Year 4 Orthopaedics

Question 1

analgesia ladder in children

Answer 1

1. paracetamol or ibuprofen

2. morphine

Question 2

why is aspirin CI in <16?

Answer 2

risk of Reye syndrome (except in Kawasaki disease)

Question 3

age of those who get osteosarcoma

Answer 3

10-20

Question 4

where does osteosarcoma usually present?

Answer 4

femur

Question 5

presentation of osteosarcoma

Answer 5

bone pain

worse at night

Question 6

diagnosis of osteosarcoma

Answer 6

XR (within 48 hours) shows sunburst appearance, destruction of normal bone with poorly defined lesion
ALP

Question 7

management of osteosarcoma

Answer 7

surgical resection often with limb amputation and adjuvant chemo

Question 8

risk factors for DDH

Answer 8

first degree relative
breech from >36 weeks
multiple pregnancy

Question 9

diagnosis of DDH

Answer 9

Barlow’s and Ortolani (clunking)

USS

Question 10

management of DDH

Answer 10

<6 months = Pavlik harness
surgery >6 months or if harness fails
after surgery use hip spica cast to immobilise the hip

Question 11

what is achondroplasia?

Answer 11

short stature/ dwarfism

Question 12

what genetic mutation causes achondroplasia?

Answer 12

fibroblast growth factor receptor 3 (FGFR3) on chromosome 4