CPEN Orthopedic and Musculoskeletal Emergencies Flashcards
6 cards from real CPEN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CPEN Orthopedic and Musculoskeletal Emergencies flashcards as text
Which assessment finding indicates vascular compromise in a child with a lower extremity fracture?
Answer: Absent or diminished distal pulses with pallor and coolness
Absent or diminished distal pulses combined with pallor and cool skin distal to a fracture indicates arterial injury requiring immediate intervention.
A 12-year-old male presents with knee pain and a visible bump just below the knee. He is an avid basketball player. What is the most likely diagnosis?
Answer: Osgood-Schlatter disease
Osgood-Schlatter disease is caused by traction apophysitis at the tibial tubercle insertion of the patellar tendon, common in active adolescents during growth spurts.
What is the purpose of a long arm splint versus a circumferential cast in the acute management of a pediatric fracture?
Answer: A splint allows for swelling while reducing compartment syndrome risk
Splints are preferred acutely because they accommodate post-injury swelling and reduce the risk of iatrogenic compartment syndrome from a circumferential cast.
A 7-year-old presents with acute limp and hip pain. Which condition requires urgent orthopedic evaluation due to risk of avascular necrosis?
Answer: Septic arthritis of the hip
Septic arthritis of the hip is a surgical emergency because elevated intra-articular pressure and bacterial enzymes can rapidly destroy the femoral head vascularity, causing avascular necrosis.
Which Kocher criteria combination most strongly predicts septic arthritis versus transient synovitis in a child with a painful hip?
Answer: Fever, non-weight-bearing, elevated ESR, and elevated WBC
The Kocher criteria (fever, non-weight-bearing, ESR >40, WBC >12,000) predict septic arthritis; all four positive criteria carry >99% probability of septic arthritis.
Which position of comfort is typically seen in a child with septic arthritis of the hip?
Answer: Hip flexed, abducted, and externally rotated
Children with septic arthritis of the hip hold the joint in flexion, abduction, and external rotation to maximize joint space volume and reduce intra-articular pressure.