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Boards apea peds exam (actual exam)questions,answers 2024 – 2025
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Boards apea peds exam (actual exam)questions,answers 2024 – 2025
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Boards apea peds exam (actualexam)questions,answers 2024 – 2025
Developmental Dysplasia of the Hip (DDH) - ANSWERS-- acetabulum (socket) too
shallow to properly hold the femoral head (ball), chronic dislocation
- ~4/1,000 births
- screen at newborn exam, at all health screenings, until age 9 mo or until child
walks independently
screening:
- birth to 3mo: Ortolani and Barlow maneuvers (hip instability), Galeazzi sign
(shortening femur), asymmetry of leg creases
- 3-12 mo: limitation of hip abduction in 90 degree flexion, femur shortening,
asymmetry of leg creases
imaging:
-u/s primary technique for assessing the morphology and stability of the infant
hip up to age 4-6mo
- xray limited in young infants, femoral head and acetabulum are cartilaginous
and unossified
,Club foot - ANSWERS-- deformity of the foot and ankle present at birth
- causes: neuro, idiopathic, underlying syndrome
- deformities in 2 planes may be present
- excess plantar flexion (equines) or dorsiflexion (calcaneus)
- excess medial (varus) or lateral (valgus) angulation
- talipes equinovarus most common
- REFER
Metatarsus Adductus - ANSWERS-- foot has a kindey bean shape due to medial
deviation of the metatarsal bones
- heel bisector line is lateral
Nursemaid's Elbow - ANSWERS-- entrapment of the annular ligament at the elbow
joint
- caused by subluxation of the radial head due to arm pulling or twisting
- common elbow injury in 1 to 4 yo (falls while holding hands, swinging by arms)
- child holds arm straight at their side and refuses to bend it, no pain in this
position
- flexion causes pain
mgmt: reduction:
1. hold child's arm in prone position
,2. place hand under arm w. thumb on radial head
3. apply gentle traction away from child's body
4. supinate the forearm
5. flex the elbow
scoliosis - ANSWERS-- defined as a curvature of the spine =>10 degrees
- slight curvature in spine may be clinically insignificant
- some spines become increasingly curved as child grows
- risk greatest during pubertal growth spurt
- uneven shoulder or hip height
- prominence of one shoulder blade or side of the rib cage
- lump in back when bending forward
- children should be examined while touching toes
osgood-schlatter disease - ANSWERS-- aka osteochondiritis of the tibial tubercle
- anterior knee pain that increases over time
- swelling and tenderness where patella meets tibia
- common cause of adolescent knee pain
- usually unilateral, can be b/l
- overuse injury
, - athletes 9-14yo who have undergone rapid growth spurt; jumping/pivoting
sports
- natural course: 6-18 mo (until growth plate closes)
- continuation of activity as tolerated
- ice to painful areas
- analgesics for 3-4 intervals prn
- protective pad over tubercle
- pt/exercises: strengthen quads and keep hamstrings flexible
Tdap - ANSWERS-- >7 yrs
- 11-12 yrs: Tdap booster- contains tetanus, diphtheria, and acellular pertussis
- Tdap can be administered regardless of last interval since the last tetanus- and
diptheria-toxoid- containing vaccine
- After Tdap, pts should receive Td booster 10y (routine)
Pregnancy and Tdap - ANSWERS-1 dose Tdap during each pregnancy, preferably in
early part of gestational weeks 27-36
Hib (Haemophilus influenzae Type B) - ANSWERS-- #1: 2m
- #2: 4m
- #3: 6m
- #4: 12-15m
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