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peds boards > Musculoskeletal/Sports injuries > Flashcards

Musculoskeletal/Sports injuries Flashcards

1
Q

-the growth plate

A

Physis

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2
Q

-the end of the long bone, adjacent to the growth plate or physis

A

metaphysis

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3
Q

-when the distal part of the deformity points inward

A

Varus

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4
Q

-when the distal part of the deformity points away from midline

A

Valgus

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5
Q 
Pain 
Paresthesias
Pallor
Paralysis
Pulselessness
A

Compartment Syndrome

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6
Q
  • blue sclerae
  • fractures during preschool years
  • autosomal dominant
  • hearing loss (both kinds)
  • bad teeth associated with Type 1B
  • type 2 is the most severe form and is usually lethal (bag of bones stillborn delivery)
  • type 3 is the progressive deforming type, born with fractures, macrocephaly and short stature
A

Osteogenesis Imperfecta

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7
Q
  • macrocephaly, frontal bossing, midface hypoplasia, and proximal shortening of the limbs
  • MC cause of sudden death is cervicomedullary junction compression
  • 80% of cases occur as a spontaneous mutation
A

Achondroplasia

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8
Q
  • infant with head tilted to one side
  • mass in the SCM
  • facial asymmetry
  • Tx: daily stretching and PT, then surgery
  • can be associated with hip dysplasia
A

Congenital Torticollis

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9
Q
  • infants with repeated attacks of head tilting which only last for minutes at a time.
  • often accompanied by vomiting, irritability, and pallor
  • require no intervention
A

Paroxysmal Torticollis

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10
Q
  • head tilt with UMN findings (increased DTRs)

- Dx: MRI

A

Posterior fossa tumor

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11
Q
  • fusion of the cervical vertebrae
  • short neck and low occipital hairline
  • scoliosis, spina bifida, renal probs, Sprengel deformity, deafness
A

Klippel-Feil Syndrome

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12
Q
  • the convex alignment of the thoracic spine in the sagittal plane
  • 20-40 degrees is normal
  • < 60 degrees: no intervention
  • > 60 degrees: PFTs
A

Kyphosis

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13
Q
  • bad posture, back pain, and kyphosis in a teenager
  • presents at puberty
  • Tx: NSAIDs, PT
A

Scheurmann disease

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14
Q
  • -results from poor fetal development and the failure of the scapula to descend to its normal position
  • affected side of neck will seem broader and shorter
  • mimics torticollis
A

Sprengel Deformity

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15
Q
  • MC on the left
  • Dx: US
  • asymmetric gluteal folds
  • Tx: Pavlik harness (not double diapering)
  • Risks: breech, FHx, female, first born
A

Developmental Dysplasia of the Hip

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16
Q

-adduction of the hip with downward pressure

A

Barlow

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17
Q

-abduction of the hip with attempt at relocating a dislocated femoral head

A

Ortolani

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18
Q
  • recent URI
  • some passive ROM of the painful joint
  • normal ESR
  • negative gram stain
  • normal or slightly elevated temperature
  • Dx of exclusion
  • Tx: reassurance
A

Toxic synovitis

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19
Q
  • MC hematogenous spread
  • high fever, joint warm to touch, little or no PROM
  • positive gram stain, elevated ESR
  • increased joint space on Xray
  • MC younger than 2yo
  • Tx: aspiration, Abx to cover S. aureus
A

Septic joint

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20
Q

-migratory arthritis coupled with a rash

A

Rheumatic fever

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21
Q

-avascular necrosis of the femoral head
-MC boys 4-8 yo
-Xray: one femoral head smaller than the other
-hip pain may be referred to the knee
(Forrest Gump)

A

Legg Calve Perthes Disease

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22
Q
  • infection of the bone
  • MC S. aureus
  • MRI is most sensitive (but not specific)
  • Bone scan is most specific
  • begins with an episode of bacteremia seeding to the metaphysis
  • can spread by local extension
  • Dx: direct aspiration of the metaphysis
  • Xray findings do not usually appear until 10-14 days after infection
  • Tx: PO meds can be used when there is a good response to IV meds and an organism is identified
A

Osteomyelitis

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23
Q
  • chronic knee pain that locks and swells
  • MC in adolescent boys
  • necrosis of the articular surface of a joint
  • Dx: MRI
  • Tx: immobilization and surgical removal of fragments
A

Osteochondritis Dessecans

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24
Q
  • results from the stress at the insertion of the patellar tendon at the anterior tibial tubercle from excessive activity
  • adolescent who presents with pain just below the knee
  • Tx: couple weeks rest with gradual resumption of activity, NSAIDs
A

Osgood-Schlatters

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25
Q
  • teenager with asymmetry of the hips or scapula

- 40 deg: surgery

A

Scoliosis

26
Q
  • infantile cortical hyperostosis
  • first 6 mo of life
  • swelling of the bone shafts (cortical bone)
  • Xrays: progressive corrtical thickening
  • periosteum is NOT involved (as opposed to NAT)
A

