Step 2 Pediatrics 2 (10-14-15)

ruhland1's version from 2015-10-23 11:11

Section 1

Question Answer
DDH dx after PXEXU/S (radiograph no b/c hips are unossified)
DDH treatmentPavlik harness
hydrocephalus shunt bugStaph Epidermis (all artificial entry devices)
leukocytosis with left shiftup PMN (bact)
leukocytosis with right shiftup Lymphocyte (viral)
S. Epidcogulase-neg
left shiftexcess neutophils
right shiftexcess lymphocytes
congenital hypothyroidpoor feed, constip, low tone, large tongue and Ant fonatanelle, umbilical hernia
cogenital low levels of thyroid hormoneretarded, poor linear growth, failure of bone maturation
TRI 21Acute Lymphoblasttic Leukemia risk
Beckwith-Wideman vs cogenital hypothyroidBW=omaphocele, CHypothy=umbilical hernia
10 mocrawl, pull to stand, 3-finger pincer grasp, mama-dada(nonspecific), pat-a-cake
run, kick ball18 mo
2 finger pincer grasp12 mo

Section 2

Question Answer
DDH(+) Galeazzi sign
Galeazzi signapparent shortened femur when comparing knee heights
Trendeleberg StanceDDH
eval joint effusionaspirate
dial testeval posterolateral corner (PLC) injury of knee
dial test (+)>10degree assym=+, 30 degree assym= PLC injury, 30-90 degree + = Posterior cruciate lig tear
DDH riskhip capsule lax, breech preg, fam hx, female sex, 1st child
legg calve perthsidiopathic osteonecrosis of proximal femoral epiphysis
leg calve perth classicmale 4-8yo painless limp
septic arthritisKocher criteria
Kocher tempF
Kocher gaitrefusal to bear weight on affected leg
Kocher labESR>40, WBC>12000
Kocher CriteriaFever, weight bearing=pain, ESR>40, WBC>12000
MC hip pain in childhoodtransient synovitis
transient synovitismild fever acute painful limp (must r/o kocher criteria for septic arthritis)
DDH <6 moPavlik Harness
DDH 6-18mohip arthography-> percutaneous adductor tenotomy, closed reduction and SPICA casting
DDH 18mo-3yropen reduction
DDR >3yrpelvic/femoral osteotomy

Section 3

Question Answer
EBV mouthpalatal petechiase
EBV spleenmega
EBV smear50% lympho and atleast 10% atypical lymphocyte
monospot testheterophileantibodies
heterophile antibodies inEBV
toxoF and LAD and hx of exposure
CMVprolonged F, less LAD than EBV, absent pharyngitis
CMV dxidentify IgM Antibodies
EBV and take amoxicillindevelop morbilliform rash
monospot testheterophile antibodies interact with antigens (horse red blood cells)
reverse car seatif <2 years old and <30lbs
identifying mullerian structuresCT Abd/Pelvis (got to go up to atleast kidneys)
Streak ovaries (premature ovarian failure)turner
2ndary ammenorrhea work upB-HCG->TSH->FSH->Prolactin
2nd metatarophalgeal jointFreidberg
PannersPitcher (capitellum)
male 14-16 with tender tibial tuberosityosgood schlatter (traction apophysitis)
osgood schlatter txNSAID, hamstring strech, brace knee
Sinding-Larsen-Johanssoninferior pole of knee has tract apophysitis

Section 4

Question Answer
National Practicioner Data Bankdetermine if doc has engaged in unprofessional behavior or malpractice litigation
Healthcare Integrity and Protection Data Bankcombat fraud and abuse in health insurance and healthcare delivery
Joint Commissionoperates accrediation programs to subscriber hospitals and other Health Care organizations
A hospital that meets Joint Commision accreditation is deemed to meetMedicare Conditions for Participation
National Committe of Quality Assuranceimporve health care quality and manages voluntary accredidation programs for individual physicians and medical groups