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376 Cards in this Set
- Front
- Back
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difference between a tendon and a ligament |
tendon connects a muscle to bone
ligament connects a bone to a bone |
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these anatomical structures are pouches of synovial fluid that cushions the movements of tendons and muscles over the bone
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bursae
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common example of a fibrous joint
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skull sutures
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which type of joints are located in the vertebral bodies of the spine
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cartilaginous
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function of the nucleus pulposus
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shock absorber
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characterized by saddle anesthesia and urinary retention (with overflow incontinence)
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cauda equina syndrome
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most common cause of sudden onset of severe pain in a joint in adults
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septic arthrtitis or gout
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most common cause of sudden onset of severe pain in a joint in children
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osteomyelitis
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joint stiffness combined with fibromyalgia is suggestive of what
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polymyalgia rheumatica
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what is "gelling"
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degenerative joint disease characterized by stiffness and limited motion lasting only a few minutes; this commonly happens after a period of inactivity
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butterfly rash on cheeks
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SLE
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scaly rash (plaques) with pitting of the nail
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psoriasis (psoriatic arthritis)
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papules, pustules, and/or vesicles over a reddened rash on the distal extremities
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gonococcal arthritis
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target-like rash followed by expansion
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Lyme disease
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hives are most linked to what
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drug/allergic reaction or serum sickness
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maculopapular rash beginning at head and moves downward
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rubella
(rubeola in addition to the rash would have Koplik spots and conjunctivitis) |
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joint pain coinciding with diarrhea and abdominal pain
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IBS (seronegative spondyloarthropathies)
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risk factors for osteoporosis
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postmenopausal
older than 50 weight < 70kg (150lbs) family history history of fractures alcohol delayed menarche or early menopause smoking low vitamin D corticosteroid use for >2 months inflammatory disorders |
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audible clicking when opening/closing jaw
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TMJ dysfunction
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rotator cuff muscles
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supraspinatus
teres minor infraspinatus subscapularis |
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ratio of movement in the glenohumeral joint vs. scapulothoracic joint
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2:1
(first 90 degrees is GH, next 60 is ST, and last 30 is GH) |
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where do the rotator cuff muscles insert
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all insert on the greater tubercle of the humerus except the subscapularis (lesser tubercle)
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which rotator cuff muscle(s) abduct
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supraspinatus
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which rotator cuff muscle(s) internally rotate
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subscapularis
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which rotator cuff muscle(s) externally rotate
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teres minor and infraspinatus
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only rotator cuff muscle NOT directly palpable
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subscapularis (inserts anteriorly)
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MOST commonly injured rotator cuff muscle
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supraspinatus
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muscles mediating shoulder flexion
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anterior deltoid
pectoralis major coracobrachialis biceps brachii short head |
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normal shoulder flexion ROM
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180 degrees
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normal shoulder extension ROM
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80 degrees
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muscles mediating shoulder extension
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latissimus dorsi
teres major posterior deltoid triceps long head |
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normal shoulder abduction ROM
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180 degrees
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normal shoulder adduction ROM
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90 degrees
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muscles mediating shoulder abduction
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supraspinatus
middle deltoid serratus anterior |
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muscles mediating shoulder adduction
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pectoralis major
coracobrachialis lattisimus dorsi teres major subscapularis |
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muscles mediating shoulder internal rotation
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subscapularis
anterior deltoid pectoralis major teres major latissimus dorsi |
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muscles mediating shoulder external rotation
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infraspinatus
teres minor posterior deltoid |
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OMM tests to assess rotator cuff muscles
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Neers
Hawkins Drop-arm Empty-can |
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"Cross-over" test assesses what joint
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AC joint
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test to assess general shoulder ROM
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Apley scratch test
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major action of the brachioradialis
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flexion
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function of the lumbricals
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flexion at the MCP joints
extension at the PIP joints |
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innervation to the lumbricals
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median nerve- 1st and 2nd lumbricals
ulnar nerve- 3rd and 4th lumbricals |
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function of the dorsal and palmar interossei
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dorsal interossei- abduct
palmar interossei- adduct |
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innervation to the interossei muscles of the hand
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ulnar nerve
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roof of the carpal tunnel
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flexor retinaculum
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location of Heberden's nodules
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DIP joints
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location of Bouchards nodules
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PIP joints
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rheumatoid arthritis spares which hand joints
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spares the DIPs
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pannus formation is suggestive of what
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RA
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is the pain of RA worse in the morning or night? what about osteoarthritis?
