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Ravi Board/OITE Prep > PEDS OITE > Flashcards

PEDS OITE Flashcards

(114 cards)

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1
Q

ortho sx of CMT (PMP 22)

A

on c-some 17p12; look for areflexia, hammer toes, hip dysplasia, cavocarus - slowing of peroneal, ulnar, and median nerves

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2
Q

inhertiance for duchenne

A

x-link recessive

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3
Q

hemophilia inheritance

A

both A and B are x-linked recessive

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4
Q

nerve injury with flex vs ext SCH frx

A

flexion - ulnar; extension - AIN - typically neuropraxia- resolves by 6-12 wks

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5
Q

most important prognostif factor in peds radial neck frx

A

PRIMARY angulation - goal is < 30 deg after closed reduction

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6
Q

osteopetrosis genetics

A

proton pump mutations > chloride channel CLCN 7 gene > Carbonic anhydrase - 3 types - malignant infantile(AR); intermediate (AR); benign type 2 (AD)

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7
Q

osteopetrosis assoc with

A

coxa vara, osteomyeltiis, CN palsies; appendicular fractures

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8
Q

pre-op planning before resection tarsal coalition

A

get CT of subtalar

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9
Q

sx of beckwith wiedemann

A

exopthalmos; macroglossia; hemi hypertrophy; neonatal hypoglycemia; viseromegaly and abd wall defects

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10
Q

cancer risk of beckwith wiedemann

A

wilms tumor or hepatoblastoma - get routine US until age 7

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11
Q

conditions with hemihypertrophy of body

A

NF; proteus; Klippel-Trenaunay; beckwith wiedemann

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12
Q

prox humerus fractures neer 3 and 4

A

in older kids > 12years - consider closed reduction and pinning

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13
Q

neer peds prox hum classification

A

grade 1 < 5mm displacement; grade 2 < 33% of physis ; grade 3 is 33%-67%; 4 is most

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14
Q

tib tubercle frx extending into joint needs

A

might needs arthroscopy to rule out or fix meniscus tear

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15
Q

SED vs MED genes

A

SED is collagen type 2 defects; MED is COMP defect

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16
Q

fibrillin gene defect causes

A

marfan

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17
Q

glucocerebrosidase defect causes

A

Gauchers

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18
Q

involucurm vs sequestrum

A

sequestrum is INSIDE; involucrum envelopes

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19
Q

peds pre-ganglionic injury

A

hits long thoracic (wing scapula); rhomboids (Dorsal scapular n); cuff ( suprascapular nerve); lat dorsi (thoracodorsal n); horners (sympathetic chain) and elevated hemidiaphragm

