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LSUHS Alexandria Family Medicine Board Review (Pediatric Orthopedics) Flashcards | StudBud
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LSUHS Alexandria Family Medicine Board Review (Pediatric Orthopedics)
LSUHS Alexandria Family Medicine Board Review (Pediatric Orthopedics)
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1
An 8-year-old has cramping thigh pain only at night which is worse after days with increased activity. You recommend?
CBC, ESR, and CRP
MRI
Reassurance
Night Splinting
Radiography
2
A 6-year-old male has a 2-week history of awakening at night with severe back pain. A likely cause of his pain is?
scoliosis
compression fracture
rheumatoid arthritis
discitis
lumbar sprain
3
A 16-year-old has knee pain with swelling 1 cm distal to the medial joint line. Exam otherwise normal. The diagnosis is?
Pes anserine bursitis
Medial meniscal tear
Tibial apophysitis (Osgood-Schlatter disease)
Fibular head stress fracture
Iliotibial band syndrome
4
Which one of the following disorders is caused by an underlying mechanism of osteochondrosis rather than apophysitis?
Sever’s disease
Osgood-Schlatter disease
Legg-Calvé-Perthes disease
Sinding-Larsen-Johansson syndrome
5
Which of the following is the most accurate and appropriate maneuver to detect an anterior cruciate ligament tear?
The lever sign test
The McMurray test
The pivot shift test
The Lachman test
The anterior drawer test
6
A 3-year-old has in-toeing from internal tibial torsion. Which of the following is recommended at this time?
No intervention
Surgery to correct the deformity
Shoe modification with wedges to externally rotate the feet while walking
Night splinting with the feet externally rotated
Serial casting to gradually externally rotate the feet
7
A baby born via vaginal delivery complicated by shoulder dystocia has the depicted arm deformity. What is the diagnosis?
Fractured clavicle
Cerebral palsy
Fractured humerus
Klumpke's paralysis
Erb's palsy
8
A 13-year-old has non-traumatic knee pain and tenderness to palpation of the tibial tuberosity. Evaluation includes?
No imaging
MRI
Ultrasonography
Plain film radiographs
A bone scan
9
A patient has a distal phalanx fracture after his hand was stepped on during a basketball game. Appropriate therapy is?
Splint the affected digit for 2–4 weeks
Tape the first and second digits together until symptoms resolve
Refer to a hand surgeon
Treat symptomatically with ice and an anti-inflammatory medication
Remove the nail to evaluate for a nail bed injury
10
An athlete has persistent pain of the proximal 5
th
metatarsal. Plain films do not show a fracture. The next step is?
Start NSAIDs and allow him to continue practicing as tolerated
Place him at non–weight bearing for 2 weeks and repeat the plain films
Place him in a hard shoe for 3 weeks and then reexamine
Order a bone scan of the foot
Order MRI of the foot
11
A 12-year-old pitcher reports 5 weeks of medial elbow pain and decreased throwing velocity. Appropriate management is?
Complete rest from throwing for 6 weeks followed by gradual return to play
Corticosteroid injection
Immediate referral to physical therapy for brachioradialis strengthening
Ice, compression, and NSAIDs followed by return to play when pain resolves
Sugar-tong splinting for 6 weeks
12
A 16-year-old has a minimally displaced mid-clavicular fracture after a hit playing football. Appropriate management is?
a weekly radiograph to monitor for displacement
a shoulder immobilizer for 6 weeks
a sling for 2–6 weeks
immediate referral to an orthopedist
a figure-of-eight bandage for 8 weeks
13
A female athlete has anterior knee pain worse with running and after sitting. Examination is normal. The diagnosis is?
Patellofemoral pain syndrome
Pes anserine bursitis
A torn medial meniscus
Prepatellar bursitis
Osgood-Schlatter syndrome
14
A 2-year-old has right leg pain with refusal to bear weight and tenderness of the tibia. X-ray is negative. You should?
Provide reassurance only
Order a CBC and C-reactive protein level
Recommend Immobilization with a cam boot, and repeat radiographs in 7 days
Order Bone scintigraphy
Refer to an orthopedic surgeon
15
A 6-year-old patient presents with a distal tibia fracture depicted in the following image. Appropriate management is?
Non weight-bearing and NSAID analgesia
Early physical therapy
Reassurance
Referral to pediatric orthopedist for surgery
A long leg cast
16
A 3-year-old has pain in the lower extremity, limping, and fevers. X-ray is negative. Initial evaluation should include?
A CBC, erythrocyte sedimentation rate, and C-reactive protein level
Bone scintigraphy
Joint aspiration
MRI
Ultrasonography
17
Which one of the following is the preferred first-line treatment for chronic midsubstance Achilles tendinopathy?
Tendinoplasty
Eccentric strengthening of the gastrocnemius and soleus muscles
Local corticosteroid injection of the retrocalcaneal bursa
Oral corticosteroids
Oral NSAIDs
18
A 13-year-old male is brought to your office for evaluation of back pain. Plain radiography is indicated if he has?
pain that awakens him at night
pain that is localized to the midthoracic spine
intermittent pain that has persisted for 2 weeks
a recent history of an upper respiratory infection
pain that is increased with flexion
19
Which one of the following is the most useful single maneuver to evaluate for a meniscal tear?
Lachman’s maneuver
McMurray Test
The anterior drawer test
The valgus stress test
Thessaly’s maneuver
20
A 5-year-old has in-toeing due to excessive femoral anteversion. Which of the following is appropriate management?
