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Peds Exam 3 - Ortho/Sports Physical

Total questions: 75

Worksheet time: 41mins

Name
Class
Date
1.

Kid has tenderness over growth plate and injury and nothing on x ray --> Salter-Harris ______ until proven otherwise

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

e)

Type V

2.

Fracture through physis

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

e)

Type V

3.

Fracture through physis and metaphysis

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

e)

Type V

4.

Fracture through epiphysis and physis

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

e)

Type V

5.

Fracture through epiphysis, physis and metaphysis

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

e)

Type V

6.

Compression injury to physis without fracture *cannot see growth plate

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

e)

Type V

7.

Salter-Harris Fracture is only seen in pediatrics

a)

True

b)

False

8.

growth plate

a)

physis

b)

metaphysis

c)

epiphysis

9.

part of long bone attached to growth plate

a)

physis

b)

metaphysis

c)

epiphysis

10.

after growth plate

a)

physis

b)

metaphysis

c)

epiphysis

11.

fracture around an open growth plate

a)

salter-harris fracture

b)

buckle (torus) fracture)

c)

"greenstick" fracture

d)

"toddler's fracture"

e)

radial head subluxation

12.

= disruption @ cortical bone

a)

salter-harris fracture

b)

buckle (torus) fracture)

c)

"greenstick" fracture

d)

"toddler's fracture"

e)

radial head subluxation

13.

bend in the bone on one side and a visible break in the bone cortex on the other side

-usually occurs from a direct blow or twisting motion

a)

salter-harris fracture

b)

buckle (torus) fracture

c)

"greenstick" fracture

d)

"toddler's fracture"

e)

radial head subluxation

14.

-1-2 yr old

-acute limp/refusal to walk

-tender distal tibia

*get leg stuck in crib

a)

salter-harris fracture

b)

buckle (torus) fracture

c)

"greenstick" fracture

d)

"toddler's fracture"

e)

radial head subluxation

15.

suspicious fractures

a)

spiral fractures of humerus or femur

b)

corner fractures

c)

posterior rib fractures

d)

toddler's fracture

16.

= radial head slips off ulnar joint

-2-3 yr old

-acute decreased use of an arm -- kid won't use arm or reach for toy

-following a "jerk" on arm, a fall, or no clear hx

a)

salter-harris fracture

b)

buckle (torus) fracture

c)

"greenstick" fracture

d)

"toddler's fracture"

e)

radial head subluxation

17.

"nursemaid/s" elbow

a)

salter-harris fracture

b)

buckle (torus) fracture

c)

"greenstick" fracture

d)

"toddler's fracture"

e)

radial head subluxation

18.

-most common type

-four or fewer joints

-usually large joints

-asymmetrical

-uveitis (usually only systemic sx)

a)

oligoarticular

b)

polyarticular

c)

systemic

d)

enthesitis associated

19.

-five or more joints

-large and small joints

-symmetrical

-systemic sx mild: low grade fever, fatigue, nodules, anemia

a)

oligoarticular

b)

polyarticular

c)

systemic (still disease)

d)

enthesitis associated

20.

-large and small joints

high fever w macular rash is hallmark

-fever occurs 1-2 times a day, self limited

-systemic sx: hepatosplenomegaly, lymphadenopathy, leukocytosis

a)

oligoarticular

b)

polyarticular

c)

systemic (still disease)

d)

enthesitis associated

21.

-more common in males > 10 yrs

-lower extremity, large joints

-inflammation at tendon insertions

-sacrolitis

a)

oligoarticular

b)

polyarticular

c)

systemic (still disease)

d)

enthesitis associated

22.

rule out septic arthritis with

a)

joint fluid culture

b)

anti-CPP antibody

c)

ESR

d)

CRP

e)

CBC

23.

most specific lab for juvenile idiopathic arthritis

a)

joint fluid culture

b)

anti-CPP antibody

c)

ESR

d)

CRP

e)

CBC

24.

chronic arthritis in one or more joints for at least 6 wks, +/- systemic sx

a)

juvenile idiopathic arthritis

b)

"toddler's fracture"

c)

radial head subluxation

25.

tx for juvenile idiopathic arthritis includes:

a)

NSAIDS

b)

DMARDS

c)

Corticosteroids

d)

Treat uveitis -- opthalmology

e)

PT

26.

sports physical performed ________ season

a)

during

b)

4-6 weeks before

c)

after

d)

2 weeks before

27.