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20
Q

tx of pre ganglioninc nerve injury in infants

A

nerve transver using med/ulnar nerve by 3 months

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21
Q

significance of 3 rib pencilling

A

means curve progression in NF scoliosis

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22
Q

tx of PAINLESS lateral condyle NON-union

A

insitu ORIF with bone graft

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23
Q

AL bowing assoc with

A

NF and congen pseudoarthrosis of tibia

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24
Q

anterior tibia bowing

A

normal at birth or assoc with fib hemimelia

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25
posteromedial tibial bowing assoc with
calcaneovalgus foot
26
LE growth rates
4mm; 9mm; 6mm; 5mm prox femur to distal tibia
27
pelvic osteotomy for INcongruent hips after maturity
chiari;
28
what condition presents as fixed rocker bottom
Congen vertical talus - needs surg to reduce talonavicular and talocalc joints
29
how to distinguish CVT from others
put foot in plantar flexion; if talonavicular line up with 1st ray it is NOT CVT
30
anteromedial bowing seen with
osteogenesis imperfecta
31
muscle imbalance in CMT
Peroneus longus over powers the Tib Ant
32
tx of LCP group B
if < 8 no treatment; If > 8 femoral or pelvic osteotomy - no role for core decompression
33
congenital LLD and long term length
LLD will increase slowly until maturity
34
type 1 Hypersensitivity
IgE mediated; mast cells; anaphylaxis
35
type 4 HSN
cell mediated via T-helper cells; uses macrophage or Eosinophils
36
physeal bridge with angular deformity
if < 50% and angle > 10-20 degrees do both osteotomy and bridge excision
37
genetics of diastrophic dyspasia
auto recessive DTDST gene
38
order of distal tibia physis closure
central, anteromedial, posteromedial, lateral
39
tillaux vs triplane
tillaux is salter 3 and in older kids; triplane is salter 4 in younger kids
40
myleomeningocele levels
L3 or ABOVE - confined to wheel chair; high risk of hip dislocation but might be house hold ambulator; L4 - has quad function and can ambulate; L5 has GOOD prognosis;
41
tarsal coalition assoc with what injury
recurrent ankle sprains
42
external tibial torsion normals
normal is 25 deg (0-40) use transmalleolar axis and knee condyles axises
43
main complication of intercondylar eminence frx fixation
arthrofibrosis and stiffness
44
chance of recover with total brachial plexus and horners
less than 10%
45
genetics of NF 1
auto dominant on c-some 17
46
multiple vs single pin fixation in SCFE
use just one pin; multi pin has higher rate of osteonecrosi
47
mc complication for hip spica under 5 for femur frx
loss of reduction
48
best value of teloradiograph
single shot xray of both legs - best for angular deformity
49
cervical fusion for downs
ONLY if myelopathic signs or symptoms
50
best candidiate for split post tib transfer
ages 4-7; flexible cavovarus and SPASTIC hemiplegia
51
galactocerebrosidase deficiecny
Krabbe
52
sphingomyelinase deficiency
Niemann-pick
53
alpha galactosidase
Fabrys
54
Hexosaminidase A deficiecny
Tay-sachs
55
acute vs chornic scfe
before or after 3 weeks
56
synovectomy for severe hemophelia
to reduce recurrent hemarthrosis, does not improve ROM or eventual hemophilic arthropathy
57
where does scfe fail in growth plate
hypertrophic zone (unless renal osteodystrophy - then secondary spongiosa)
58
prognositic factor CP kids to walk
able to sit by age 2
59
chronic bisphos use for OI shows
lots of parallel lines in metaphysis
60
when to remove elastic nails from femur
6-12 months
61
tx of blounts
brace until age 3, or if failure with 12 months bracing or > 4years then prox tib osteotomies
62
Friedrichs ataxia
auto recessive repeat of GAA - areflexia; babinski; and ataxia - caused by spinocerebellar degeneration - typically starts from age 7-15 progressive; fatal by 50
63
peds fem neck frx classification
delbet 1-4 - transphyseal, transcervical, cervicotrochanteric and intertrochanteric
64
tx of peds fem neck
type 1-3 if under age 3 gets smooth wires; 4-10 gets 4.5-6.5 screws ; 6.5-7.3 screw if >10; all type 4 gets DHS
65
when does posteromedial bowing resolve
age 5-7
66
effect of SCFE on limb
limb shortening; decreased hip flexion and internal rotation
67
tx of periosteal sleeve avulsion in patella
tension band fixation - do not excise the fragment - big cartilage piece
68
duchenne inhertiance
x linked recessive
69
CMT inheritance
auto dominant
70
worst spot for SCFE pin
anterosuperior
71
rugger jersey spine seen with
osteopetrosis (Auto recessive)
72
basilar invagiation sx
myelopathic symptoms
73
basilar invagiation seen with
osteogenesis; Klippel-Feil syndrome, occipitocervical synostosis, achondroplasia, osteogenesis imperfecta, Morquio syndrome, and spondyloepiphyseal dysplasia.
74
what other work up does JIA need
optho eval with slit lamp for anterior uveitis - can lead to blindness
75
child abuse rank on mortalit cause
2nd most commona cause
76
excess abduction in pavlik causes
AVN fem head
77
cast index
sagittal over AP; should be less than .7
78
clubfoot peroneals
weak - tib ant over powers and causes the dynamic supination gait
79
patella sleeve fracture fixation
ORIF - with suture fixation
80
peak age of onset of JIA
2-4 years
81
NF genetics
autodominant; NF 1
82
tx of SMA 2 subluxing hips
Observation - unlikely to walk; they ALL get scoliosis;
83
tx of hallux valgus in CP
fusion
84
which injury is a/w highes risk of peds Mand M
spine fracture
85
when to fuse scoliosis for Duchenne
when curve of TL spine is at 20-30 deg
86
posteromedial tibial bowing assoc with
LLD
87
TC coalition leads to what foot type
pes planus
88
axis deviation in femoral lenghtening
if using frame - no change in mech axis; if using growing nail - lateral axis deviation occurs
89
femoral head blood supply by age
2-4 years its LFCX and ligamentum; 4+ its MFCX
90
tx of peds curly toe
if symptomatic do flexor tenotomy after age 3; before then just do obs
91
tx of AL bowing in NF-1
if pseudoarthrosis - surgery; if no fracture - total contact clamshell orthosis
92
contractures of knee tx
if 20 or less - obs; 20-40 hamstrings release and post-op stretches;
93
arthrogyropsis natural course
NOT progressive
94
morquio syndrome features
accumulation of Keratin sulfate by age 2 ; waddling gait; genu valgum; thoracic kyphosis; cloudy cornea; NORMAL IQ; C1-2 instability
95
Klippel Feli features
low hairline; webbed neck; limited c-spine motion due to fused segments
96
risk factors of AVN in peds fem neck
fracture displacement, age of over 10
97
dural ectasia is a/w
marfan, ehlers danlos, NF 1 and Anky spondy
98
poterior leaf spring orthosis used for
absent heel strike and excess plantar flexion/limited DF in swing
99
what orthosis for crouch gait
floor reation AFO; or KAFO for those who are minimally ambulatory
100
triple arthrodeiss contraindicated in what age
10-12 for coalition bc fusion would limit foot growth
101
what is the ostetomy to treat a healed scfe
flexion; int rot; and valgus - imhauser - goal is to fix the retroversion;
102
measuring q agle
ASIS to center of knee vs mechanical axis
103
how does botox work
blocks presynapse release of AcH
104
pyridostigmine fxn
increased Ach levels by BLOCK Ach-esterase
105
when to fuse to pelvis in DMD
if curve over 40 or greater than 10 deg of pelvic obliquity
106
hemi vs diplegia
hemi is one side and arm is MORE affected than leg; di is both and legs rae more affected
107
lysosomal vs lipid storage disorders
Hunters, Hurler are muccoPS; and Gauchers is LIPID
108
genetics of CMT
Auto dominant; but can be recessive or x-linked
109
what other bony issues assoc with CMT
acetb dyspasia
110
when does acetab teardrop show up on kids
18 months
111
tear drop in dysplasia hips
v-shaped, wider top part usually means worse outcome bc thicker tab floor
112
ortolani test
already out
113
distal femur frx in peds
non displaced - cast; SH 1/2 CRPP; 3/4 - OR PP
114
hindfoot parallelism indicates
club foot

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