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RA- worse in the morning
osteoarthritis- worse at night |
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what is a Colles fracture
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fracture of the distal radius
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tenderness and inflammation over the extensor and abductor tendons of the thumb
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De Quervain's tenosynovitis
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chronic medical conditions linked to carpal tunnel syndrome
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rheumatoid arthritis
diabetes hypothyroidism pregnancy |
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distribution of the median nerve in the hand
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provides sensation to the palmar side of the 1st, 2nd, 3rd, and half of the 4th digit, as well as the nail beds of the 2nd/3rd digits and half of the 4th digit
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distribution of the ulnar nerve in the hand
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provides sensation to the palmar and dorsal sides of half of the 4th digit and entire 5th digit
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distribution of the radial nerve in the hand
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provides sensation to the dorsal side of the first 3 digits NOT including the nail beds
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OMM test to assess thumb movement while checking for tenosynovitis
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Finkelstein's test
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special tests for carpal tunnel
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Tinel, Phalen, and Prayer tests
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action of the splenius capitus
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neck extension (also is the "headache" muscle)
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forward displacement of a vertebrae relative to the one below it
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spondylolithesis
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scotty dog fracture
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spondylolysis
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tenderness directly over the SI joint
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ankylosing spondylitis
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nerve and muscle associated with winging of the scapula
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long thoracic nerve and serratus anterior m.
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hairy patch over spine in lower back
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spina bifida occulta
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cafe-au-lait spots, skin tags, and fibrous tumor
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NF type 1
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nerve roots that contribute to the sciatic nerve
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L4-S3
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sciatic nerve lies between what 2 bony anatomical landmarks
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greater trochanter and ischial tuberosity
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primary flexor of the hip
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iliopsoas
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primary extensor of the hip
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gluteus maximus
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major abductors of the hip
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gluteus minimus and medius
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the "stance" phase represents what percent of a normal gait
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60%
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the "swing" phase represents what percent of a normal gait
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40%
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wide based gait
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cerebellar dysfunction
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waddling gait suggests what pathology
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hip dislocation or arthritis
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Most gait abnormalities occur during which gait phase
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the "stance" phase
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leg shortening with external rotation
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hip fracture
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vertebral level of iliac crest
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L4
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how are the femoral vessels organized going lateral -> medial
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Nerve
Artery Vein Lymph ("NAVEL" -> Nerve, Artery, Vein, Empty space, Lymph) |
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inguinal ligament connects to what 2 bony landmarks
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ASIS and pubic tubercle
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internal rotators of the hip
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gluteus medius and minimus
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external rotators of the hip
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obturators, quadratus femoris, gemelli
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adductors of the hip
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adductor brevis/longus/magnus
also the pectineus and gracilis |
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insertion of the patellar tendon
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tibial tuberosity
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lateral collateral ligament connects what
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lateral femoral epicondyle to head of the fibula
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connects the posterior portion of the tibia to the anterior portion of the femur
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PCL
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connects the anterior portion of tibia to the posterior portion of the femur
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ACL
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positive patellar grind test
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chrondromalacia or patellofemoral syndrome
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knee condition linked to excessive kneeling
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prepatellar bursitis ("housemaid's knee")
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Baker's cysts are linked to what chronic medical condition
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rheumatoid arthritis
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"bulge signs" and "balloon signs" are suggestive of what
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effusion in the knee
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test to assess meniscus injury
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McMurray test
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Valgus stress test assesses what ligament
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MCL
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Varus stress test assesses what ligament
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LCL
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Lachman test and anterior drawer test assesses what ligament
