Rosh cards Flashcards
Absent cremasters reflex is typically ass/w?
Testicular torsion
Testicular torsion is?
Twisting of the spermatic cord leading to lack of blood flow.
What population does Testicular torsion usually occur?
Late childhood to early adolescence
Testicular torsion presents as?
Sudden onset of testicular pain/swelling that is progressively worse.
Testicle will lay horizontally
Pain may radiate into abdomen
+- N/V
Testicular torsion Dx confirmation study?
Doppler U/S
TXT of Testicular torsion is?
Manual detorsion immediately.
W/in 6h Emergent surgery (orchiopexy bilaterally)
Hydrocele is general characteristics?
Oblong non-TTP mass
Pyuria/relief with scrotal elevation is ass/w
Epididymitis
Legg-calve-perthes disease is?
Idiopathic avascular necrosis of proximal femoral epiphysis.
Population of Legg-calve-perthes disease?
4-10yo M>F
Legg-calve-perthes disease presents as?
Unilateral (20% bilateral) hip pain Pain refers to anteromedial thigh/knee gradually Worse w/ activity - Better w/ rest Limp or leg discrepancy may develop LROM of Hip (esp. internal rotation)
Legg-calve-perthes disease is Dx how?
Hip XR (+- may be normal early in Dz process)
Legg-calve-perthes disease XR may show?
Smaller femoral head than unaffected side
Widened joint space = subchondral lucent zone (crescent sign)
Radiodensity - new bone formation at epiphysis
Legg-calve-perthes disease Mgmt?
Non-wgt bearing
Ortho referral
Keep femoral head w/in acetabulum (Splinting/surgery)
Osgood-Schlatter syndrome presents as?
TTP at tibial tiberosity - insertion of patellar tendon
Slipped capital femoral epiphysis is?
Posterior/inferior slippage of femoral epiphysis on metaphysis.
Population of Slipped capital femoral epiphysis
Boys during adolescent growth spurts. (Esp. if >BMI)
MC bacterial cause of septic arthritis?
Staphylococcus aureus
MC cause of acute hip pain in 3-10yo?
Transient synovitis (any age however)
Toxic (transient) synovitis is?
Reactive arthritis that affects the hip.
Transient synovitis is ass/w what other process?
URI (1-2w prior)
S/S of Transient synovitis?
Pain in groin, anterior thigh, knee, or hip
Painful limping gait
+- low fever
+- joint effusion (boggy)
If a joint effusion is present w/ Transient synovitis what may be seen during the interview?
Hip held at -
- flexed
- abducted
- laterally rotated
Dx of Transient synovitis is made?
Clinically
Lab/Rad to r/o
Rads of Transient synovitis will show?
XR - Nothing
U/S - Joint effusion +-
TXT of Transient synovitis is
NSAIDs
Supportive - limit activites
Wgt bearing as tolerated
Difference between Transient synovitis and Septic arthritis?
Septic arthritis pts will have more systemic illness w/ fever.
Before Dx of Transient synovitis you must R/O?
Septic arthritis.
What helps w/ iron absorption?
Calcium (orange juice)
Bronchiolitis is?
Lower respiratory tract infection
- inflamed bronchioles
Bronchiolitis MC pathogens?
RSV (MC)
- Rhino, parainflu, flu
Pop of Bronchiolitis?
MC in <2yo Peds
Clinical presentation of Bronchiolitis?
URI prodrome 1-3d prior
Fever, Cough
Respiratory distress (Tachy-P / retractions)
Wheezing/crackles
Complications of Bronchiolitis?
Dehydration
Apnea (premmie or <2mo)
Aspiration pneumonia
Respiratory failure
TXT of non-severe Bronchiolitis?
Nasal suctioning/hydration (conservative)
- current guidance
TXT of severe Bronchiolitis?
Heated/high flow nasal cannula
CPAP
ET Intubation
+- inhaled B-dil