Caffey Disease

27
Q
  • child pulled by the arm and is now not using that arm
  • no swelling or discoloration
  • Tx: reduction
A

Nuremaids Elbow

28
Q
  • foot is internally rotated and Achilles is contracted

- Tx: stretching, serial casting, and surgical release of the tendon

A

Club feet

29
Q
  • usually just requires reassurance
  • requires intervention when it is unilateral, worsens after age 1, or does not resolve by age 2
  • Xray findings of epiphyseal distortion
  • consider Rickets or Blounts disease if persists after age 2
A

Genu Varus (bow legged)

30
Q
  • pathology of the proximal tibial physis and epiphysis
  • infantile does not require intervention
  • adolescents are usally overweight and requires bracing or surgery
A

Blount’s disease

31
Q
  • high arches

- associated with Freidrich ataxia and Hurlers

A

Pes Cavus

32
Q
  • flat feet

- special inserts or arches for symptomatic pts

A

Pes Planus

33
Q
  • fx Straight thru the physis, separation of the epiphysis and metaphysis
  • Xray may be negative with only tenderness
  • casting for 2-3 weeks
A

Salter Harris Type 1

34
Q
  • fx Above the growth plate (metaphysis)

- closed reduction casting for 3-6 wks

A

Salter Harris Type 2

35
Q
  • fx through the Lower portion (epiphysis) into the joint space
  • may require open reduction
A

Salter Harris Type 3

36
Q
  • fx Totally through the metaphysis, growth plate, and epipsysis
  • reduction in the OR to avoid growth disruption
A

Salter Harris Type 4

37
Q
  • cRush fx/compRession Fx
  • causes microvascular compromise
  • high rate of poor growth following the injury
A

Salter Harris Type 5

38
Q

-pain over the anatomic snuff box

A

Scaphoid Fx

39
Q

-posterior fat pad

A

Elbow Fx

40
Q
  • teenage male, obese, with knee pain (referred hip pain)
  • Ext and ER hip
  • Dx: Xray: ice cream scoop falling off the cone
  • may be an underlying endocrine disorder
  • Tx: immobilization, NWB, stabilization with pins and/or bone grafts
A

Slipped Capital Femoral Epiphysis

41
Q
  • one of the causes of in-toeing

- MC resolves with time by school age

A

Tibial Torsion

42
Q
  • temp >105 F
  • hot dry skin (no perspiration)
  • CNS depression (confusion and lethargy)
  • leads to end organ damage bc of release of endotoxins and cytokines
  • Tx: Ice packs to groin, neck, axilla, evaporation, cool to 101-102F
A

Heat stroke

43
Q
  • pupil irregularity
  • significantly reduced visual acuity
  • decreased EOM
  • orbital fracture
A

Reasons to refer to ophthalmology

44
Q
  • collection of blood between the cornea and the iris following trauma
  • blood in the anterior chamber with possible visual impairment without diplopia
  • Tx: refer to ophthalmology or bed rest with HOB at 30 degrees
  • eye shield
A

Hyphema

45
Q
  • fracture of the orbital wall or floor
  • blunt trauma to the eye
  • double vision when looking to one side
  • dysconjugate gaze to one side
  • pupillary reflexes intact
A

Blowout fracture

46
Q

-severe pain with no diplopia or dysconjugate gaze

A

corneal abrasion

47
Q

-pain and severe photophobia without diplopia

A

Traumatic iritis

48
Q
  • visual deficit in the peripheral field, described as curtain like
  • no dysconjugate gaze
A

Detached retina

49
Q

-when to return to play after an ankle injury

A
  • Full ROM
  • Full strength
  • No swelling
  • No pain
  • No joint instability
50
Q
  • acute knee injury with the patient describing a pop
  • significant knee effusion
  • positive drawer sign
  • Dx: MRI
A

ACL tear

51
Q
  • pulseless
  • pain
  • pallor
  • paresthesia
  • paralysis
A

Compartment syndrome

52
Q
  • confusion w/o amnesia or LOC
  • Tx: remove from game and examine immediatlely and every 5 min for development of amnesia or HA
  • if no symptoms persist, they can return to the game after at least 20 minutes of rest
A

Grade 1 Concussion

53
Q
  • confusion with amnesia, but no LOC
  • Tx: remove from game and examine frequently for development of severe symptoms, 24 hr follow up, return to practice if symptoms free for 1 week
A

Grade 2 concussion

54
Q
  • LOC

- take to ED and cannot return to play until symptom free for 2 weeks

A

Grade 3 Concussion

55
Q

-sports which require mouth guards

A 
football
soccer
basketball
hockey
wrestling
shot putting
discus throwing
56
Q

-conditions that mandate refraining from participating in sports

A

Splenomegaly
Hepatomegaly
One functioning paired organ (testes, kidneys, eyes)
Repeated concussions

57
Q
  • hirsutism and low voice

- early closure of epiphyseal plates

A

Anabolic steroid use in females

58
Q
  • severe acne
  • gynecomastia
  • high pitched voice
  • hypogonadism
A

Anabolic steroid use in males

59
Q
  • elevated LFTs
  • lower HDL
  • increased LDL
  • oligospermia and azoospermia
  • hypertension
A

Lab abnormalities with steroid use

60
Q

-weight loss guidelines

A

No more than 3 pounds/week or 1.5% of body weight per week

peds boards (23 decks)

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