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ACL
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what is the Ottowa ankle rule
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after trauma, inability to bear weight after 4 steps with tenderness over the posterior aspects of either malleolus suggests an ankle fracture
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tenderness over the 3rd and 4th metatarsal head on the plantar surface
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Morton's neuroma
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MOST common nerve roots affected in sciatica
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L5 and S1
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does sciatica pain go below the knee
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yes
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nocturnal neck pain unrelieved by rest is suggestive of what
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metastatic malignancy
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pseudoclaudication pain in the legs and back that occurs with walking and is relieved by rest
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lumbar spinal stenosis
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immunization given right at birth
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Hepatitis B vaccine
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when are Apgar scores taken
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1 and 5 minutes after birth
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what is considered an acceptable Apgar score after 5 minutes
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8 or greater
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5 criteria assessed by the Apgar score
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heart rate
respiratory effort muscle tone reflex irritability color |
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what do the various grades for each criteria of the Apgar score represent
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HR: 0 (absent), 1 (<100), 2 (>100)
Respirations: 0 (absent), 1 (slow and irregular), 2 (normal and strong) Muscle tone: 0 (flaccid), 1 (flexion of the arms and legs), 2 (active movements) Reflex irritability: 0 (no response), 1 (grimace), 2 (grimace and cough) Color: 0 (blue/pale), 1 (pink body with blue extremities), 2 (pink all over) |
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small for gestational age is considered as what percentile? what about large for gestational age
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small for gestational age: <10th percentile
large for gestational age: >90th percentile |
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large gestational neonates are most commonly associated with what maternal condition
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diabetes
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what is a breech baby
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baby is born either butt or feet first; legs and head are extended
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when should a baby start walking
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1 year
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when should a baby start crawling
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10 months
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when can a baby start saying mama/dada
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6-7 months
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most effective method to measure a neonate's BP
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Doppler method
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normal systolic pressure at birth
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70 mmHg
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average HR at birth
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140
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normal range for the respiratory rate at birth
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30-60
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how does fever affect respiratory rate
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every 1 degree of fever increases respiratory rate 10 per minute (same concept for HR)
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2 conditions associated with cutis marmorata
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congenital hypothyroidism and Down syndrome
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what is acrocyanosis
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blue cast of the hands/feet when exposed to cold- common in the first few days of life
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if the acrocyanosis doesnt disappear, what should be expected
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congenital heart disease
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best areas to look for central cyanosis
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tongue and oral mucosa
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what is vernix caseosa
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cheesy white material composed of sebum and desquamated epithelial cells that covers the body and canals at birth
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how long does physiologic jaundice last in the newborn
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1 week
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when does physiologic jaundice of the newborn usually first appear
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2-3 days after birth
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what does jaundice within hours after birth suggest
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hemolytic disease of the newborn
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what does jaundice that persists for 2-3 weeks after birth suggest
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biliary obstruction or liver disease
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port wine stains commonly occur over the distribution of what nerve
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the opthalmic branch of CN V
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significant edema of the hands and feet in a newborn girl
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Turner syndrome
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scattered vesicles on an erythematous base resulting from obstructed sweat glands that disappears within weeks after birth
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Miliaria rubra
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vesiculopustules over a brown macular base seen in black infants
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pustular melanosis
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enlarged posterior fontanelle is seen in what condition
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congenital hypothyroidism
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depressed anterior fontanelle
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dehydration
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what is caput succedaneum
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swelling over the occipitoparietal region
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what is plagiocephaly
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asymmetry of the cranial vault that occurs when an infant lies mostly on one side
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what is craniosynostosis
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premature closure of the cranial sutures
