
Q

causes of in-toeing

A

metatarus adductus (medial curvature of the midfoot); talipes equinovarus (clubfoot); internal tibial torsion; femoral anteversion

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5
Q

metatarsus adductus

A

medial curvature of the mid-foot

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6
Q

metatarsus adductus- what age and cause?

A

kids less than 1; caused by intrauterine constraint

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7
Q

clinical features of metatarsus adductus

A

C-shaped foot that can be straightened by manipulation; ankle can’t dorsiflex

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8
Q

management of metatarsus adductus

A

observation, exercises, if foot is stiff and cannot be straightned, refer to ortho for possible cast

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9
Q

talipes equinovarus

A

clubfoot; fixed foot in inversion with no flexibility; bilateral in 50% of cases

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10
Q

etiology of clubfoot

A

fam hx; associated with DDH, myelomeningocele, myotonic dystrophy, and some skeletal dysplasias;

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11
Q

treatment of clubfoot

A

casting within the first week of life; surgical correction may be necessary if does not improve

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12
Q

internal tibial torsion

A

medial rotation of the tibia, causing the foot to point inward

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13
Q

most common cause of intoeing in kids less than 2

A

internal tibial torsion

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14
Q

cause of internal tibial torsion

A

uterine positioning

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15
Q

clinical features of internal tibial torsion

A

foot points medially; bilateral most commonly; present at birth but noticed when kid starts to stand

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16
Q

management of internal tibial torsion

A

observation only; usually improves by 3 yo and resolution by 5 yo

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17
Q

femoral anteversion

A

inward angulation of the femur

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18
Q

most common cause of in-toeing in kids over 2 years

A

femoral anteversion

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19
Q

clinical features of femoral anteversion

A

feet and patella point medially; hips are able to internally rotate more than normal; kid prefers to sit in W position

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20
Q

management of internal tibial torsion

A

observation only; usually resolves by 8 yo

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21
Q

out-toeing major cause

A

calcaneovalgus foot (flexible foot held in lateral position)

22
Q

out-toeing cause

A

uterine constraint

23
Q

clnical features of out-toeing

A

flexible foot with toes pointed outward; plantar flexion is restricted and foot is excessively dorsiflexed

24
Q

management of out-toeing

A

stretching the foot; rarely, casting may be needed

25
Q

bowed legs

A

aka genu varum; symm bowing of the legs in kids less than 2

26
Q

clinical featuers of bowed legs

A

“cowboy stance”; normal gait;

27
Q

when to order a radiograph for bowlegged

A

only if bowing is unilateral, is severe, or perists after 2 years of age to assess for pathologic bowing (rickets, growth plate injury)

28
Q

management of bowing

A

observation; bracing not necessary; resolved by 2 yo

29
Q

blount’s disease

A

aka tibia vara; progressive angulation a the proximal tibia

30
Q

classic kid for blount’s disease

A

obese african american boys who are early walkers; thought to be result of overload injury to the medial tibial growth plate

31
Q

clinical features of blount’s disease

A

angulation just below the knee; lateral thrust with gait (shifting weight away from midline when walking)

32
Q

when should blount’s disease be suspected?

A

any kid with progressive bowing, unilateral bowing, or persistent bowing after 2 yo; dx with AP radiograph

33
Q

metaphyseal-diaphyseal angle of greater than 11 deg in lower extremity

A

Blount’s disease

34
Q

management of blount’s disease

A

bracing for 1 year; surgical osteotomy of no improvement w bracing

35
Q

prognosis for blount’s disease

A

osteoarthritis common if angulation not corrected; recurrance of angulation common in obese kids or if treatment started after 4 yo

36
Q

knock-knees

A

aka genu valgum; idiopathic angulation of the knees toward the midline

37
Q

cause of knock-knees

A

usually overcorrection of normal genu varum

38
Q

clinical features of knock knees

A

separation of ankles when standing erect; lateral swinging of legs when walking

39
Q

management of knock knees

A

observation; surgery only if it persists after 10 yo or causes knee pain

40
Q

prognosis for knock knes

A

spontaneously resolves in majority of patients; osteoarthritis may occur if persists beyond adolescence

41
Q

osgood-schlatter disease

A

inflamm or microfracture of tibial tuberosity caused by overuse injury

42
Q

age of onset for osgood-schlatter

A

10-17 yo; happens in kids who play sports like basketball or soccer w repetitive jumping

43
Q

clinical features of osgood shlatter

A

swelling of tibial tuberosity and knee pain with point tenderness over the tibial tubercle; pain worsens with running/jumping

44
Q

management of osgood-shlatter

A

rest, stretchign of quads and hamstrings, and analgesics

45
Q

patellofemoral syndrome

A

slight malalignment of the patella that causes knee pain; common in adolescent girls

46
Q

clinical features of patellofemoral syndrome

A

knee pain directly under or around the patella; pain worse with activity and relieved w rest; phys exam shows patella in lateral position

47
Q

diagnosis of patellar femoral sydnrom

A

hx and pe; a “sunrise view” radiograph of the knee may show he patella in a lateral position

48
Q

management of patellofemoral syndrome

A

rest, stretching and strengthening of the medial quadriceps

49
Q

growing pains

A

idiopathic bilateral leg pains that occur in the late afternoon or evening but do not interfere w play during the day

50
Q

growing pains in what age group

A

very common; occur in 4-12 year olds

Peds (99 decks)

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