Peds Exam 3 Review | Questions And Answers Latest {2024- 2025} A+ Graded | 100%
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Metatarsus Adductus - "in-toeing" - toes point INWARD. most common.
Most of time - spontaneously resolves by a few months
Sometimes - therapy/ exercise, casting
Club Foot (Equinovarus) - *Muscles, tendons, and bones involved- cannot be corrected w/ exercise!
Foot = small, achilles tendon = shortened/ TIGHT, leg lengths = normal
*Start treatment EARLY, all steps must be followed or will not work!!!
Ponseti Method:
1. serial casting w/ weekly manipulation
2. heel cord tenotomy (cut achilles tendon)
3. shoes/ braces on foot (Denis Browne Bar)
Developmental Dysplasia of the Hip (DDH) - *acetabulum (hip socket) and femoral head are not aligned.
Newborns- perform U/S
After 4 months- X-ray (won't SEE bones on x-ray early on, mostly cartilage!)
Test: Barlow + Ortolani
S/S: ASYMMETRY of gluteal and thigh folds, limited hip abduction, shortened femur
Treatment: *start right away
0-6 months: Pavlik Harness = ensures hips stay FLEXED and ABDUCTED
6 mo-2 years: spica cast or Bryant Traction
,older children: surgical reduction
Dysplasia of hip - acetabulum is shallow, doesn't provide sufficient coverage of femoral head
Subluxation of hip - partial dislocation
Dislocation of hip - totally out = displacement of femoral head from acetabulum
Legg-Calve-Perthes Disease - *avascular necrosis of the femoral head
*early detection is key- can lead to osteoarthritis or dysfunction of hip
S/S: Painless limp, limited ROM, hip stiffness, hip/thigh/knee pain
Progressive disease, takes 1-4 years (long time!) for bones to re-ossify
Treatment: NSAIDs and rest (treat inflammation)
Stress ABDUCTION of hip!! (maybe brace, cast)
Limited/ non-weight bearing status on affected side
Slipped Capital Femoral Epiphysis (SCFE) - femoral head displaced from femoral head- during adolescent
growth spurt (obesity, boys)
S/S: gradual process; lip, loss of motion, out-toeing, thigh/groin/hip pain
Treatment: *if don't treat, will end up w/ deformed hip
Surgery = fixation w/ screw (usually outpatient unless severe)
Scoliosis - Idiopathic- most common, females between 10-13
*over 10 degrees = abnormal
, Screening- look for:
S/S: *ASYMMETRY- truncal, bend over @ waist, uneven shoulder/hip heights, prominent scapula.
Screen- measures w/ scolimeter.
Diagnosis:
X-ray to find Cobb Angle!
Risser Grade = measure of how mature child's bones are (want to catch when bones are immature, so
we have time to fix it!!!) = 0,1,2,3,4 open. 5 is highest = fully skeletal mature
Treatment:
Mild Scoliosis, 10-20 degrees = exercises, watch
Moderate Scoliosis, 20-40 degrees = brace
Severe Scoliosis, > 40 degrees = surgery (spinal fusion- log roll!!)
Osteomyelitis - infection of bone! (staph from skin penetrates, more common with boys- roughhousing,
long bones of leg)
S/S: decreased mobility of joint, pain, inflammation, redness, warmth, may have limp
Dx: *elevated WBC (above 10,000), elevated ESR + CRP (above 10), biopsy/culture to confirm organism
Tx: IV antibiotics- long course!! (3-6 weeks, broad spectrum)
Marfan Syndrom - *connective tissue disorder- long, lanky, skinny
Top 3 Abnormalities:
1 = cardiac (heart murmur, aortic aneurysm biggest concern)
2 = skeletal (pectum excavatum, scoliosis)
3 = eyes (glasses)