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upslanting palpebral fissures
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Down syndrome
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downslanting palpebral fissures
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Noonan syndrome and Treacher Collins
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Chvostek sign suggests what
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hypocalcemia (tetanus)
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pathologic eye lesions suggestive of Down syndrome
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Brushfield spots
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chemical linked to chemical conjunctivitis
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silver nitrate
(instead use erythromycin) |
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normal visual acuity after 1 year
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20/50
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white light reflex is suggestive of what
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retinoblastoma
cataracts retinal detachment chorioretinitis |
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small, deformed, low-set ears at birth
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renal disease
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what are Epstein's pearls
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tiny white/yellow mucous retention cysts located along the posterior midline of the hard palate
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Macroglossia, hypoglycemia, omphalocele
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Beckwith-Widemanns syndrome
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what is the thoracoabdominal paradox (Hoover sign)
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inward movement of the chest and outward movement of the abdomen during inspiration
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congenital cardiac conditions in which symptoms manifest very soon after birth
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transposition, pulmonary valve atresia, pulmonary stenosis, Ebstein's malformation
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increases pulses/pressure in the UE and decreased in the LE
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coarctation of the aorta
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most common arrhythmias in the neonates
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APCs and VPCs
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common heart sound heard in infants that is abnormal in adults
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S3
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how many umbilical arteries and how many umbilical veins does an infant have
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2 umbilical arteries and 1 umbilical vein
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what is the condition called when breast tissue begins growing in the 1st year of life
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premature thelarche
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healthy liver size in newborn
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6cm
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2 common scrotal masses seen in newborns
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hydroceles and inguinal hernias
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ambiguous genitalia in female newborn
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congenital adrenal hyperplasia
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most commonly fractured bone in children and neonates
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clavicle
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2 tests to assess the integrity of the hips in the newborn
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Ortolani and Barlow tests
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MOST common congenital foot abnormality
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talipes equinovarus (club foot)
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how can you test hearing in the newborn
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acoustic blink reflex
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how can you test CN V in a newborn
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test the rooting and sucking reflexes
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how can you test CN VII in a newborn
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observe facial movements while the baby is crying
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how can you test EOM in a newborn
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smile at the baby and watch its eyes as it tracks your smile
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progressive increase in DTRs throughout the first year of life
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cerebral palsy
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is Babinski reflex normal in a newborn
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yes (up to 1-2 years old)
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when does the palmar grasp disappear
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3-4 months
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what is the Moro reflex
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holding the baby supine and abruptly lower the body about 2 feet to give the sensation that the baby is falling-- the arms should abduct and extend, the hand should open, and the legs should flex
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when does the Moro reflex disappear
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3-4 months
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what is the tonic neck reflex
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with baby supine, turn head to one side-- the extremities on the side the head is facing will extend and the opposite extremities will flex
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when should the tonic neck reflex disappear
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2 months
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persistance of the Moro reflex suggests what
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cerebral palsy
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persitence of the palmar and plantar grasp reflex
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pyramidal dysfunction
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what is the rooting reflex
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stroking the side of the mouth causes the baby to turn its head and suck
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when does the rooting reflex disappear
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3-4 months
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what is the trunk incurvation (Galants) reflex
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hold the baby prone and stroke one side of the back-- the spine will curve towards that side
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what is the Landau reflex
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holding the baby prone, the head should lift up and spine should straighten
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what is the parachute reflex
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holding the baby prone and lowering its head towards a surface should cause its extremities to extend in a "protective" fashion
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when can a child jump in place and balance on one foot
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3-4 years
