4. Pediatrics MCQs

A 12-year-old obese boy presents with sudden severe left groin pain and inability to bear weight after a minor fall. Radiographs show a severe left slipped capital femoral epiphysis. He is treated with urgent open reduction and internal fixation via a surgical hip dislocation approach to decompress the intracapsular hematoma. Which of the following is the most likely complication of this injury?

A 6-week-old female infant is treated with a Pavlik harness for a dislocated left hip (Graf Type IV). After 3 weeks of strict harness wear, ultrasound shows the hip remains persistently dislocated. What is the most appropriate next step in management?

A 5-year-old boy falls from monkey bars and sustains a widely displaced extension-type supracondylar humerus fracture. On presentation, his hand is pink and warm, but the radial pulse is absent. After prompt closed reduction and percutaneous pinning, the hand remains pink and warm, but the radial pulse is still absent. Doppler signal is present in the radial artery. Management should consist of:

A 4-year-old boy who was treated for a right idiopathic clubfoot with the Ponseti method presents with a recurrent deformity. Examination reveals active supination of the foot during the swing phase of gait and dynamic forefoot adductus. Ankle dorsiflexion is 10 degrees. What is the most appropriate treatment?

A 14-year-old girl with adolescent idiopathic scoliosis presents with a right thoracic curve of 55 degrees and a left lumbar curve of 35 degrees. On bending films, the lumbar curve reduces to 15 degrees. The apical vertebral translation of the thoracic curve is 4 cm and the lumbar curve is 1 cm. What is the correct Lenke classification curve type for this patient?

A 4-year-old boy with spastic diplegic cerebral palsy (GMFCS Level IV) is evaluated for hip surveillance. He has bilateral hip flexion and adductor contractures. Anteroposterior pelvis radiograph shows a migration percentage of 45% bilaterally. What is the most appropriate management?

A 13-year-old obese boy presents with 2 weeks of worsening left hip pain and an inability to bear weight. Radiographs reveal a severe slipped capital femoral epiphysis (SCFE). He cannot ambulate even with crutches. Which of the following management strategies carries the highest risk of avascular necrosis (AVN) in this patient?

A 6-month-old infant with achondroplasia is brought to the clinic due to episodes of central apnea, hyperreflexia, and profound hypotonia. Which of the following is the most appropriate diagnostic test to evaluate the underlying cause of these symptoms?

A 3-year-old girl is evaluated for severe bilateral genu varum. Standing radiographs demonstrate medial tibial metaphyseal beaking, a metaphyseal-diaphyseal angle of 18 degrees, and depression of the medial physis. What is the most appropriate initial treatment for this patient?

An 8-week-old female infant is being treated with a Pavlik harness for developmental dysplasia of the left hip. At her 2-week follow-up, the mother reports the infant is no longer kicking her left leg. On examination, the knee lacks active extension, but ankle and toe movements are normal. What is the most likely cause of this complication?

A 13-year-old obese boy presents with acute on chronic left groin pain and an inability to bear weight. Radiographs confirm a severe, unstable slipped capital femoral epiphysis (SCFE). Which of the following complications is most significantly increased in this patient compared to a stable SCFE?

An infant is born with bilateral idiopathic clubfeet. During the Ponseti casting technique, which of the following represents the correct sequence of deformity correction?

A 2-month-old girl is being treated for developmental dysplasia of the hip with a Pavlik harness. At her 2-week follow-up, she exhibits decreased active knee extension on the right side. The harness is noted to be holding the hips in 120 degrees of flexion. What is the most appropriate next step in management?

A 10-month-old boy presents with anterolateral bowing of his left tibia. Radiographs reveal diaphyseal sclerosis and a narrow medullary canal. Which of the following systemic conditions is most closely associated with this clinical presentation?

An infant presents at 6 weeks of age with a right-sided neck mass. Her head is tilted to the right and her chin is rotated to the left. She has limited passive cervical range of motion. Which of the following screening tests should be routinely ordered for this condition?

A 14-year-old boy with a BMI of 38 presents with left hip pain and an antalgic gait for 6 weeks. Radiographs show a mild slipped capital femoral epiphysis. He undergoes uncomplicated in situ pinning. Three years later, he presents with groin pain exacerbated by hip flexion and internal rotation. What is the most likely cause of his current symptoms?

A 6-month-old girl with developmental dysplasia of the hip is taken to the operating room for a closed reduction and spica casting. An intraoperative arthrogram demonstrates a medial dye pool of 7 mm. What is the most appropriate next step in management?