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S7- Differential Diagnosis > Week 14- Screening in Special Popuulations > Flashcards

Week 14- Screening in Special Popuulations Flashcards

1
Q

PART 1: PEDIATRIC/ADOLESCENT PATIENTS

A

PART 1: PEDIATRIC/ADOLESCENT PATIENTS

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2
Q

What are some things to keep in minds in regards to pediatric/adolescent populations? (3)

A
  • Ask patient and caregiver preference for the presence of caregiver during examination.
  • Remember to talk to the patient and not around them.
  • Keep modesty in mind.
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3
Q

Pediatric/Adolescent Pathologies. (7)

A
  • Meningitis
  • Neoplastic Disorders
  • Osteochondritis (Legg-Calve-Perthes, Freiberg’s Panner’s, -Keinbock’s)
  • Disorders of Epiphyseal Growth (Slipped Capital Femoral Epiphysis, Adolescent Idiopathic Scoliosis)
  • Myositis Ossificans
  • Female Athlete Triad
  • Heat Illness
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4
Q

Meningitis:

  • What is it?
  • Most cases are caused by ______ infection.
  • 20% of cases occur in individuals ___-___ years of age.
A
  • Inflammation of membranes (meninges) surrounding brain or spinal cord.
  • viral infection
  • 14-24 years
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5
Q

What are the (3) hallmark symptoms of Meningitis?

A
  • Fever
  • HA
  • Stiff/painful neck
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6
Q

Meningitis Risk Factors:
-Skipping __________
-

A
  • skipping vaccinations
  • <5 years old
  • <20 years old
  • immune system
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7
Q

Neoplastic Disorder:

  • Bone tumors are usually ______ tumors that usually do not cause constant severe pain associated with malignant tumors.
  • Can manifest as pathological _______.
A
  • benign

- pathological fracture

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8
Q

Bone Tumors S/Sx. (5)

A
  • Soft tissue swelling
  • Tenderness
  • Joint pain
  • Presence of mass without history of trauma
  • Night pain, pain unrelated to position, fever, weight loss, night sweats, fatigue
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9
Q

Osteochondrosis:

  • ______ _______ of the ________.
  • ___________ disorders seen in the immature skeleton.
  • Most common in _____ years of growth (__-__ yo).
  • Does it affect boys or girls more?
  • Does it affect lower or upper limbs more?
  • Present bilaterally ___-___% of the time.
A
  • Avascular necrosis of the epiphysis
  • idiopathic
  • middle years (3-10)
  • boys > girls
  • lower limbs > upper limbs
  • 10-15%
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10
Q

What are the (4) types of Osteochondritis?

A
  • Legg-Calve-Perthes Disease (LCP disease)
  • Freiberg’s Disease
  • Panner’s Disease
  • Keinbock’s Disease
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11
Q

Legg-Calve-Perthes Disease:

  • Most ______/________ of LE osteochondritis diseases.
  • Involves pressure epiphysis of proximal _____.
  • Is it more common in boys or girls?
  • What ethnicity is more at risk?
  • Most often occurs between __-__ years old.
  • Bilateral __-__% of time.
  • What is the cause?
A
  • common/serious
  • proximal femur
  • boys > girls (5:1)
  • caucasian > AA (10:1)
  • 4-8 years old
  • 10-15%
  • unknown cause
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12
Q

Legg-Calve-Perthes Disease S/Sx. (3)

A
  • Limping
  • Pain/stiffness in hip, groin, thigh or knee
  • Limited ROM of hip joint
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13
Q

Freiberg’s Disease:

  • Osteochondritis of pressure epiphysis of ___________.
  • Results in ________ pain with _____.
  • Is it more common in males or females?
  • May occur secondary to what?
  • How is it treated?
A
  • metatarsal heads
  • forefoot pain with WBing
  • females > males
  • long 2nd metatarsal or short 1st metatarsal
  • shoe modifications to redistribute weight
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14
Q

Panner’s Disease:

  • Osteochondritis of capitellum of the _______.
  • MUST BE RULED OUT in pts 3-11 years old presenting with what S/Sx?
  • How is it treated?
  • What is the prognosis?
A
  • capitellum of humerus
  • 3-11 yo with S/Sx including PAIN, SWELLING, and LIMITED ROM in elbow joint
  • Treated with immobilization in sling.
  • Prognosis good giver non-WBing nature of elbow joint.
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15
Q

Keinbock’s Disease:

  • Osteochondritis of _______.
  • What age group is this most common in?
  • Healing is _____ in adults compared to children/adolescents.
  • How is it treated?
A
  • lunate
  • late adolescence to young adulthood
  • slower
  • Treated by excision of lunate before degenerative changes develop in surrounding carpals.
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16
Q

