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MSK 7 (Pedi Ortho)
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Question | Answer |
---|---|
What are the four potassium-sparing diuretics? | Spironolactone (antiandrogen effects), eplerenone, amiloride, triamterene |
Low urine specific gravity in the presence of high serum osmolality. What is the dx? | DI |
What is the diagnostic test for hereditary spherocytosis? | osmotic fragility test |
Which infants should be screened fro developmental dysplasia of the hip? | Obtain hip sono at 6 weeks if: Breech female, female with fam h/o developmental dysplasia of the hip |
What is the tx for slipped capital femoral epiphysis? | avoid weight bearing and prompt surgicall pinning of the head of the femur |
Which infants should receive vit D supplementation? | All children (including breastfed infants) should receive 400IU daily starting the first few days of life. |
What is the treatment for juvenile idiopathic arthritis? | NSAIDS are the drug of choice, but if unresponsive to a trial of 2 different NSAIDS over at least 6 weeks then second line is methotrexate or corticosteroids |
What are the characteristic features and treatment for Osgood-Schlatter disease? | Most common sx is anterior knee pain that increases over time and is worsened by quadriceps contraction. Signs at the tibial tuberostiy include soft tissue swelling, a palpable bony mass |
What is the tx for Osgood Schatter? | It's ok to continue sports despite pain, rehab including stretching the hamstring and quads and strengthening the quads, ice to the area, NSAIDS, protective pad |
T/F It is important to immobilize the knee in a patient with Osgood schlatter disease in order to fully heal? | False. It is contraindicated to immobilize the knee |
What is the tx for developmental dysplasia of the hip in children younger than 6 months of age? | Pavlik Harness |
What is the tx for SCFE? | non-weight bearing, followed by surgical pinning. |
What is the tx for clavicle fracture in the newborn? | no treatment needed(no need to immobilize) |
A child presenting to the ER with his parents is unable to bend his elbow after his father jerked him out of the street an hour prior to presentation. What is the tx? | This is nursemaid's elbow. Reduce by gently flexing and supinating the arm with one hand while supporting the elbow and applying gentle pressure to the radial head with the other. |
What is the tx for legg-calve-perthes dz? | non-wt bearing on affected side for an extended period of time. If limited femoral head involvement & full ROM then observe. If extensive femoral head involvement or limited ROM, options include bracing, hip abduction w/ a petrie cast or an osteotomy. |
What is the classic presentation of childhood spondylolithesis? | Forward slip of a vertebrae resulting in a palpable "step-off" on PE. Subacute back pain exacerbated by hyperextension of the spine. Difficult time getting up from a squatting position. Possible neurological dysfunction including urinary incontinence. |
What dz is responsible for a painful limp in a child with the following scenario: xray reveals femoral head sclerosis | legg calve perthes dz |
What dz is responsible for a painful limp in a child with the following scenario: xray reveals ice cream scoop (femoral head) falling off of cone(femur) | SCFE |
What dz is responsible for a painful limp in a child with the following scenario: obese, male adolescent with dull hip pain and inability to bear weight. | SCFE |
What dz is responsible for a painful limp in a child with the following scenario: acute onset of tibial pain, fever, malaise, elevated ESR , no joint pain. | osteomyelitis |
What dz is responsible for a painful limp in a child with the following scenario: acute onset of knee pain, fever, elevated ESR, leukocytosis. | Septic arthritis. |
What dz is responsible for a painful limp in a child with the following scenario: 7 y/o with growth delay and inner thigh pain | legg calve perthes dz |
What dz is responsible for a painful limp in a child with the following scenario: 13 y/o boy with pain and swelling at the tibial tuberosity | osgood schlatter dz |
Developmental dysplasia of the hip more commonly affects _______M/F. | Female>Male |
Which imaging modality is most commonly used to to help diagnose developmental dysplasia of the hip? | US |
A bony growth on a long bone that sits on top of cortical bone and is not continuous with the normal cancellous bone is most likely a _________(B9/Malignant) lesion. | Malignant |
A patient with SCFE will have limited ______(external/internal) rotation and _______(abduction/adduction) of the hip | Internal rotation and abduction of the hip |
Juvenile RA is a nonmigratory arthropathy affection 1 or more joints for >____months. | 3 |
Club foot is treated by ______ ________ of the foot in the correct position. | Serial casting |
Club foot is______(eversion/inversion) of the foot, plantar flexion of ankle, and adduction of forefoot. | inversion of foot |
Patients with small curves of the spine (scoliosis) are typically treated with what method? | observation. |
Duchenne muscular dystrophy is an x-linked d/o resulting from deficiency of ________. | dystrophin |
What is the most common lethal muscular dystrophy? | Duchennes MD |
What is the tx for Duchennes Muscular dystrophy? | PT, corticosteroids, pulmonary support, ACE-I decrease cardiac afterload |
Which muscular dystrophy is similar to Duchennes except for less severe symptoms and slower progression? | Becker muscular dystrophy |
According to the Salter-Harris Classification of physeal fractures, which fracture type is described below: crush injury of physis | Type V |
According to the Salter-Harris Classification of physeal fractures, which fracture type is described below: partial physeal separation with proximal extension into metaphysis | Type II |
According to the Salter-Harris Classification of physeal fractures, which fracture type is described below: Fracture extends through the metaphysic, physis, and epiphysis | Type IV |
According to the Salter-Harris Classification of physeal fractures, which fracture type is described below: physeal separation w/o extension into adjacent bone | Type I |
According to the Salter-Harris Classification of physeal fractures, which fracture type is described below: Partial physeal separation with distal extension into epiphysis | Type III |