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when should a child be speaking in sentences
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age 3
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when should a child's speech be fully understandable
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age 4
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when should a child be able to play peek-a-boo
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age 1
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when should a child be able to dress itself
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age 4-5
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permanent teeth discoloration in children is linked to what drug
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tetracyclines
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reversible black teeth discoloration is linked to what exposure
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iron exposure
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strawberry tongue in children (infection?)
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streptococcal pharyngitis
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cause of acute epiglottitis
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H. influenzae
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MOST common cancer in children
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ALL
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what is Still's murmur
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a benign grade I-II/VI murmur in children
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main cause of precocious puberty
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pituitary tumors
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how do you elicit the cremasteric reflex
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stroke the medial aspect of the thigh
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Gower's sign is significant of what
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muscular dystrophy
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nodules in the breasts of adolescent girls
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cysts or fibroadenomas
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adolescent boys with enlarged breasts
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gynecomastia
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staging to assess stage of puberty in men and women
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Tanner's stages
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Tanner stage characterized by projection of the areola and nipple forming a secondary mound
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stage 4
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Tanner stage characterized by initial elevation of the breast and nipple as a small mound with enlargement of the areolar diameter
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stage 2
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Tanner stage characterized by vellus hair around the genitlia
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stage 1
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Tanner stage in which pubic hair beings spreading over the pubic symphysis
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stage 3
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Tanner stage in which the penis grows mostly in length
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stage 3
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Tanner stage in which the glans develops
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stage 4
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Tanner stage in which scrotal skin darkens
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stage 4
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Tanner stage in which pubic hair begins forming sparsely
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stage 2
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Tanner stage in which pubic hair reaches medial thighs
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stage 5
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what vertebral level do you place the plumb line at
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C7
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things assessed in preparticipation sports physical
|
step 1: strand up straight, assess front
step 2: ROM of neck step 3: shrug shoulders step 4: hold arms out to side against resistance step 5: internal/external rotation of shoulder step 6: flexion/extension at elbow step 7: pronation/supination of forearm step 8: make a fist, spread all fingers step 9: squat and duck walk step 10: strand straight up, assess back step 11: bend over and check for scoliosis step 12: stand on heels then toes |
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MOST common arrhythmia in children/teens
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paroxysmal SVT
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erythema, scaling, dry skin, and intense itching
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atopic dermatitis (eczema)
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bright red rash involving the intertriginous folds with "satellite lesions" in infants
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candidal diaper dermatitis
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rash secondary to diarrhea in infants
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diaper rash (contact diaper dermatitis)
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diagnostic term for dry rough warts on hands
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verruca vulgaris
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diagnostic term for small, flat warts
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verruca plana
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characterized by open and closed comedones on the face, back, chest, and groin
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acne
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scaling, crusting, and hair loss along the scalp
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tinea capitis
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subperiosteal hemorrage that presents within the first 24 hours of life; involves the cranial bones
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cephalohematoma
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bulging of the anterior fontanelle and "setting sun eyes"
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hydrocephalus
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trigonocephaly is premature closure of which suture
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metopic
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scaphocephaly is premature closure of which suture
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parietal
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frontal plagiocephaly is premature closure of which suture
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unilateral coronal
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occipital plagiocephaly is premature closure of which suture
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unilateral lambdoid
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brachycephaly is premature closure of which 2 sutures
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coronal and metopic
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when a child is born, a PE reveals 5% in size, microcephaly, short palpebral fissures, and a widened/flattened philtrum; after a year, his parents believe he is developing slowly based on other children his age
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fetal alcohol syndrome
