Peds short answer

  1. Name the layers of the physis
    • Reserve
    • Proliferation
    • Hypertrophic:
    • -Maturation
    • -Degeneration
    • -Provisional calcifiaction
    • Primary spongiosa
    • Secondary spongiosa
  2. List 3 at risk signs for Perthes (total 5)
    Caterall head at risk signs

    • Calcification lateral to epiphysis
    • Gage sign 
    • Femoral head subluxation
    • Horizontal growth plae
    • metaphyseal cyst
  3. 8 month old with unilateral DDH. a. list the most important clinical sign b. list 5 possible blocks to reduction
    A: Galeazzi

    • B
    • Ligamentum teres
    • Inverted labrum
    • Iliopsoas
    • pulvinar
    • Transverse acetabular ligament
    • COntracted joint capsule
  4. List 4 reasons to CRPP a distal radius fracture in a child (6 total)
    • Open fracture
    • Shortening > 1cm
    • angulation >45 degrees
    • SH 3 or 4 and displaced: intrarticular
    • <50% appositon
    • Ipsilateral elbow injury
  5. In the evaluation of a child’s hip, mention 4 criteria that will help differentiate between septic arthritis and transient synovitis.
    Kocher criteria

    • WBC> 12000
    • ESR > 40
    • Temp > 38.5
    • Refusal to weight bear
  6. List 4 long term complications of osteomyelitis in pediatric patient. (total 6)
    • Growth arrest: LLD
    • angular deformity
    • Recurrence: chronic osteo or brodies abcess
    • pathologic #
    • Septic arthritis 
    • DVT
  7. List 3 x-ray findings of Madelung’s deformity. ( 5 total)
    • Pyramidal carpus
    • Proximal subsidence of lunate
    • Narrowing ulnar aspect distal radial physis
    • Anterior bowing of radial shaft
    • Dorsal subluxation radial head
  8. What are 3 ways to decrease the rate of AVN when performing an antegrade femoral nailing in an adolescent patient.
    • Trochanteric entry
    • smaller nail
    • solid nail: not reaming
  9. List 3 spine findings in Anchondroplasia.(total 5)
    • Narrowing interpedicular space lumbar spine
    • Short pedicles
    • Thoracic kyphosis
    • Foramen magnum stenosis
    • Lumbar stenosis
  10. List 3 relative indications to perform contralateral prophylactic pinning in a patient with SCFE. (total 7)
    • Age < 10
    • Weight <50th percentile
    • Endocrine
    • Downs
    • Unable to assure follow up
    • renal osteodystrophy
    • Open tri radiate cartilage
  11. List 3 predictors that contribute to poor prognosis for Perthes disease on initial presentation. (total 4)
    • Age > 6
    • Herring classification: b/c or c
    • 2 or more caterall head at risk signs
    • Premature physeal closure
  12. Duchenne Muscular dystrophy. Use of corticosteroids• Benefits (3)• Complications (3)
    • BENEFITS
    • Prolonged ambulation
    • Decreased pulmonary complications
    • prevention scoliosis
    • Improved strength 

    • COMPLICATIONS
    • AVN
    • short stature
    • cataracts
  13. List 3 components of the minimally invasive treatment of congenital vertical talus
    Pre operative casting: reverse ponseti to stretch dorsal soft tissues. cast in plantarflexion and inversion

    Closed reduction and perc pinning of TN joint: release capsule around talus to achieve reduction

    Percuatanous TAL
  14. List 4 features of pediatric radial neck fractures that would lead to a poor outcome.
    • Angulation > 60 degrees
    • associated elbow dislocation/med epicondyle #/olecranon #
    • Age: younger have better outcome
    • Late surgical intervention: > 5 days
  15. List 4 risk factors for developing a DVT in a pediatric patient with MRSA osteomyelitis. ( total 5)
    • CRP>6
    • Age >8
    • Surgical treatment
    • higher mean temperature on admission
    • Lower extremity/axial infections
  16. List 4 risk factors for developing a DVT in a pediatric patient with MRSA osteomyelitis.
    • Hypothyroid
    • Hypogonadism
    • Panhypopituitarysm
    • Renal osteodystrophy
  17. Name two radiographic risk factors for SCFE development
    • Retroverted pelvis
    • Increased physeal obliquity
  18. Name 4 radiographic reasons for progression of infantile Blount’s
    • MDA >16
    • Stage 4-6: physeal bar formation
    • Lateral subluxation of proximal tibia
    • Prominent beaking of medial metaphysis
  19. List 5 complications with managing a displaced intra-articular tibial tubercle fracture in an adolescent
    • Growth arrest causing recarvatum of knee
    • Harware irritation
    • COmpartment syndrome: anterior tibial artery
    • malunion
    • nonunion
    • Decreased ROM
  20. Order of ossification of the pediatric elbow (didn't ask for age)
    CRITOE