Keinbock’s Disease S/Sx. (3)

A
  • Aching in wrist
  • Tenderness over lunate
  • Swelling secondary to repetitive microtrauma
17
Q

Correctly identify the following pathologies:

  1. )Most common/serious LE osteochondritis involving pressure epiphysis of proximal femur.
  2. ) Osteochondritis of capitellum of the humeris.
  3. ) Osteochondritis of the lunate.
  4. ) Osteochondritis of pressure epiphysis of metatarsal heads.
A
  1. ) Legg-Calve-Perthes Disease
  2. ) Panner’s Disease
  3. ) Keinbock’s Disease
  4. ) Freiberg’s Disease
18
Q

What are the (2) main disorders of epiphyseal growth?

A
  • Slipped Capital Femoral Epiphysis (SCFE)

- Adolescent Idiopathic Scoliosis

19
Q

Slipped Capital Femoral Epiphysis:

  • Most common hip disorder seen in ___________.
  • _____ (__-__ yo) 2-5x more likely than _______ (__-__ yo).
  • What are (3) risk factors for SCFE?
A
  • adolescents
  • Males (13-16 yo) 2-5x more likely than Females (11-14 yo)
  • obesity, AA, endocrine abnormalities
20
Q

SCFE S/Sx. (4)

A
  • Limping that increases with fatigue
  • Pain in distal thigh/knee
  • May have mild hip pain
  • Prefer hip flexion, ER, and abduction
21
Q

Adolescent Idiopathic Scoliosis:

  • Develops during pediatric years and typical onset is _______.
  • Most common form of scoliosis.
  • ______ curvature of the spine.
  • Is it more common in males or females?
  • What test is used as a screening tool?
  • Surgical correction necessary for progressive curves >__-__ degrees
A
  • puberty
  • lateral curvature
  • females
  • Adam’s forward bending test
  • > 45-50 degrees
22
Q

Myositis Ossificans:

  • What is it?
  • Results as a complication of severe or poorly managed ________.
  • Common sites include which muscles?
  • Watch for __________ at the site of injury SEVERAL DAYS POST INJURY.
A
  • Formation of heterotrophic bone within the muscle.
  • contusion
  • quadriceps and biceps brachii
  • palpable mass
23
Q

What are some warning signs of myositis ossificans? (4)

A
  • Marked decrease in ROM
  • Significant pain
  • Joint effusion
  • Decreased function
24
Q

Female Athlete Triad:

  • Refers to the relationship between what (3) things?
  • What (3) things does this result in?
A
  • energy availability, menstrual function, and BMD

- energy deficiencies, functional hypothalamic amenorrhea, and osteoporosis

25
Q

What are some cues to screen for Female Athlete Triad? (3)

A
  • Low body weight
  • Current or past stress fractures
  • Participation in sport that favors lean body size or that have weight classes
26
Q

Heat Illness:

  • Do children acclimate to heat as well as adults? When does ability to dissipate heat improve?
  • What are (2) things that can be done to prevent heat illness?
A
  • No, improves in adolescences

- Limit time platin in hot and humid conditions, ensure adequate fluid intake

27
Q

Heat stroke is defined as a temp >____.

A

105 degrees

28
Q

1

A

1

29
Q

1

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30
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1

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31
Q

PART 2: OBSTETRIC PATIENTS

A

PART 2: OBSTETRIC PATIENTS

32
Q

What are some things we should avoid when examining and treating obstetric patients? (7)

A
  • Avoid flat prone lying in mid-late pregnancy.
  • Avoid supine position for longer than a few minutes after 4th month of pregnancy (monitor for NAUSEA, BRADYCARDIA, and SYNCOPE)
  • Avoid activities that strain the pelvic floor/abdominal muscles.
  • Avoid positions that involve rapid uncontrolled bouncing or swinging.
  • Avoid overaggressive stretching of hip adductors.
  • Avoid overheating.
  • Avoid deep heat modalities or electrical stimulation over the trunk.
33
Q

What is Supine Hypotension Syndrome?

A

Caused when the gravid uterus compresses the inferior vena cava when a pregnant woman is in a supine position, leading to decreased venous return centrally.

34
Q

With Supine Hypotension Syndrome, what (3) things do we need to monitor for?

A
  • Nausea
  • Bradycardia
  • Syncope
35
Q

What is the suggested positioning for Supine Hypotension Syndrome?

A

Rotate 30 degrees to left supported with pillows under R side to shift uterus to L and relieve caval occlusion.

S7- Differential Diagnosis (15 decks)

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