Childhood Injuries

Question 1

Anatomy of pediatric population that contributes to incidence of head trauma

Answer 1

large heads, thin skulls, poor muscle control

Question 2

Type of head trauma more common than intracranial hematomas in kids

Answer 2

diffuse edema

Question 3

When is neuroimaging recommended in children?

Answer 3

LOC >1 min, evidence of skull fx, focal neuro findings

Question 4

Sx that characterize the Cushing Response which indicated elevated ICP

Answer 4

HTN, bradycardia, apnea

Question 5

Which way should an infant face in a motor vehicle?

Answer 5

backwards

Question 6

At what age or weight can a child be in a forward facing carseat?

Answer 6

Children 1-4 and weighing 20-40 pounds

Question 7

Until what age or weight should a child be in a booster seat in MT?

Answer 7

age of 6 or greater than 60 pounds

Question 8

Why should an infant not have a walker?

Answer 8

high risk of falls

Question 9

Greatest period of risk for choking or swallowing foreign bodies

Answer 9

1st year of life

Question 10

What age group should be given liquid (or chewable) medications?

Answer 10

children < 3yrs

Question 11

Top three sports/activities with the highest rate of injury in children

Answer 11

Gymnastics, trampoline, baseball

Question 12

Most common sports injuries in children

Answer 12

sprains, strains, contusions

Question 13

Differences between pediatric bone and adult bone

Answer 13

Pediatric bone has a higher water content and lower mineral content (ie less brittle, thick periosteum, rich blood supply)

Question 14

cartilaginous structure that is weaker than bone predisposed to injury

Answer 14

the physis (growth plate)

Question 15

Osteochondrosis of the heel

age 8-12

Answer 15

Sever’s Disease

Question 16

Apophysitis of the tibial tubericle (age 11-15)

Answer 16

Osgood-Schlatters

Question 17

Apophysitis of the inferior pole of the patella (age 10-15)

Answer 17

Sinding-Larsen Johansson

Question 18

Apophysitis of the medial epicondyle of the elbow (age 10-15)

Answer 18

Little League Elbow

Question 19

Mechanism of injury is plant and twist of knee. Usually non-contact. Higher incidence in girls. Knee effusion common

Answer 19

ACL injuries

Question 20

injury in which the FDP tendon is completely ruptured cannot flex the affected digit at the DIP joint.

Answer 20

Jersey finger

Question 21

extensor tendon injury, is an injury of the extensor digitorum tendon at the (DIP)

Answer 21

mallet finger

Question 22

Overuse injury secondary to throwing mechanics. Tender directly over the medial aspect of elbow. Will often elicit a history of child pitching “too many” innings or “too many” pitches per week

Answer 22

Little league elbow

Question 23

Most common type of ankle sprain

Answer 23

lateral

Question 24

stress fracture or defect of the pars interarticularis in a vertebra. due to repetitive increase in shear forces in the lumbar spine

Answer 24

spondylolysis

Question 25

movements of extension and rotation leading to slipping of all or part of one vertebra forward on another. occurs as a result of repetitive hyperextension which causes a shear stress at the pars interarticularis

Answer 25

spondylolisthesis

Question 26

Amount of acetamnophen that suggests toxic exposure

Answer 26

greater than 140mg/kg ingested in single dose or greater than 7.5g is ingested within a 24 hour period

Question 27

When should you draw a serum acetaminophen level?

Answer 27

draw 4 hours following ingestion in ANYONE suspected of overdose

Question 28

Treatment of acetaminophen overdose

Answer 28

N-acetylcysteine (Mucomyst)

Question 29

Why should you avoid Ipecac with acetaminophen overdose?

Answer 29

will delay the administration of N-acetylcysteine

Question 30

Poisoning presentation that includes: tinnitus, vomiting, hyperpnea, fever, lethargy

Answer 30

aspirin

Question 31

Treatment for aspirin overdose

Answer 31

activated charcoal, alkalinization w/IV bicarb. Possibly dialysis

Question 32

Poisoning presentation that includes: vomiting, abdominal pain, GI bleed, diarrhea

Answer 32

Iron

Question 33

Tx for iron poisoning

Answer 33

Deferoxamine IV (chelating agent)

Question 34

Poisoning that is insidious and may include vague sx: weakness, irritability, weight loss, ataxia, behavoral disorders, anemia

Answer 34

lead poisoning

Question 35

Tx of lead poisoning

Answer 35

interrupt ingestion. Chelation therapy with Succimer (in symptomatic children)

Question 36

Sx that suggest increased ICP

Answer 36

vomiting, HA, changes in mental status