    • capitellum
    • radial head
    • medial epicondyle
    • trochlea
    • olecranon
    • lateral epicondyle
  21. List 4 findings on clinical exam that you would see in a 6-month old kid to diagnose a posterior shoulder dislocation resulting from a brachial plexus injury
    • Shoulder resting in IR
    • Decreased ER
    • Assymety of shoulder: prominent coracoid
    • Asymmetry of skin fold due to telescoping of humerus posteriorly
  22. Name 4 reasons not to do a re-directional pelvic osteotomy (total 5)
    • Deficient acetabulum
    • Incongruent hip
    • Age >8
    • Abduction <30 degrees
    • Arthritis
  23. Syndactyly, definitions . Define the following: complete, complex, synonychia
    • • Complex: fusion of adjacent phalanges
    • • Complete: Skin fused to the fingertips
    • • Synonychia: Fusion of the nails
  24. Signs of AVN following closed reduction of DDH? Name 3 radiographic signs of osteonecrosis of the femoral epiphysis in a pediatric patient with developmental dysplasia of the hip.
    • Delayed appearance: failure to ossify within 1 year
    • widening of femoral neck
    • Changes in femoral head density
  25. Prognostic factors in the management of juvenile knee OCD?
    • • Young age with open physis: better success with conservative tx
    • • Lateral condyle, patella: worse
    • • MRI: fluid behind the lesion = worse
  26. Muscles contributing to equinovarus foot? How to differentiate?
    • • Tibialis anterior, tibialis posterior, gastroc-soleus complex
    • • Confusion test: active hip flexion against resistance, if tib. Ant. Contracts, likely not involved (like on CP), if foot supinated, tib. Ant. Likely involved
  27. You are treating a 8 year old patient with open reduction of the lateral condyle fracture. List 3 surgical considerations
    • Avoid posterior dissection
    • Anatomic reduction articular surface
    • Fixation with 2 pins
  28. What are 6 factors that are associated with failure of treatment of DDH with a brace
    • Compliance by parents
    • Male
    • Bilateral
    • Irreducible
    • Pavlik after 7 weeks
    • Absent ortolani at initial presentation
  29. What are 6 radiographic findings associated with non accidental trauma in pediatric patients with no metabolic bone disease
    • corner fracture
    • Posterior rib fracture
    • multiple fractures at different stages of healing
    • transverse long bone fractures in non ambulatory
    • Transphyseal fractures
    • Skull fractures
  30. When treating a transverse femoral fracture in a child, what are 4 surgical technique considerations to prevent failure of implant fixation and loss of reduction
    • Nail diameter combined 80% canal
    • Prebend nails so the apex of the bend lies at fracture site
    • Retrograde double c configuration
    • if child weights >100 lb use solid nail
  31. . List the 4 deformities IN ORDER that need to be corrected in clubfoot
    • CAVE
    • cavus
    • addustus
    • varus
    • equinus
  32. List the 4 different subtypes of neural tube defects
    • Meningocele: sac without neural elements protruding
    • Spina bifida occulta
    • myelomeningicele: neural elements into sac
    • Rachischisis: neural elements exposed
  33. Give 4 conditions associated with radial club hand
    • • VACTERL
    • • TAR – thrombocytopenia, absent radius
    • • Holt Oram – cardiac defects
    • • Fanconi’s anemia
  34. Give 5 non-orthopaedic manifestations of Down's syndrome
    • • Heart disease (50%)
    • • Early aging
    • • Mental retardation
    • • Early Alzheimer’s
    • • Endocrine – hypothyroid
  35. Give 5 radiographic findings are associated with a dystrophic curve in neurofibromatosis (NF-1)?
    • • Short segment curves (4-6 levels)
    • • Vertebral scalloping (>3mm in T-spine, >4mm in L-spine; assoc w/ dural ectasia or neural tumour)
    • • Enlarged foramina
    • • Rib penciling (3 or more prognostic for progression of spinal deformity); penciling - width of rib is more narrow than narrowest part of 2nd rib
    • • TP penciling
    • • Severe apical rotation
  36. Give 3 conditions assoc with childhood spondylolisthesis
    • • Spina bifida occulta
    • • Thoracic hyperkyphosis
    • • Scheuermann’s kyphosis
  37. What outcomes following clubfoot surgery resulted in unsatisfactory results? (3)
    • • OA in foot & ankle
    • • Ankle stiffness
    • • Gastroc weakness
  38. What are the indications to intervene surgically in Perthes (LCP)?
    • Age >8
    • lateral pillar b or b/c
  39. question 326
Author
egusnowski
ID
345835
Card Set
Peds short answer
Description
Pediatrics sa
Updated