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a neonate is noted to have a low-set hair line, sparse eyebrows, and an enlarged tongue; his cry is noted to be hoarse, and he has mottled skin; knowing the features of this condition, he is at an increased risk for umbilical hernias and retardation... diagnosis???
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cretinism (congenital hypothyroidism)
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signs of congenital syphilis
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saddle nose, rhinitis, circumoral rash, fissures on the lips, saber shins, and Hutchinsons teeth
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edema and discoloration of the lower orbitopalpebral grooves
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allergic rhinitis
|
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what is the allergic salute
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pushing the nose upwards constantly to relieve a frequent runny nose
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white plaques on the tongue and oral mucosa that do NOT rub off
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oral candidiasis (thrush)
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MOST common penile abnormality
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hypospadias
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MOST common cause of periorbital cellulitis in an infant
|
H. influenzae
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what is a Boxer's fracture
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displaced 5th metacarpal
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MOST common cause of death in newborns
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congenital/chromosomal abnormalities
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what's the time frame to be considered a newborn or neonate
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up to 1 week
|
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what's the time frame to be considered an infant
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1 week - 1 year
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what's the time frame to be considered a toddler or in early childhood
|
year 1-5
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what's the time frame to be considered in late childhood
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year 6-12
|
|
|
what's the time frame to be considered in adolescence
|
year 13-18
|
|
|
which immunoglobulins are present in breast milk
|
IgA
|
|
|
What is the Ballard scoring system used for
|
to estimate gestantional age
|
|
|
90% of Mongolian spots are in what race
|
African Americans
|
|
|
how do you perform Barlow's test
|
hip is flexed and thighs are adducted; push posteriorly on shaft of femur and femoral head will dislocate posteriorly (positive sign)
|
|
|
barrel-chested child
|
severe asthma or cystic fibrosis
|
|
|
shield chest with wide spaced nipples
|
Turner syndrome
|
|
|
location of Still's murmur
|
L sternal border
|
|
|
classic findings in Tetralogy of Fallot
|
VSD (L->R)
pulmonary (infundibular) stenosis RVH overriding aorta |
|
|
what will an xray in someone with tetralogy of fallot show
|
boot shaped heart
|
|
|
will someone with tetralogy of fallot have a murmur
|
yes, a harsh systolic ejection murmur on the L sternal border
|
|
|
observable symptoms of tetralogy of fallot
|
sudden severe cyanosis, dyspnea, and mental status changes
|
|
|
full-term newborn appears severely cyanotic immediately at birth
|
transposition of great arteries
|
|
|
only way someone can live with transposition of great arteries
|
they must have a VSD or ASD
|
|
|
which congenital heart defects do NOT cause cyanosis
|
all L->R shunts (VSD, ASD, PDA), as well as coarctation
|
|
|
coarctation is associated with what genetic condition
|
Turner syndrome
|
|
|
PE palpatory finding in someone with coarctation
|
rib notching
|
|
|
is there a murmur in coarctation
|
yes, heard best on the back
|
|
|
is there a murmur in PDA
|
yes, machinery-like murmur
|
|
|
DOC to close a PDA
|
indomethacin
|
|
|
ASD is MOST common in what genetic disorder
|
Down syndrome
|
|
|
fixed and wide split S2
|
ASD
|
|
|
MOST common congenital heart defect
|
VSD
|
|
|
pulmonary HTN causes shunt reversal leading to cyanosis in what condition
|
Eisenmenger's
|
|
|
when do the posterior and anterior fontanelles close
|
posterior fontanelle closes first when the child is 2 MONTHS old
anterior fontenelle close when the child is 2 YEARS old |
|
|
high arched palate in child with no history of cleft palate
|
Marfan syndrome
|
|
|
abnormal protruding tongue
|
hypothyroidism or Down syndrome
|
|
|
common childhood tumor palpable in abdomen
|
Wilms tumor
|
|
|
sausage shaped mass in RUQ and current jelly stool
|
intussusception
|
|
|
common age group for intussusception
|
3-18 months old
|
|
|
2 year old presents with painless rectal bleeding
|
Meckel's diverticulum
|
|
|
What are the "Rules of Two" in Meckel's diverticulum
|
Most common findings include:
-2 years old -2% of the population -2 inches in length -2 feet from the end of the small intestine -2 types of tissue- stomach and pancreatic -2x more common in males |
|
|
longstanding constipation in child
|
Hirschsprungs
|
|
|
where is a stork's bite found
|
back of the neck
|
|
|
where is an angel's kiss found
|
eyelids or lips
|
|
|
what is trichotillomania
|
pulling out one's own hair due to stress and anxiety
|
|
|
reflex used to test for esotropia or exotropia
|
Hirschberg light reflex
|
|
|
when should visual acuity first become 20/20 in a child
|
age 6
|
|
|
chest caves in at sternum
|
pectus excavatum
|
|
|
chest protrudes out at sternum
|
pectus carinatum
|
|
|
comprimised blood flow to the femoral head leading to tissue destruction and deformity; common in young boys
|
Legg-Calves-Perthes
|
|
|
very painful knee condition characterized by apophyseal traction injury at the tibial tubercle in teenage boys
|
Osgood-Schlatter disease
|
|
|
decreased enamel is teenage girls
|
eating disorder
|
|
|
leukoplakia in teenager
|
most likely smokeless, chewing tobacco use
|
|
|
maneuvers to help calrify murmurs
|
Valsalva and squatting
|
|
|
athlete takes a blow to the head and displays transient confusion for less than 15 minutes with NO loss of consciousness
|
grade 1 concussion
|
|
|
athlete takes a blow to the head and displays transient confusion for more than 15 minutes with NO loss of consciousness
|
grade 2 concussion
|
|
|
athlete takes a blow to the head, loses consciousness, and upon awakening, displays transient confusion
|
grade 3 concussion
|
|
|
Which diseases are reportable
|
HAV
HBV HCV HIV Salmonella Shigella Syphilis Measles Mumps AIDS Rubella TB Chickenpox Gonorrhea |
|
|
leading cause of death in teenagers
|
accidental injuries
|
|
|
when is parental consent NOT required for a pediatric patient
|
emergencies
prescribing contraceptives treating STDs medical care during pregnancy managing drug addiction **Note that parental consent IS required for an abortion** |
|
|
when would a pediatric patient NO longer be considered a minor
|
if they are married, self-supporting, have children, are in the military, or are emancipated
|
|
|
A pediatric patient wishes to know more about his/her illness; what's the next step?
|
first ask the parents how much they have disclosed to their child about the illness and go from there
|
|
|
pediatric patient requests an abortion; what's the next step?
|
this requires parental consent; unless patient is at medical risk, NEVER advise to have an abortion
|
|
|
pediatric patient is pregnant and wants to keep the child, but the parents want to give it away; what's the next step
|
follow the wishes of the patient in this scenario
|
|
|
definition of low birth weight
|
<2500g
|
|
|
baby has rooting reflex and orients to your voice; what's the age?
