Pediatric Part 2

Question 1

What are the 3 left to right shunts?

Answer 1

ASD
VSD
PDA

Question 2

What will be heard when an ASD is present?

Answer 2

Fixed split S2

Question 3

What will be heard when a VSD is present?

Answer 3

Harsh holosystolic murmur at left sternal border

Question 4

The smaller a VSD, the ____ the sound of the murmur

Answer 4

Louder

Question 5

With VSDs, what are the treatment options?

Answer 5

Observe
Surgery if symptomatic

Question 6

What is heard with a PDA?

Answer 6

Continuous machine-like/multiphase murmur

Question 7

How do you close the PDA?

Answer 7

Indomethacin

Question 8

How do you keep the PDA open?

Answer 8

Prostaglandins

Question 9

What does the PDA connect?

Answer 9

Aorta and Pulmonary artery

Question 10

Right to Left shunts will present with?

Answer 10

Cyanosis

Question 11

Transposition of great vessels often occurs in mothers with what condition diagnosed before pregnancy?

Answer 11

Diabetes

Question 12

What are the 4 components of Tetralogy of Fallot?

Answer 12

VSD
Overriding Aorta
Pulmonic Stenosis
RV hypertrophy

Question 13

What will be seen on CXR with Tetralogy of Fallot?

Answer 13

Boot shaped heart

Question 14

With certain Right to Left shunts, what should remain open to ensure survival?

Answer 14

PDA – give prostaglandins

Question 15

Why can Developmental Dysplasia of the Hip be present anatomically?

Answer 15

Acetabulum is not deep enough yet

Question 16

If a newborn has clunky hips (barlow-ortolani) what is the treatment?

Answer 16

Harness

Question 17

What is Legg-Calve-Perthes Disease and in who?

Answer 17

AVN of the femoral head
= Boys < 10 years old

Question 18

Symptom of Legg-Calve- Perthes Disease?

Answer 18

PainLESS limp

Question 19

Treatment for Perthe’s Disease?

Answer 19

Non-weight bearing
– Body will remodel the dead bone with time

Question 20

What is SCFE and in who?

Answer 20

Femoral head slips through the growth plate from the femoral neck
= OBESE boys > 10 years old

Question 21

Symptom of SCFE?

Answer 21

Painful limp

Question 22

What specific X-ray should be done for SCFE?

Answer 22

Frog-leg X-ray

Question 23

Treatment for SCFE?

Answer 23

Surgery

Question 24

How will Septic Arthritis present?

Answer 24

Acute, painful joint where a child refuses to put weight on it + FEVER

Question 25

How will Transient Tenosynovitis present?

Answer 25

Acute, painful joint where a child refuses to put weight on it following a viral illness

Question 26

What lab changes are present with Septic Arthritis only?

Answer 26

HIGH WBC, ESR, CRP

Question 27

What will the Arthrocentesis show with Septic Arthritis?

Answer 27

Cell count > 50K

Question 28

Treatment for Septic Arthritis?

Answer 28

Drainage and ABx

Question 29

Treatment for Transient Tenosynovitis?

Answer 29

NSAIDs/time because it will heal on its own

Question 30

Are there systemic signs with Transient Tenosynovitis?

Answer 30

NO

Question 31

Another name for Osgood-Schlatter's Disease?

Answer 31

Tibial Tuberosity Apophysitis

Question 32

Describe how Osgood-Schlatter's Disease occurs?

Answer 32

Tendons attach to the tibial tubercle which is attached to the apophysis that connects to the tibia -- Overuse causes the apophysis to become inflamed

Question 33

What is unique about the Apophysis compared to other growth plates?

Answer 33

It does NOT fuse until after age 18! -- The rest are much earlier than that

Question 34

Treatment for Osgood-Schlatter's Disease?

Answer 34

Rest or play through the pain

Question 35

When will the pain most often occur with Osgood-Schlatter's?

Answer 35

AFTER overuse of leg muscles

Question 36

Ewing's Sarcoma is a neuroendocrine tumor with what translocation?

Answer 36

11;22

Question 37

How will Ewing's Sarcoma present?

Answer 37

Local pain, swelling + fever, weight loss, cytopenias

Question 38

What will be seen on X-ray with Ewing's Sarcoma?

Answer 38

Onion skinning

Question 39

What 2 conditions can lead to Osteosarcoma?

Answer 39

RB gene mutation Pagets disease of bone

Question 40

How will an Osteosarcoma present?

Answer 40

Local pain and swelling ONLY

Question 41

What 2 things can be seen on X-ray with an Osteosarcoma?

Answer 41

1. Sunburst lytic lesion 2. Codman's triangle

Question 42

What is unique about the pain with an Osteoid Osteoma?

Answer 42

Relieved by NSAIDs or aspirin

Question 43

What will be seen on X-ray with an Osteoid Osteoma?

Answer 43

Central lucency + cortical thickening

Question 44

Treatment for Osteoid Osteoma?

Answer 44

NSAIDs/Aspirin and time

Question 45

What 3 diagnostics are needed for Ewing's and Osteosarcoma?

Answer 45

X-ray MRI Core needle biopsy