All murmurs noted during a sports physical should be evaluated and monitored

a)

True

b)

False

28.

collision sports

a)

boxing

b)

football

c)

ice hockey

d)

lacrosse

e)

basketball

29.

contact sports

a)

basketball

b)

soccer

c)

cheerleading

d)

football

e)

downhill skiing

30.

limited contact sports

a)

gymnastics

b)

downhill skiing

c)

baseball

d)

volleyball

e)

cheerleading

31.

non contact sports

a)

archery

b)

curling

c)

golf

d)

tennis

e)

swimming

32.

NOT recommended to participate in sports

a)

hypertrophic cardiomegaly

b)

severe aortic stenosis

c)

current fever/diarrhea

33.

typically fine to participate but may need specialty consult to limit type of sports

a)

HTN

b)

asthma

c)

seizure

d)

congenital heart disease

e)

arrhythmias

34.

Anticoagulation tx/bleeding disorder dx not recommended for contact sports

a)

True

b)

False

35.

= femoral head not sitting where it should

a)

congenital hip dysplasia

b)

club foot

c)

torticollis

d)

brachial plexus injuries (Erbs palsy)

e)

clavicle fractures

36.

ultrasound gold standard dx

a)

congenital hip dysplasia

b)

club foot

c)

torticollis

d)

brachial plexus injuries (Erbs palsy)

e)

clavicle fractures

37.

Barlow and/or Ortolani used to assess

a)

congenital hip dysplasia

b)

club foot

c)

torticollis

d)

brachial plexus injuries (Erbs palsy)

e)

clavicle fractures

38.

tx may include a pavlik harness or spica cast

a)

congenital hip dysplasia

b)

club foot

c)

torticollis

d)

brachial plexus injuries (Erbs palsy)

e)

clavicle fractures

39.

= plantar flexion or inversion that does not fix

-will not correct on its own -- REFER

a)

congenital hip dysplasia

b)

club foot

c)

torticollis

d)

brachial plexus injuries (Erbs palsy)

e)

clavicle fractures

40.

-usually a results of malpositioning in uterus or birth trauma

-SCM tight and sometimes spasm

-tx: stretching, positioning, PT

-older children usually self resolved in 2-3 days w stretching

a)

congenital hip dysplasia

b)

club foot

c)

torticollis

41.

all sutures are still open

a)

plagiocephaly

b)

craniosynostosis

42.

one or more suture close prematurely

a)

plagiocephaly

b)

craniosynostosis

43.

all sutures are open

a)

positional molding

b)

lambdoid synostosis

44.

close lambdoid suture

a)

positional molding

b)

lambdoid synostosis

45.

tx: surgery

a)

craniosynostosis

b)

positional deformity

46.

molding ortho or observation

a)

craniosynostosis

b)

positional deformity

47.

-birth injury to brachial plexus which leads to weak/paralyzed muscles in upper extremity

-usually due to positioning, shoulder dystocia, difficult delivery

-most resolve but need PT, OT. no improvement refer for surgery

a)

congenital hip dysplasia

b)

club foot

c)

brachial plexus injuries (Erbs palsy)

48.

