peds68

Question 1

emergency parenteral rehydration

Answer 1

20mL/kg boluses of IV solutions wit a high enough oncotic load to keep it; normal saline or lactated ringers is commonly used

Question 2

if hip Is affected in septic arthritis, it is usually helfd how?

Answer 2

flexion, abduction, and external rotation

Question 3

diagnosis for septic arthritis

Answer 3

elevated WBC, elevated ESR, elecated CRP; culture of synovial fluid pos in only 60% of cases

Question 4

management of septic arthritis

Answer 4

joint aspiration to avoid avascular necrosis and to dx infx; empiric antibiotics for 4-6 weeks to cover gram pos

Question 5

complications of septic arthritis

Answer 5

avascular necrosis and cartilagenous damage

Question 6

transient synovitis

Answer 6

peak age 2-7 years; low grade fever, limp, hip pain

Question 7

most common cause of painful joint in toddlers

Answer 7

transient synovitis

Question 8

management of transient synovitis

Answer 8

NSAIDs, bedrest, and observation

Question 9

Legg-Calve-Perthes

Answer 9

idiopathic avascular necrosis of the femoral head

Question 10

typical patient for Legg-Calve- Perthes

Answer 10

active thin boys who are small for their age

Question 11

clinical features of legg-calve-perthes

Answer 11

slightly painful limp wuth increased internal rotation and abduction of hip

Question 12

diagnosis of legg-calve-perthes

Answer 12

AP and frog lef lateral radiograph of pelvis showing incr density in the affected femoral head and a crescentic subchondral fracture in femoral head (crescent sign”)

Question 13

treatment of legg-calve-perthes

Answer 13

physcial therapy and restriction of exercise; surgery if more than 50% damage to the femoral head or if there is movement of the femoral head out of the acetabulum

Question 14

prognosis of legg-calve-perthes

Answer 14

best in younger patinets; less than 9 yo resolve; older develop osteoarthritis as adults

Question 15

slipped capital femoral epiphysis (SCFE)

Answer 15

slipping of the femoral head off the femoral neck

Question 16

typical patient for slipped capital femoral epiphysis

Answer 16

obese adolescent boy

Question 17

clinical features of slipped capital femoral epiphysis

Answer 17

painful limp; bilateral in 30% and patients with hypothyroidism are esp more likely to develop bilat diseasel internal rotation, flex, and abduction are decreased in affected hip

Question 18

diagnosis of slipped capital femoral epiphyses

Answer 18

AP and forgleg lateral radigraphs of pelvis; “Klein line” doesn’t cross the epiphysis

Question 19

management of slipped capital femoral epiphysis

Answer 19

pinning the epiphysis to prevent further slippage; don’t just place back into normal position

Question 20

complications of slipped capital femoral epiphysis

Answer 20

avascular necrosis and collapse of fem head; chondrolysis; limb length discrepancy; osteoarthritis

Question 21

chondrolysis

Answer 21

degeneration of articular cartilage

Question 22

osteomyelitis

Answer 22

infection of the bone

Question 23

causes of osteomyelitis

Answer 23

staph aureus and strep pyogenes are most common; salmonell and pseudomonas also

Question 24

clinical features of osteomyelitis

Answer 24

fever, bone pain, erytehma, swelling, and induration; painful limp

Question 25

imaging in osteomyelitis

Answer 25

bone scan or MRI; plain radigraph is not good bc it will be normal early on