|
1-3 months old
|
|
|
baby can hold his head up on his own and has a social smile; the Moro reflex has disappeared; what's the age?
|
3 months
|
|
|
baby can sit without assistance and can crawl; he has developed stranger anxiety; what's the age?
|
7-9 months
|
|
|
baby can walk on its own and no longer has a Babinski reflex; what's the age?
|
15 months
|
|
|
baby can only speak a few words and just developed separation anxiety; what's the age?
|
15 months
|
|
|
child can climb stairs and stack 3 blocks; what's the age?
|
1 year
|
|
|
child can stack 6 blocks and speak in 2 word sentences; what's the age?
|
2 years
|
|
|
child can stack 8-9 blocks and is beginning to toilet train; what's the age?
|
3 years
|
|
|
child can ride a tricycle and can copy line or circle drawings; what's the age?
|
3 years
|
|
|
child knows roughly 900 words and is speaking in complete sentences; what's the age?
|
3 years
|
|
|
child can draw stick figures and hop on 1 foot; what's the age?
|
4 years
|
|
|
child can play cooperatively with peers, has imaginary friends, grooms himself, brushes his own teeth, and dresses himself; what's the age?
|
4-5 years
|
|
|
child wakes up screaming in the middle of the night but can't remember it the next morning
|
night terrors
|
|
|
night terrors are in which stage of sleep
|
stages 3,4
|
|
|
DOC for bedwetting
|
imipramine
|
|
|
repeated stimulation leads to decreased response
|
habituation
|
|
|
common defense mechanism seen in children when a younger sibling is born, the older child begins wetting the bed again
|
regression
|
|
|
depression in infants due to separation from caregiver
|
anaclitic depression
|
|
|
signs of child abuse
|
multiple healed fractures, cigarette burns, subdural hematomas, bruising, retinal hemorrhages, retinal detachment
|
|
|
symptoms of anaclitic depression
|
decreased muscle tone
poor language skills poor socialization skills lack of trust weight loss illness |
|
|
caregiver purposefully evokes illness in their child
|
Munchausen by proxy
|
|
|
child begins throwing temper tantrums and displays object permanence; what's the age?
|
year 2
|
|
|
embryologic cause of transposition of the great arteries
|
failure of the AP septum to SPIRAL
|
|
|
embryologic cause of tetralogy of fallot
|
SKEWED development of the AP septum
|
|
|
embryologic cause of truncus arteriosus
|
PARTIAL development of the AP septum
|
|
|
congenital heart defects in DiGeorge syndrome
|
truncus arteriosus and tetralogy of fallot
|
|
|
embryologic cause of congenital heart defects in Down syndrome
|
endocardial cushion defect
|
|
|
congenital heart defect in the infant of a diabetic mother
|
transposition of the great arteries
|
|
|
pediatric patient's voice changes into hypernasal speech
|
submucosal cleft palate
|
|
|
pediatric patient's voice changes into a nasal voice with snoring
|
adenoidal hypertrophy
|
|
|
pediatric patient's voice changes into a hoarse voice with coughing
|
viral infection (croup)
|
|
|
while looking in a child's mouth who complains of a sore throat, the back of the throat appears to be "full of rocks"
|
tonsillitis
|
|
|
FIRST and MOST COMMON ligament affected in lower back pain
|
iliolumbar ligament
|
|
|
MOST common cause of low back pain
|
accidental injury (70%)
|
|
|
movements that worsen the pain of sciatica
|
bending over, sneezing, coughing, straining during bowel movements
|
|
|
positive straight leg test
|
disc herniation
|
|
|
causes of lumbar spinal stenosis
|
degenration of the vertebrae
thickening of the ligamentum flavum narrowing of the spinal canal |
|
|
congenital spasm of the neck muscles
|
torticollis
|
|
|
what is whiplash
|
rapid neck flexion followed by rapid neck extension
|
|
|
MOST common cervical nerve root herniation
|
C7
|
|
|
flexion of the neck causes a pain sensation to shoot down the spine
|
Lhermitte's sign
|
|
|
disease characterized by chronic inflammation of the synovial membranes
|
RA
|
|
|
