Rosh cards

Question 1

Absent cremasters reflex is typically ass/w?

Answer 1

Testicular torsion

Question 2

Testicular torsion is?

Answer 2

Twisting of the spermatic cord leading to lack of blood flow.

Question 3

What population does Testicular torsion usually occur?

Answer 3

Late childhood to early adolescence

Question 4

Testicular torsion presents as?

Answer 4

Sudden onset of testicular pain/swelling that is progressively worse.
Testicle will lay horizontally
Pain may radiate into abdomen
+- N/V

Question 5

Testicular torsion Dx confirmation study?

Answer 5

Doppler U/S

Question 6

TXT of Testicular torsion is?

Answer 6

Manual detorsion immediately.

W/in 6h Emergent surgery (orchiopexy bilaterally)

Question 7

Hydrocele is general characteristics?

Answer 7

Oblong non-TTP mass

Question 8

Pyuria/relief with scrotal elevation is ass/w

Answer 8

Epididymitis

Question 9

Legg-calve-perthes disease is?

Answer 9

Idiopathic avascular necrosis of proximal femoral epiphysis.

Question 10

Population of Legg-calve-perthes disease?

Answer 10

4-10yo M>F

Question 11

Legg-calve-perthes disease presents as?

Answer 11

Unilateral (20% bilateral) hip pain
Pain refers to anteromedial thigh/knee gradually
Worse w/ activity - Better w/ rest
Limp or leg discrepancy may develop
LROM of Hip (esp. internal rotation)

Question 12

Legg-calve-perthes disease is Dx how?

Answer 12

Hip XR (+- may be normal early in Dz process)

Question 13

Legg-calve-perthes disease XR may show?

Answer 13

Smaller femoral head than unaffected side
Widened joint space = subchondral lucent zone (crescent sign)
Radiodensity - new bone formation at epiphysis

Question 14

Legg-calve-perthes disease Mgmt?

Answer 14

Non-wgt bearing
Ortho referral
Keep femoral head w/in acetabulum (Splinting/surgery)

Question 15

Osgood-Schlatter syndrome presents as?

Answer 15

TTP at tibial tiberosity - insertion of patellar tendon

Question 16

Slipped capital femoral epiphysis is?

Answer 16

Posterior/inferior slippage of femoral epiphysis on metaphysis.

Question 17

Population of Slipped capital femoral epiphysis

Answer 17

Boys during adolescent growth spurts. (Esp. if >BMI)

Question 18

MC bacterial cause of septic arthritis?

Answer 18

Staphylococcus aureus

Question 19

MC cause of acute hip pain in 3-10yo?

Answer 19

Transient synovitis (any age however)

Question 20

Toxic (transient) synovitis is?

Answer 20

Reactive arthritis that affects the hip.

Question 21

Transient synovitis is ass/w what other process?

Answer 21

URI (1-2w prior)

Question 22

S/S of Transient synovitis?

Answer 22

Pain in groin, anterior thigh, knee, or hip
Painful limping gait
+- low fever
+- joint effusion (boggy)

Question 23

If a joint effusion is present w/ Transient synovitis what may be seen during the interview?

Answer 23

Hip held at -

• flexed
• abducted
• laterally rotated

Question 24

Dx of Transient synovitis is made?

Answer 24

Clinically

Lab/Rad to r/o

Question 25

Rads of Transient synovitis will show?

Answer 25

XR - Nothing | U/S - Joint effusion +-

Question 26

TXT of Transient synovitis is

Answer 26

NSAIDs Supportive - limit activites Wgt bearing as tolerated

Question 27

Difference between Transient synovitis and Septic arthritis?

Answer 27

Septic arthritis pts will have more systemic illness w/ fever.

Question 28

Before Dx of Transient synovitis you must R/O?

Answer 28

Septic arthritis.

Question 29

What helps w/ iron absorption?

Answer 29

Calcium (orange juice)

Question 30

Bronchiolitis is?

Answer 30

Lower respiratory tract infection | - inflamed bronchioles

Question 31

Bronchiolitis MC pathogens?

Answer 31

RSV (MC) | - Rhino, parainflu, flu

Question 32

Pop of Bronchiolitis?

Answer 32

MC in <2yo Peds

Question 33

Clinical presentation of Bronchiolitis?

Answer 33

URI prodrome 1-3d prior Fever, Cough Respiratory distress (Tachy-P / retractions) Wheezing/crackles

Question 34

Complications of Bronchiolitis?

Answer 34

Dehydration Apnea (premmie or <2mo) Aspiration pneumonia Respiratory failure

Question 35

TXT of non-severe Bronchiolitis?

Answer 35

Nasal suctioning/hydration (conservative) | - current guidance

Question 36

TXT of severe Bronchiolitis?

Answer 36

Heated/high flow nasal cannula CPAP ET Intubation +- inhaled B-dil