Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ortho-Rheum > Ortho Pediatrics > Flashcards

Ortho Pediatrics Flashcards

1
Q

idiopathic avascular necrosis of proximal femoral epiphysis

A

Legg-Calve-Perthes disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how is avascular necrosis different in children vs adults?

A

can heal and remodel in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are 4 risk factors for Legg-Calve-Perthes disease?

A

+ family history
low birth weight
abnormal birth presentation
secondhand smoke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the pathophys of LCP disease?

A

osteonecrosis d/t lack of blood supply to femoral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the presentation of LCP disease? (2)

A

change in gait
painless limp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

a patient presents with loss of abduction and internal rotation of hip, and a limp (antalgic gait/trendelenburg gait). Dx?

A

Legg-Calve-Perthes disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a late sign of Legg-Calve-Perthes disease?

A

limb length discrepancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is an xray taken for Legg-Calve Perthes disease? what will be seen? (3)

A

frog leg

joint space widening
irregular femoral head ossification
crescent sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dx?

A

Legg-Calve Perthes disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what should be considered when determining treatment of Legg-Calve Perthes disease?

A

age + bone age
degree of necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what patients should be treated for Legg-Calve Perthes disease non-operatively? (2)

A

patient < 8 yrs
bone age < 6 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the non-op treatment for Legg-Calve Perthes disease? (2)

A

activity restriction
physical therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the operative treatment for Legg-Calve Perthes disease?

A

osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the most common complication of Legg-Calve Perthes disease?

A

premature physical arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what 2 situations lead to a good long term prognosis of Legg-Calve Perthes disease?

A

spherical femoral head
<6 at presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

abnormal development resulting in dysplasia, subluxation, and dislocation of hip secondary to capsular laxity and mechanical instability

A

developmental dysplasia of the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the most common orthopedic disorder in newborns?

A

developmental dysplasia of the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

where is developmental dysplasia of the hip most common?

A

left hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are 4 risk factors for developmental dysplasia of the hip?

A

female
first born
frank breech
+ family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what classification is developmental dysplasia of the hip if it is subluxable?

A

barlow-suggestive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what classification is developmental dysplasia of the hip if it is dislocatable?

A

barlow-positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what classification is developmental dysplasia of the hip if it is dislocated? (2)

A

ortolani-positive when reducible
ortolani-negative when irreducible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

dislocation of hip by adduction and depression of the flexed femur

A

barlow exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

reduction of dislocated hip by elevation and abduction of flexed femur

A

ortolani exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

limb length discrepancy

A

galeazzi exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

at what age can an xray be taken if a parent is concerned for their newborn’s hip click?

A

4-6 months old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

at what age can an ultrasound be taken if a parent is concerned for their newborn’s hip click?

A

birth-4 months old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

when should newborn patients with a hip click receive an ultrasound if they are considered high risk?

A

at 6 weeks old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the 1st line non-op treatment for developmental dysplasia of the hip in a patient that is younger than 6 months with a reducible hip?

A

pavlik harness (abducting splinting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the 2nd line non-op treatment for developmental dysplasia of the hip in a patient that is 6-18 months? (2)

A

closed reduction
spica casting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the operative treatment for a patient over 18 months, with developmental dysplasia of the hip, who has failed non-op treatment? (2)

A

open reduction
spica casting

32
Q

what is the operative treatment for a patient over 2 years, with developmental dysplasia of the hip, who has failed non-op treatment? (2)

A

open reduction
osteotomy

33
Q

injury that occurs with sudden, longitudinal traction to the hand with elbow extended and forearm pronated

A

nursemaid elbow

34
Q

a patient presents with an audible click of their arm, the elbow is kept in flexion with the forearm pronated, they refuse to use it, and they have pain with supination. Dx?

A

nursemaid elbow

35
Q

what is the treatment for nursemaid elbow?

A

closed reduction with supination technique OR hyperpronation technique

36
Q

arm supinated, elbow maximally flexed with pressure over radial head

A

supination technique for nursemaid elbow

37
Q

hyperpronation of arm in flexed position

A

hyperpronation technique for nursemaid elbow

38
Q

tibial tubercle apophysitis; there is osteochondrosis or traction apophysitis of the tibial tubercle

A

osgood-schlatter disease

39
Q

a patient presents with pain on anterior knee, exacerbated with kneeling, has an enlarged and tender tibial tubercle, with pain on resisted knee extension. Dx?

