paeds ortho

Question 1

what are growth plates made from

Answer 1

Hyaline cartilage

Question 2

Why kids more prone to greenstick fractures?

Answer 2

Cancellous bone (less string)- one side break other stays intact

Question 3

compression of long bone fracture is

Answer 3

Buckle/torus

Question 4

SALTR mnemonic is…

Answer 4

1. straight across
2. above
   3 beLow
   4Through
   5 cRush

Question 5

pain ladder for kids

Answer 5

1. Paracetamol or brufen
2. Morphine
   No codeine tramadol aspirin (unless kawasaki)

Question 6

Joint pain in kids ages
0-4
5-10
10-16

Answer 6

0-4
Septic arthritis
Developmental dysplasia of the hip (DDH)
Transient sinovitis

5-10
Septic arthritis
Transient sinovitis
Perthes disease

10-16
Septic arthritis
Slipped upper femoral epiphysis (SUFE)
Juvenile idiopathic arthritis

Question 7

Urgent assessment for limping child criteria…

Answer 7

<3 yo
>9 with WB issue or painful hip
No WB
Neurovascular
pain/agitation severe
red flag
abuse

Question 8

most common septic arthritis bacteria?

Answer 8

Staph aureus
Other
Neisseria gonorrhoea (gonococcus) in sexually active teenagers
Group A streptococcus (Streptococcus pyogenes)
Haemophilus influenza
Escherichia coli (E. coli)

Question 9

Antibiotic length of time for SA

Answer 9

3-6 weeks

Question 10

assc with Viral URTI

Answer 10

transient synovitis

Question 11

transient synovitis is assc iwth

Answer 11

Limp
Refusal to weight bear
Groin or hip pain
Mild low grade temperature

Question 12

T/F transient synovitis is always a 1 off

Answer 12

no may recurr in 20%

Question 13

Children 3-9 yo with Transient synovitis in primary need what kind of follow up

Answer 13

safety net to a and e with fever
48 hour check up
1 week check up

Question 14

What is cause of perthes disease

Answer 14

Blood flow disruption- > avascular necrosis of bone. Affects epiphysis

Question 15

all patients with perthes require total hip replacement T/F?

Answer 15

no but 5% will due to remodelling causing

Question 16

choice of iomaging in perthes

Answer 16

XRAY
Then maybe some other

Question 17

When do kids get SUFE?

Answer 17

During growth suprt (8-15yo) may have minor trauma

Question 18

susepct SUFE when…

Answer 18

Pain dispoportionate to trauma
obese pre teen

Question 19

Where does osteomyelitis effect in kids bones

Answer 19

Metaphysis

Question 20

risk factors for osteomyelitis

Answer 20

Open bone fracture
Orthopaedic surgery
Immunocompromised
Sickle cell anaemia
HIV
Tuberculosis

Question 21

Osteomyelitis is always febrile? T/F

Answer 21

no, but may have high fever if spread to join and causing sepctic arthtris

Question 22

most common site for osteosacrcoma

Answer 22

Femur
Then tibia and humerus

Question 23

How quick xray for sus osteosarcoma

Answer 23

48 hours
unexplained bone pain or swelling
if positive get specialist assessment in 48 horus after xray

Question 24

blood test result in osetosacroma may show

Answer 24

ALP raised

Question 25

talipes equinovarus is

Answer 25

Plantar flexion and supination

Question 26

Talipes calcaneovalgus is

Answer 26

Doresiflexion and pronation

Question 27

what method is used for talipes

Answer 27

ponsetti method