Term
HLA DR3 and HLA DR4 increase risk to diabetes
which ones reduce risk? |
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Definition
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Term
| talipes equinovarus features and mx |
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Definition
males to females 2:1
can be familial or idiopathic,
can associated with oligohydramnios
can be due to neuromuscular disorder like spin bifida
associated with DDH
mx: plaster casting and bracing AKA ponsetti method for many months
if unsuccessful corrective surgery is needed |
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Term
| osteochondritis of the patellar tendon at the knee. what is the eponymous name? |
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Definition
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Term
| chondromalacia patellae features |
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Definition
affect adolescent females especially when standing up from sitting or going up stairs
they may also be hyper mobile and have flat feet
rx: rest and physio |
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Term
| stress fracture of the pars interarticularis of the vertebra is also known as? |
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Definition
| spondylolisis/spondylolisthesis |
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Term
red flags for back pain in children
LEARN |
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Definition
young age
high fever
night waking from pain
painful scoliosis
focal neuro signs
associated weightless and systemic signs |
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Term
| transient synovitis 'irritable hip' features |
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Definition
2-12 years old
often follows or accompanied by viral infection
sudden onset hip pain or limp
no pain at rest but decreased ROM especially internal rotation
pain may be referred to knee
child afebrile or mild fever, does not appear ill
mx: bed rest and analgesia. rarely skin traction
px: improves within a few days
in small proportion proceeds to perches disease.
hard to distinguish this from early septic arthritis, if in doubt take joint aspiration and blood cultures |
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Term
| difference between transient synovitis and septic arthritis |
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Definition
in septic arthritis:
child looks ill, hip held in flexion, severe pain at rest and worse on any attempt to move it
in irritable hip:
child looks well, comfortable at rest, limited internal rotation and pain on movement |
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Term
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Definition
avascular necrosis of capital femoral epiphysis
mainly affects boy 4-10 years
insidious presentation with limp, hip or knee pain
ix: X-ray including frog view, bone scan and MRI may be helpful
mx: if identified early and <50% femoral head affected then bed rest and traction
if more severe: femoral head needs to be covered by the acetabulum to act as a mould for the reossyfying epiphysis. this is done by keeping hip in abduction using plaster cast or callipers OR by femoral or pelvic osteotomy
potential for arthritis in later life |
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Term
| slipped epiphyseal features |
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Definition
posterior-inferior displacement of the epiphyses of the femoral head
needs prompt rx to prevent avascular necrosis
most common 10-15 years age during adolescent growth
common in obese boys and association with metabolic endocrine abnormalities (hypothyroid and hypogonad)
presentation: limp or hip pain, may be referred to knee.
onset: acute, insidious or following minor trauma
exam: restriction abduction and internal rotation of hip
dx: confirmed by X-ray
mx: surgical with pin fixation in situ |
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Term
| what position would a infant with septic arthritis hold their leg? |
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Definition
flexed
abducted
externally rotated
no spontaneous movement (psuedoparalysis) |
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Term
child has nocturnal wakening with leg pain
DDX |
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Definition
growing pains or osteoid osteoma is child is normal
leukimia, lymphoma or neuroblastoma is child has anemia, bruising, irritability or infections |
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Term
sudden limp in otherwise young well child
DDX? |
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Definition
transient synovitis
perthes disease |
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Term
fever, erythematous rash, red eyes, irritability in infant or young child <5 years with oedema of hands and feet, oral mucositis and cervical lymphadenopathy
DDX |
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Definition
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Term
irritability, fever, reluctance to move in infant.
stiff back 'tripod' sitting
DDX |
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Definition
discitis
verterbal osteomyelitis |
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Term
hip pain in obese adolescent boy
ddx |
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Definition
| slipped capital femoral epiphyses |
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Term
| in osteogenesis imperfecta, which is the most common type and which is the lethal type? |
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Definition
type 1 most common
type 2 is lethal |
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Term
| what is the name for marble bone disease? |
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Definition
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Term
symmetrical headache
gradual onset
described as a band or tightness
usually no other symtptoms |
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Definition
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Term
| migraine without aura features |
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Definition
accounts for 90% of migraine
uni or bilateral
usually accompanied GI disturbance
pulsatile pain over frontal or temporal areas
may be associated photophobia or phono phobia (sound) |
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Term
| raised ICP and space occupying lesion features |
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Definition
headache worse when lying down or coughing or straining
morning vomiting
night time wakening
change of mood, personality, school performance
visual field defects
torticolis
abnormal gait
growth failure
papilloedema |
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Term
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Definition
| a seizure accompanied by fever in the absence of intracranial infection due to bacterial meningitis or viral encephalitis. |
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Term
| features of febrile seizures |
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Definition
affect 3% of children
6months and 5 years
family predisposition
generalised tonic clonic
30-40% will have further febrile seizures
does not cause brain damage
1-2% chance of epilepsy in the future |
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Term
| which lobe seizures may lead to jacksonian march? |
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Definition
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Term
| which lobe seizures are the commonest focal seizures? |
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Definition
temporal lobe seizures
aura beforehand
lip smacking
jamais vu
deja vu |
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Term
| in which seizures is there always a loss of consciousness? |
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Definition
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Term
| what signs might one experience with parietal lobe focal seizures? |
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Definition
| contralateral altered sensation |
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|
Term
focal seizures signs
frontal
temporal
occipital
parietal |
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Definition
frontal - motor phenomena
temporal - auditory or sensory
occipital - visual phenomena
parietal - contralateral altered sensation |
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Term
|
Definition
4-6 months
hysparryhtmia on EEG
flexor spasms of head, trunk and limbs
reversal in developmental milestones
rx: vigabatrin or corticosteroids
most develop learning difficulties and epilepsy |
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Term
there is an association between bells palsy and coarction of aorta
true or false? |
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Definition
true
if the facial weakness is bilateral then sarcoidosis or lyme disease should be suspected. |
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Term
| subdural haematoma and retinal haemorrhages in an infant. ddx? |
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Definition
| non accidental injury causes by shaking or direct trauma |
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Term
| grossly enlarged head and 'setting sun sign' in eyes is suggestive of? |
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Definition
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Term
| cutaneous manifestations of tuberous sclerosis |
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Definition
ash leaf patches
shagreen pathces over lumbar spine
adenoma sebaceum in a butterfly distribution on face |
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