condition characterized by progressive loss of cartilage and formation of new bone
|
osteoarthritis
|
|
|
MOST common location of gout
|
metatarsal joint of the big toe (podagra)
|
|
|
are gout attacks more common at night or the morning
|
during the night
|
|
|
triggers of acute gout attacks
|
alcohol and excessive food intake (especially food high in protein)
|
|
|
DOC for acute gout
|
colchicine or indomethacin
|
|
|
DOC for chronic gout in someone who overproduces uric acid
|
allopurinol
|
|
|
DOC for chronic gout in someone who undersecretes uric acid
|
probenecid
|
|
|
dermatologic manifestation of gout
|
tophi
|
|
|
vascular disease linked to polymyalgia rheumatica
|
temporal arteritis
|
|
|
widespread musculoskeletal pain characterized by various trigger and tenderpoints
|
fibromyalgia
|
|
|
MOST common tendon affected in tendinitis of the shoulder
|
supraspinatus tendon
|
|
|
maximal point of tenderness in rotator cuff tendinitis
|
below the tip of the acromion
|
|
|
difference in common age distribution in rotator cuff tendinitis vs. calcific tendinitis of the shoulder
|
rotator cuff tendinitis: teenagers and athletes, more common in men
calcific tendinitis: older adults, more common in women |
|
|
maximal point of tenderness in bicipital tendinitis
|
in the bicipital groove near the long head
|
|
|
dull, achy pain in the shoulder characterized by progressive loss in ROM
|
adhesive capsulitis
|
|
|
OMM treatment for adhesive capsulitis
|
Spencer tenchnique
|
|
|
MOST direction of dislocation of the humerus
|
anterior and inferior
|
|
|
positive apprehension sign
|
dislocated humerus
|
|
|
difference between a separated and dislocated shoulder
|
dislocated shoulder: dislocation of the humeral head
separated shoulder: tearing of the AC and CC ligaments (more serious) |
|
|
50 year old patient presents with tenderness and pain on his elbow; PMH is remarkable for rheumatoid arthritis and chronic gout
|
olecranon bursitis
|
|
|
tennis elbow
|
lateral epicondylitis
|
|
|
golfer's elbow
|
medial epicondylitis
|
|
|
cause of lateral epicondylitis
|
repetitive pronation/supination of the forearm
|
|
|
cause of medial epicondylitis
|
repetitive wrist flexion/extension
|
|
|
specific finger deformities seen in chronic rheumatoid arthritis
|
Boutonniere and Swan-neck deformities
|
|
|
initial sign of Dupuytren's contracture
|
thickened plaque overlying the flexor tendon of the ring finger
|
|
|
round, nontender swelling along the tendon sheaths of the dorsum of the hand
|
Ganglion cysts
|
|
|
does acute tenosynovitis in the fingers have pain on extension or flexion
|
pain on extension
|
|
|
injury to the fingertip resulting in an infection in the enclosed fascial spaces of the finger pad
|
a felon
|
|
|
how does the 1st metatarsal and big toe deviate in hallux valgus
|
1st metatarsal deviates medially
big toe deviates laterally |
|
|
Is morton's neuroma painful
|
yes
|
|
|
are heel/bone spurs painful
|
usually NO
|
|
|
when is plantar fasciitis MOST painful
|
the morning
|
|
|
difference between a corn and a callus
|
corns form over THIN skin
calluses form over THICK skin |
|
|
what is a hammer toe
|
hyperextension at the metatarsalphalangeal joint
hyperflexion at the PIP joint |
|
|
MOST common toe to develop a corn
|
5th digit (pinky toe)
|
|
|
MOST common toe to develop an ingrown toenail
|
1st digit (big toe)
|
|
|
painless ulcer on the foot
|
neuropathic ulcer secondary to diabetes
|
|
|
t-score to diagnose osteoporosis
|
>2.5
|
|
|
fatality rate in elders who sustain a hip fracture
|
20%
|
|
|
muscles for ankle eversion
|
peroneus longus and brevis
|
|
|
where is the anserine bursa
|
1-2 in. below the knee joint on the medial surface
|
|
|
the Achilles tendon attaches what 2 muscles
|
gastrocnemius and soleus
|
|
|
complication of fractured scaphoid
|
avascular necrosis
|
|
|
9 tendons in the carpal tunnel
|
4 from the FDP
4 from the FDS 1 from the flexor pollicis longus |
