MVU EXAM WITH CORRECT ANSWERS

MVU EXAM WITH CORRECT ANSWERS Rovsing's sign - ANSWER- apply pressure to left lower abdomen, pain is felt in right side of abdomen when pressure is released, may indicate acute appendicitis. Positive anterior/posterior drawer test indicates injury of what ligament(s) - ANSWER- anterior or posterior cruciate ligament Osgood-Schlatter disease - ANSWER- initial treatment stretching boys more than girls most common in children who participate in sports ages 10-14 years usually self limiting treatment recommendations for sprained ankle - ANSWER- apply cold for 20 minutes then take off for 30-45 minutes, repeat for first 24-48 hours Rest, Elevation, Compression. (RICE) Legg-Calve-Perthes - ANSWER- Frog leg xray is BEST to diagnose Idiopthic osteonecrosis of femoral head 4x more common in males Hip pain, knee pain or painless limp that is worse at the end of the day. Disorder that happens in adolescents after undergoing rapid growth spurt the prior year (tall boys) - ANSWER- Osgood-Schlatter Disease Occurs ages 4-8 uncommon in african americans Unilateral in 90% of cases Most often in males - ANSWER- Legg-Calf-Perthes Legg-Calf Perthes diagnostic test - ANSWER- AP and frog leg lateral--increased density of the femoral head. Treatment is referral to ortho Viral Gastroenteritis - ANSWER- Most common complication in children--dehydration Tx. small frequent amounts of oral rehydration solution. Normal blood sugar in children - ANSWER- 90-130 Suspected growth hormone deficiency - ANSWER- ***Initial eval should include thyroid function, screen for hypoglycemia and GI illness**** Short and slow growth Child like faces with prominent forehead CBC, SED rate, UA, growth factor, IGF-1, IGFBP-3 Evaluation of Isolated menarche - ANSWER- ***Sexual abuse should be ruled out first*** other causes vaginal tumor, functional estrogen producing ovarian cyst, and primary hypothyroidism Isolated or recurrent vaginal bleeding in a prepubertal female in the absence of appropriate secondary sexual characteristics, or a known pathological cause - ANSWER- Isolated menarche What is essential for a child's mental health? - ANSWER- Predictable home childcare and school routines migraine headache - ANSWER- unilateral pulsing pain in the head that may or may not be accompanied by an aura; may be associated with vertigo, nausea, vomiting, photophobia, vision changes, is aggravated by physical activity. Associated with family history. How long does a migraine headache last? - ANSWER- 2-72 hours Tension Headache - ANSWER- pain is like a band squeezing the head dull, frontal, occipital pain non pulsating no n/v not aggravated by physical activity bilateral pain How long does a tension headache last? - ANSWER- days to weeks Cluster headache - ANSWER- cyclic clusters around eyes How long does a cluster headache last? - ANSWER- Weeks to months Allergic headache (Sinus) - ANSWER- Frontal region with sinus involvement Usually other allergy symptoms Secondary headaches (s/s of brain tumor) - ANSWER- Headache wakes child at night Pain worse in the morning when rising Vomiting without nausea Increased pain with straining or sneezing Occipital and neck pain Edema of optic disc Mental status changes Red flags for headaches - ANSWER- SNOOPS S-systemic symptoms or disease N-Neurologic s/s O-Onset sudden O-onset before age 5 or after age 50 P-Pattern changes from prior HA's Diagnostic testing for headaches - ANSWER- Headache diary CT only if tumor suspected Differential Dx for headaches - ANSWER- Sinusitis Trigeminal neuralgia Pseudotumor cerbri sleep disorder hyperthyroidism hypertension cyclic vomiting abdominal migraine BPV TMJ Headache treatment - ANSWER- Reduce triggers lower caffeine intake consistent sleep increase fluids exercise NSAIDS prophylactic CCB's Tricyclics abortive tx in adolescents triptans iron deficiency anemia - ANSWER- most common cause, poor dietary intake 25% of children between 10-15 months of age microcytic hypochromic anemia - ANSWER- iron deficiency anemia low levels of red blood cells that are also paler than usual. Iron deficiency anemia - ANSWER- Infants fed cows milk before 12 months of age at risk Tx fortified cereals and formula breastfed infants usually have adequate supply till 4-6 months S/S of Iron Deficiency anemia - ANSWER- Weakness, irritability, Headaches, poor feeding, anorexia, PICA, poor weight gain PE: Pallor, spoon shaped nails (Koilonychia), can be unremarkable Tx of iron deficiency anemia - ANSWER- Oral iron, limit milk to encourage iron rich food intake Thalassemia trait - ANSWER- This produces mild microcytic anemia of thalassemia but rbc will be increased. Most common with HGB higher than 9 Risk factor for Depression in Children - ANSWER- Separation anxiety Depression Screening tool - ANSWER- PHQ-9 **(used for age 11 and up)** Sign of PTSD in children - ANSWER- Extreme temper tantrums in preschool age children Slipped Capital Femoral Epiphysis - ANSWER- occurs when the head of the femur becomes displaced due to a separation at the growth plate Slipped Capital Femoral Epiphysis Risk Factors - ANSWER- Obesity Male Sports Femoral retroversion hypothyroidism average age of presentation 12 for girls 13 for boys