-occur during difficult delivery

-get x ray in nursery

-heal w no long-term complications in 2-3 wks

a)

congenital hip dysplasia

b)

club foot

c)

clavicle fractures

49.

chronic or acute hip, groin, or thigh pain -- PAINFUL limp

-needs surgical intervention *tx early!

a)

SCFE

b)

Legg-Calve-Perthes Disease

c)

Osgood-Schlatter Disease

d)

Patello-femoral pain syndrome

50.

idiopathic osteonecrosis of the femoral head as a child

a)

SCFE

b)

Legg-Calve-Perthes Disease

c)

Osgood-Schlatter Disease

d)

Patello-femoral pain syndrome

51.

PAINLESS limp is often the initial presentation, may become painful over time

-tx variable (bed rest, casting, surgery)

a)

SCFE

b)

Legg-Calve-Perthes Disease

c)

Osgood-Schlatter Disease

d)

Patello-femoral pain syndrome

52.

apophysitis or osteochondritis of the tibial tuberosity

-overuse syndrome, eventually resolves

-advanced imaging unnecessary

-tx pain, reduce but do not eliminate activities

a)

SCFE

b)

Legg-Calve-Perthes Disease

c)

Osgood-Schlatter Disease

d)

Patello-femoral pain syndrome

53.

common in adolescent females (increased q angle/hyper mobile)

-anterior knee pain

-usually due to weak core and hip abductors

-tx: PT, NSAIDs, bracing, RICE

a)

SCFE

b)

Legg-Calve-Perthes Disease

c)

Osgood-Schlatter Disease

d)

Patello-femoral pain syndrome

54.

"bowlegs"

a)

genu varum

b)

genu valgum

55.

"knock knees"

a)

genu varum

b)

genu valgum

56.

Ricketts can be a cause of

a)

genu varum

b)

genu valgum

57.

causes of in-toeing

a)

femoral anteversion

b)

internal tibial torsion

c)

metatarsus adductus

d)

skeletal dysplasia

e)

blount disease

58.

-infection in hip

-very painful

-babies, teens

a)

septic arhritis

b)

transient synovitis

59.

-synovium becomes inflamed (not infection)

-painful

-young children (3-10)

a)

septic arhritis

b)

transient synovitis

60.

usually happens post-viral inflammation

a)

septic arhritis

b)

transient synovitis

61.

_____ and _____ gold standard in telling septic arthritis and transient synovitis apart

a)

x-ray

b)

U/S

c)

aspirate joint

62.

hematogenous seeding of bone or direct inoculation via trauma

a)

septic arhritis

b)

transient synovitis

c)

osteomyelitis

63.

definitive dx for osteomyelitis

a)

needle aspirate/bone bx

b)

MRI

c)

CBC

d)

xray

e)

bone scan

64.

best imaging for osteomyelitis

a)

MRI

b)

xray

c)

bone scan

65.

sx: fever, point tenderness, erythema, warmth, febrile infant w frozen hip

a)

septic arhritis

b)

transient synovitis

c)

osteomyelitis

66.

tx for osteomyelitis

a)

abx to cover S. aureus or other pathogens

b)

NSAIDs

c)

DMARDs

d)

PT

e)

observation

67.

scoliosis < 25 degrees

a)

observe

b)

brace

c)

fusion

68.

scoliosis 25-45 degrees

a)

observe

b)

brace

c)

fusion

69.

scoliosis > 45 degrees

a)

observe

b)

brace

c)

fusion

70.

causes of scoliosis

a)

congenital

b)

neuromuscular

c)

idiopathic

d)

trauma

71.

defect of vertebral lamina btwn posterior articulation points, w/o slippage

a)

spondylolysis

b)

spondylolisthesis

72.

defect of vertebral lamina btwn posterior articulation points, with slippage

-may results from repeated stress and trauma (gymnasts)

a)

spondylolysis

b)

spondylolisthesis

73.

"scotty dog sign"

a)

pars interarticularis

b)

spondylolysis

c)

spondylolisthesis

74.

breaks

a)

pars interarticularis

b)

spondylolysis

c)

spondylolisthesis

75.

breaks and slips

a)

pars interarticularis

b)

spondylolysis

c)

spondylolisthesis

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