A

osgood schlatter disease

40
Q

Dx?

A

Osgood schlatter disease

41
Q

what is the conservative treatment for osgood schlatter disease? (3

A

NSAIDs
RICE
quad stretching

42
Q

what is the non-op treatment for osgood schlatter disease that does not respond to conservative treatment?

A

cast immobilization

43
Q

slippage of the metaphysis relative to the epiphysis; femoral neck slides off of femoral head

A

slipped capital femoral epiphysis

44
Q

what is the most common disorder affecting adolescent hips?

A

slipped capital femoral epiphysis

45
Q

what part of the body is a slipped capital femoral epiphysis most common?

A

left hip

46
Q

an overweight male patient presents with pain that has been present for months, the affected leg is crossed over the other. On physical exam they have abnormal gait, abnormal leg alignment, externally rotated foot, and thigh weakness/atrophy. Dx?

A

slipped capital femoral epiphysis

47
Q

what xray view should we obtain for a slipped capital femoral epiphysis?

A

frog leg

48
Q

what labs should be ordered for a slipped capital femoral epiphysis if the patient is less than 10 yrs, pre-pubertal, short, or has a weight below 50th percentile? (4)

A

TSH
free T4
BUN
serum creatinine

49
Q

Dx?

A

slipped capital femoral epiphysis

50
Q

what is the treatment for a slipped capital femoral epiphysis?

A

percutaneous in situ fixation

51
Q

in which 3 situations should a contralateral hip prophylactic fixation be done if a slipped capital femoral epiphysis occurred on the other side?

A

initial slip < 10 yrs old
obese males
+ endocrine disorder

52
Q

coronal plane spinal deformity

A

scoliosis

53
Q

what side is scoliosis most common?

A

right thoracic curve

54
Q

what score on a scoliometer during Adams forward bending test indicates scoliosis?

A

7 degree curve

55
Q

a patient presents with leg length discrepancy, shoulder height differences, truncal shift, waist asymmetry with pelvic tilt, and a flat foot (cavovarus). Dx?

A

scoliosis

56
Q

what sign in scoliosis indicates neurological involvement?

A

delayed bowel/bladder control

57
Q

when should we get an xray on a patient to check for scoliosis?

A

cobb angle (>10 degrees)

58
Q

when should we get an MRI on a patient to check for scoliosis? (2)

A

children < 10 yrs w/ curve > 20 degrees
left thoracic curve

59
Q

what is the non-op treatment for scoliosis with curves < 20 degrees?

A

observation w/ serial imaging

60
Q

what is the non-op treatment for scoliosis with curves 20-50 degrees?

A

bracing x 16-23 hrs/day until skeletal growth is completed

61
Q

what is the operative treatment for scoliosis of curves > 50 degrees with significant growth remaining?

A

non-fusion procedure

62
Q

what is the operative treatment for scoliosis of curves > 50 degrees to prevent crankshaft phenomenon (curving/twisting of spine)?

A

anterior/posterior spine fusion

63
Q

pediatric fracture involving the physis (growth plate) that is most common in active children

A

salter-harris fracture

64
Q

what extremities are most commonly affected by salter-harris fractures?

A

upper extremities

65
Q

in which 2 zones does a salter-harris fracture most commonly occur?

A

zone of provisional calcification
zone of hypertrophy

66
Q

a patient presents with a history of a traumatic event, has localized joint pain, swelling, TTP, limited ROM, and inability to bear weight. Dx?

A

salter-harris fracture

67
Q

where does a type I salter-harris fracture occur?

A

Straight across growth plate

68
Q

where does a type II salter-harris fracture occur?

A

Above growth plate

69
Q

where does a type III salter-harris fracture occur?

A

Lower (below) level of growth plate

70
Q

where does a type IV salter-harris fracture occur?

A

Through Everything

71
Q

where does a type V salter-harris fracture occur?

A

Rush (extra-articular)

72
Q

what is the treatment for a type I and II salter-harris fracture? (2)

A

closed reduction
cast/splint

73
Q

what is the treatment for a type III and IV salter-harris fracture?

A

ORIF

74
Q

what is the treatment for a type V salter-harris fracture? (2)

A

emergent ortho consult

75
Q

what should all patients with a salter-harris fracture be given after treatment?

A

re-evaluation in 7-10 days

Ortho-Rheum (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions