Peds F&A

Question 1

Correction of equinus 1st in clubfoot causes

Answer 1

rockerbottom foot

Question 2

Physes locations with high incidence of growth arrest in kids

Answer 2

Distal radius/ulna

Distal femur

Question 3

the 3 zones of hypertrophy

Answer 3

Maturation
Degeneration
zone of provisional calcification

Question 4

Obstetric Brachial Plexopathy

- flexion contracture treatment

Answer 4

< 40 degrees -> night time splinting

> 40 degrees -> serial casting

refractory => release anterior capsule, lengthen biceps and BR

Question 5

Management of pediatric femoral head/neck fx’s

Answer 5

< 4yo -> closed reduction and spica cast for all delberts

> 4yo -> closed reduction pinning for Delberts 1,2,3

Delbert 4 and > 4 yo -> pediatric DHS

Question 6

Treatment for dorsal bunion after clubfoot correction

Answer 6

Tx TA to middle cuneiform (b’c TA is overpwering peroneus longus)

Question 7

Treatment for dynamic supination on clubfoot

Answer 7

Tx TA to lateral cuneiform or cuboid

Question 8

1 causing septic joint after Varicella infection

Answer 8

GAS

Question 9

Abx when Lymes gets really bad (heart, brain, multiple joints involved)

Answer 9

Ceftriaxone

Question 10

Joint most likely to have hemarthrosis in Hemophiliac

• % Factor that needs replaced to control bleeding
• % factor needs replaced b4 going to OR

Answer 10

Knee

40-50% factor replacement controls bleeding
100% replacement needed b4 going to OR

Question 11

Reasons kid with Klippel-Feil can’t play sports

Answer 11

fusion includes C2

Limited neck ROM

Question 12

Young kid has tibia vara BUT also has renal osteodystrophy

- what do you do with the varus

Answer 12

Treat the renal condition before addressing varus

Question 13

rate of angular correction with wrist deformity after DR fx

Answer 13

1 degree per month

Question 14

Imaging s/p hip reduction in kid

Answer 14

MRI (obviously avoid CT)

- need to see if there is any soft tissue in joint

Question 15

asymptomatic cubitus valgus after lateral condyle fx

- treatment ?

Answer 15

Nothing

only do osteotomy if they tardy ulnar n palsy

Question 16

Lateral condyle fx unique scenarios

• asymptomatic nonunion
• symptomatic nonunion

Answer 16

asymptomatic -> observe

symptomatic-> ORIF

Question 17

deformity caused by leaving in plate on femur s/p ORIF shaft

Answer 17

valgus

- thus remove it once its healed

Question 18

management of acetab in kid

Answer 18

place in traction

ORIF if doesn’t reduce < 2cm after traction

Question 19

age for pediatric BBFF that triggers need for ORIF

Answer 19

older than 13

Question 20

most common neuropraxia in monteggia fx

Answer 20

PIN

Question 21

Scoliosis that requires going anterior and posterior

Answer 21

Myelodysplasia

Dystrophic NF

Question 22

Myelodysplasia

- level which kid may be able to walk

Answer 22

L3

Question 23

Unilateral cavus foot

Answer 23

MRI

- spinal pathology like tethered cord

Question 24

When does odontoid ossification appear

when does dens physis close

Answer 24

appears -> 3 yo

dens fuses at 12 yo

Question 25

Pediatric pelvic osteotomies for DDH - open tritradiate - closed triradiate *********************************************

Answer 25

open -> Salter or triple closed -> Ganz "the triradiate is Ganz"

Question 26

indications for endocrine workup in SCFE kid

Answer 26

< 10 yo | < 50%tile for weight

Question 27

Tibial bowing in NF | - when to brace

Answer 27

DO NOT brace if they are NOT walking When walking-> brace to prevent progression

Question 28

When to treat external tibial torsion | - how?

Answer 28

when external > 40 supramal osteotomy

Question 29

% growth of DR to radius

Answer 29

75%

Question 30

asymptomatic perthes

Answer 30

This is Meyers dysplasia | - an abnormal development of the femoral head epiphysis which is a normal variant and no consequence

Question 31

Lower extremity condition assoc with weird hand abnormalities

Answer 31

Tibial Deficiency | - preaxial polydactyly

Question 32

minimal hours needed to wear brace for scoli success

Answer 32

13 hrs

Question 33

In relation to menarche, when does growth stop for females

Answer 33

2 years after menarche | Risser 4

Question 34

Peak growth velocity defined as

Answer 34

Risser 0, just before menarche

Question 35

When is it OK to return to sport after Mono

Answer 35

after being asymptomatic for 3 weeks OR 4 weeks from start of sx's some include absence of splenomegally

Question 36

Duration to immobilize muscle laceration

Answer 36

3-5 days

Question 37

Arcuate sign

Answer 37

avulsion off prox fibular head | - another sign of ACL tear

Question 38

Whats important to do postop after total elbow

Answer 38

immobilize for 4 weeks to prevent wound complications

Question 39

Max hole size alloweable for Outerbridge-Kashiwagi procedure

Answer 39

28 mm

Question 40

Where do you avoid RFA for osteoid osteoma

Answer 40

fingers and nerve nerves