Sleeping in a Denis Browne splint for 6 months
Derotational osteotomy of the femur
Medial shoe wedges
Observation
Torque heels
21
A 6-year-old has a limp and left hip pain. Xray is negative and WBCs, ESR, and CRP are normal. Appropriate treatment is?
Physical therapy referral
Vancomycin
Urgent orthopedic consultation
Ibuprofen
Acetaminophen/codeine
22
Which of the following descriptions of an athletic injury is most consistent with a posterior cruciate ligament tear?
An onset of pain after a running jump
Hearing a pop in the knee during a pivoting motion
A direct blow to the anterior tibia while the knee is in flexion
An immediate onset of pain after cutting on the knee
Forceful twisting of the knee
23
Which one of these is an indication to consider ultrasound screening for developmental dysplasia of the hip in infants?
A male infant who was in a breech position until 28 weeks gestation
A large-for-gestational-age infant with a vertex presentation at delivery
A firstborn female infant with a vertex presentation at delivery
An infant with a first degree relative with developmental hip dysplasia
A firstborn male infant with a vertex presentation at delivery
24
A 16-year-old has a nondisplaced fracture of the great toe with 40% joint space involvement. The preferred treatment is?
Buddy taping
Surgical fixation
A rigid-sole shoe
A short leg walking cast with a toe plate
25
An 11-year-old has heel pain and is diagnosed with Sever's disease. Which of the following therapies is contraindicated?
Whirlpool therapy
An exercise prescription
Ice packs
Therapeutic ultrasound
Moist heat
26
In a 17-year-old female with trauma to the knee, which of the following would be an indication for radiography?
Limited range of motion to 100 degrees of flexion
Bony tenderness over the proximal tibia
Her age
The inability to take more than two steps
Her sex
27
An 8-year-old has an incomplete compression fracture of the distal radius. After splinting, you should recommend?
Repeat radiography in 4 weeks
Follow-up and reevaluation in 6 weeks
Return to activity in 3 weeks if she is pain free
Ultrasonography in 3 weeks
Referral to an orthopedist
28
An obese 12-year-old has persistent groin pain worse with activity and with decreased range of motion. The diagnosis is?
Slipped capital femoral epiphysis
Legg-Calvé-Perthes disease
Transient synovitis
Apophysitis of the anterior superior iliac spine
Adductor muscle strain
29
After an inversion injury, an athlete has midfoot pain. She can bear weight but has navicular tenderness. You should?
Recommend crutches and no weight bearing for 2 weeks
Order radiographs of the ankle only
Order radiographs of the foot only
Recommend lace-up ankle support, ice, compression, and clinical follow-up
Order radiographs of the ankle and foot
30
A 3-year-old has elbow pain after his dad picked him up by the wrist abruptly. Which of these should you recommend?
Attempted reduction of the subluxed radial head by flexion and supination
Referral to an orthopedic surgeon
Attempted reduction of the subluxed radial head by hyperpronation
Splinting and close follow-up
A radiograph of the right elbow
31
Which of the following would you recommend as a corrective intervention for rigid metatarsus adductus in a 6-month-old?
Adjustable orthotic shoes
Braces
Physical therapy
Surgical correction
Night splints
32
A 10-year-old has thoracolumbar scoliosis with a Cobb angle of 42° on radiography. Appropriate intervention is?
Genetic testing (ScoliScore)
MRI of the thoracic and lumbar spine without contrast
Referral to physical therapy
Scoliosis radiography in 1 year
Referral to a pediatric orthopedist
33
Which of the following characteristics of back pain and stiffness would make ankylosing spondylitis more likely?
An acute onset over days
Symptom relief at night
Stiffness in the late afternoon and evening
Improvement with exercise and activity
34
A 2-day-old infant has a clunk on flexion and abduction of the hip. Which of the following is an appropriate next step?
Ultrasound
Radiography
Reassurance
Pavlik harness
Referral to a pediatric orthopedist
35
A 15-year-old with wrist pain from a fall has a displaced scaphoid fracture on radiography. Appropriate treatment is?
A long arm cast
A short arm cast
A thumb spica cast
Surgical fixation
Closed reduction followed by a thumb spica cast
36
An 11-year-old's parent is concerned she has spinal curvature. Initial scoliosis evaluation should include?
determination of the Cobb angle with the patient upright
comparing the length from the pelvic brim to the pelvic floor
etermination of the Cobb angle with the patient bent over to 90°
scoliometer measurement with the patient bent over to 90°
scoliometer measurement with the patient upright
37
Which of these is likely in a 16-year-old with paresthesias of the ring and little finger worsened with wrist flexion?
Ulnar entrapment
Stress fracture of the scaphoid
De Quervain’s tenosynovitis
Flexor carpi ulnaris tendinitis
Carpal tunnel syndrome
38
A 13-year-old pitcher reports 3 weeks of non-traumatic pain to his right shoulder. Pending Xrays, you should recommend?
physical therapy
sugar-tong splints both proximal and distal to the elbow
complete rest from throwing activities
a sling and swathe
39
A patient has finger pain and an extension deformity of the DIP joint after grabbing an opponent's jersey. You should?
Splint the finger with the DIP joint in extension
Splint the finger with the DIP joint in flexion
Provide Reassurance and symptomatic care
Refer to an orthopedic specialist for surgery
Buddy-tape to the adjacent finger
40
A patient has pain and a flexion deformity of the DIP joint from a volleyball injury. Which intervention is recommended?
Reassurance and follow-up in 2 weeks
Buddy-taping to the adjacent finger
Splinting the finger with the DIP joint in extension
Splinting the finger with the DIP joint in flexion
Orthopedic referral for surgery
