MSK part 1

Question 1

Clavicular fractures are common in childhood. What 2 things can they cause?

Answer 1

Brachial plexus palsy
Subclavian A. inury

Question 2

Where on the clavicle do fractures usually occur and why?

Answer 2

Middle 1/3 and the proximal end is superiorly displaced because of the SCM

Question 3

What is a Greenstick fracture?

Answer 3

Incomplete fracture involving only 1 side of the cortex of the bone

Question 4

Incomplete fracture that only involves 1 side of the bone

Answer 4

Greenstick fracture

Question 5

What is a Nursemaid’s elbow?

Answer 5

Radial head subluxation out of the Annular L.

Question 6

What are the signs of a Nursemaid’s elbow?

Answer 6

Pain, pronation and not moving the arm

Question 7

How do you reduce a Nursemaid’s elbow?

Answer 7

Hyper-Pronation
Supination with flexion

Question 8

What is a Torus fracture? Where is it common?

Answer 8

Buckling and compression of the cortex
– Common at the distal radius/ulna with a fall

Question 9

Where does a Supracondylar Humerus fracture occur?

Answer 9

Just above the elbow

Question 10

What should you beware of with a Supracondylar Humerus fracture?

Answer 10

Brachial A. entrapment
–> Check the radial pulse

Question 11

What is Osgood-Schlatter disease?

Answer 11

Overuse apophysitis at the tibial tubercle

Question 12

What is Apophysitis?

Answer 12

Inflammation where the tendon/muscle attach to the bone

Question 13

Where does Osgood-Schlatter disease present and what is a symptom?

Answer 13

Tibial tubercle = pain with quadriceps use

Question 14

What are the treatment options with Osgood-Schlatter?

Answer 14

Decreased activity or a neoprene brace

Question 15

Where do Salter-Harris fractures occur?

Answer 15

At the growth plate

Question 16

When will Duchenne Muscular Dystrophy onset?

Answer 16

3-5 years old

Question 17

How is Duchenne Muscular Dystrophy and Becker Muscular Dystrophy inherited?

Answer 17

X-linked recessive

Question 18

What causes Duchenne Muscular Dystrophy?

Answer 18

Absent Dystrophin protein

Question 19

What causes Becker Muscular Dystrophy?

Answer 19

Abnormal Dystrophin protein
– normal levels present

Question 20

Are distal or proximal muscles more affected with Duchenne Muscular Dystrophy?

Answer 20

Proximal muscles

Question 21

What are some signs of Duchenne Muscular Dystrophy?

Answer 21

Clumsiness, difficulty walking, ataxic gait

Question 22

IQ level for Duchenne and Becker Muscular Dystrophy

Answer 22

Duchenne - LOW
Becker - Normal

Question 23

What maneuver may kids do with Duchenne Muscular Dystrophy?

Answer 23

Gower Maneuver
= Pushing hands off skins, knees, thighs to stand up

Question 24

What may be present in the calf muscle with Duchenne Muscular Dystrophy?

Answer 24

Pseudohypertrophy

Question 25

What lab change will be present with Duchenne Muscular Dystrophy?

Answer 25

HIGH CK

Question 26

What will the EMG show with Duchenne Muscular Dystrohpy?

Answer 26

Polyphasic potentials and recruitment

Question 27

What is the cause of death for those with Duchenne and Becker Muscular Dystrophy?

Answer 27

High output cardiac failure because of cardiac fibrosis

Question 28

When will Becker Muscular Dystrophy onset?

Answer 28

Older kids > 5 years

Question 29

How is Myotonic Muscular Dystrophy inherited?

Answer 29

Autosomal Dominant

Question 30

What is impaired with Myotonic Muscular Dystrophy?

Answer 30

Impaired muscle relaxation

Question 31

What genetic mutation is present with Myotonic Muscular Dystrophy?

Answer 31

CTG repeats in the DMPK gene

Question 32

What are some presenting signs of Myotonic Muscular Dystrophy?

Answer 32

Infantile hypotonia ** prolonged handshake, dysphagia, cardiac conduction anomalies

Question 33

What are 2 congenital conditions that cause the foot to be turned inward?

Answer 33

Metatarsus Adductus Clubfoot (Talipes Equinovarus)

Question 34

Difference between Metatarsus Adductus and Clubfoot?

Answer 34

Clubfoot is NOT flexible and needs surgery and casting (as opposed to observing with the other)

Question 35

Spondylolysis Spondylolisthesis

Answer 35

Spondylolysis = fracture of pars interarticularis Spondylolisthesis = forward displacement of L5 on S1

Question 36

In an infant that ingests honey or soil, what can occur?

Answer 36

Botulism

Question 37

What does Clostridium Botulinum toxin do?

Answer 37

Prevents Ach release

Question 38

What is the presentation of Botulism?

Answer 38

Symmetric and descending paralysis

Question 39

Treatment for Botulism?

Answer 39

Botulism Immunoglobulin

Question 40

What gene is mutated with Spinal Muscular Atrophy?

Answer 40

SMN1

Question 41

What is degenerating with Spinal Muscular Atrophy?

Answer 41

Anterior horn degernation

Question 42

What are the signs of Spinal Muscular Atrophy?

Answer 42

Tongue fasciculations and progressive weakness

Question 43

Tongue fasciculations are present with?

Answer 43

Spinal Muscular Atrophy

Question 44

Is there a cure for Spinal Muscular Atrophy?

Answer 44

No