stuff I should have read sooner

Question 1

5 types of abuse

Answer 1

physical, neglect, mental, threat of harm, sexual/exploitation

Question 2

AVN & ages

Answer 2

3-5 LCP
6 Kohlers
8-9 Severs
9-11 Panners (capitellum)
11-13 Osgood-Schlat
12-14 Freibergs
13-16 Scheurmanns

Question 3

Discitis

Answer 3

3-5 = inflammation
teens = infection
MC @ T10-L5
\+ limp, + Lx, - hip
not bacterial = rest & brace 2-4wks

Question 4

septic hip arthritis

Answer 4

MC 0-2
holds hip in antalgic position (flex & ABd)
–X-ray unreliable takes 3 days to show up.
–**joint aspiration

Question 5

13-16

Answer 5

pubertal growth spurt

Question 6

17-19

Answer 6

pubertal development completed

Question 7

children 6-9 & sports

Answer 7

MAY start team sports

• -balance is more automatic
• -small attention
• -canish do relevant Vs non stimuli

Question 8

children 10-12 & sport

Answer 8

reaching puberty = (-) effect on balance.

• -team sports!!
• -respond well to competitive training & sports.
• SIZE not age

Question 9

infants 0-2 & sport

Answer 9

unstructured play.

Question 10

nocturnal enuresis

bed wetting

Answer 10

–symptom NOT disease
–no concern until ~6yrs
PRIMARY = never been dry = delayed neuronal maturation
SECONDARY = relapses after 3-4m dry = UTI, renal disease, motor disease, emotional, food allergy…

Question 11

Management for bed wettign

Answer 11

• -counsel * reassure
• -condition w. urine sensitive pad/bell system
• -elimination diet
• -CMT
• -meds: imipramine (anti-depressant)

Question 12

Asthma

Answer 12

MC chronic disease of kids

–nutrients = vit B6, Mg, Omega-3, Boswellia

Question 13

accidental ingestion =

Answer 13

1 pediatric concern in 1-4yrs

Question 14

cystic fibrosis =

Answer 14

–faulty transport of Na/Cl from epithelial cells of lungs & pancreas = thick mucous
~ live to 25

Question 15

triad of symptoms of cystic fibrosis =

Answer 15

1) chronic pulmonary disease (cough, recurrent res infection, failure to thrive)
2) malabsorption 2degree to pancreatic insufficiency: stools freq & bulky
3) elevated sweat electrolytes

Question 16

eval & tx for cystic fibrosis =

Answer 16

• -sweat test = for dx
• -postureal drainage/chest percuss to mobilize thick mucous
• -antibiotics for infections
• -vaporizers to thin mucous
• -enriched diets & pancreatic enzymes
• -oxygen therapy
• -lung transplant

Question 17

cough

Answer 17

cough in infants are unusual & probably needs referral

Question 18

viral croup

Answer 18

• -viral infection = obstruct upper airway (<4yoa)
• -most causes resolve some lead to fail respiratory
• -gradual onset 3-4days, fever, cough, hoarseness, sore throat, respiratory distress
• *croupy cough = short, sharp, barking, worse at night**

Question 19

treatment of viral croup

Answer 19

r/o bacterial croup,

• -avoid sugar & dairy
• -increase fluids
• -steam inhalation kinds >6m
• -Vit A, C, E, bioflavinoids, Zn
• -CMT
• -lymph drainage

Question 20

rheumatic fever

Answer 20

5-15
immune mediate reaction to group A beta hemolytic strep infection
–cardiac damage 40-50%
–polyarthritis (MC)
–chorea, erythema marginatum, sub-q nodules on extensor tendons of extremities

Question 21

common cold (viral URTI)

Answer 21

• -viral infection of mucous membranes of nose/throat

- -kids 6m-5yrs may have 6-12 colds/year

Question 22

complications/sequellae of a common cold =

Answer 22

• -otitis media
• -sinusitis
• -bronchitis & pneumonia (green sputum or blood, rales, rhonchi & remits)

Question 23

meningitis

Answer 23

–vomiting or diarrhea
–infant = >100F OR kids >103
–meningeal irritation
–HA, fatigue, crying
–bulging anterior fontanelle
–purplish blue skin lesions
SEARCH SIGNS

Question 24

Fever

Answer 24

> 99.6 in child who is acting ill

–look for SEARCH signs.

Question 25

fever management

Answer 25

>102 = tylenol or ibuprofen if uncomfortable & monitor temp 1-4h >103 = same, wait 30 mins & sponge bath for 10mins & recheck temp.

Question 26

red flags for referral with fever

Answer 26

- - >104 - - >102F for >24h - -any fever over 3 days - -infant <3-6m & >1--F + SEARCH signs - -stiff neck or skin lesions - -child is irritable, drowsy, lethargic, acts/looks sick

Question 27

febrile seizures/convulsions =

Answer 27

rising body temp = tonic-clonic contractions for 2-3min | --rare after 5

Question 28

febrile seizures/convulsions management =

Answer 28

time seizure >5mins = emergency | --lumbar puncture IF: signs of meningeal irritation, signs of increased intracranial pressure, atypical seizure

Question 29

Reyes Syndrome =

Answer 29

giving aspirin to kids until 18 - -assoc w. URTI or varicella - -encephalopathy w. fatty degeneration of liver - -may have increased liver enzymes and other bad things (personality change, confusion, delirium...)

Question 30

subluxation of radial head

Answer 30

- -hold arm in pronated position - -x-ray normal via pulled by hand - -place elbow in supination & slowly extend arm

Question 31

iron deficiency anemia (IDA)

Answer 31

MC nutritional deficiency in kids - -pallor, anorexia, poor muscle tone - -1.5mg/kg bid for 30 days WITH Vit. C** - -decrease milk & dairy consumption

Question 32

pes planus

Answer 32

<4 yrs = no tx | let them walk bare foot but don't over due it & wait for muscles to develop

Question 33

metatarsus varus (adductus)

Answer 33

kidney foot - -more spontaneously resolve - -some need casting & corrective shoes

Question 34

talipes equinovarus

Answer 34

clubfoot - -plantar flexion - -varus/inversion deformity - -forefoot varus * *use manipulation to stretch contracted medial & posterior tissues + splinting

Question 35

tibial torsion

Answer 35

>16-18m = tx w/ ext splint

Question 36

femoral anteversion

Answer 36

MC cause of toeing in after 2-3yrs | --usually resolves on its own

Question 37

word comprehension @

Answer 37

9m

Question 38

babbling @

Answer 38

12m

Question 39

270 words & commands @

Answer 39

2 years

Question 40

1600 words & intelligible speech & <5 word sentences @

Answer 40

4 years