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Pediatrics > Ped Cases Test 1 (Kaylee and Becky) > Flashcards

Ped Cases Test 1 (Kaylee and Becky) Flashcards

(92 cards)

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1
Q

What is the gestational age + chronological age called?

A

post- conceptual age

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2
Q

A baby is born at 28 weeks, 1 month ago. How old is the babies chronological age?

A

1 month

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3
Q

A baby is born at 30 weeks and since then 4 months have passed, what is the babies adjusted age?

A

4 months - 10 weeks.

Between 1 and 2 months old

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4
Q

Purpose of a posterior-wheeled walker?

A

promotes upright posture

decreases forward lean

promotes EXTENSION

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5
Q

Medical management of extremely premature and very low weight infants (under 1500g) includes what 4 things

A

surfactant administration

respiratory support

parental and enteral nutrition

early caffeine initiation

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6
Q

What level evidence does kinesiotaping and using a TOT collar for torticollis have?

A

C

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7
Q

What is neuropraxia

A

temporary nerve conduction block d/t stretching of nerves

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8
Q

T or F: Premature birth alone predisposes infant to neurodevelopmental delays

A

T

they can have whitematter abnormalities that persist into school age

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9
Q

What are the 2 major factors that impact survival/health status of extremely premature infants?

A
  1. Gestational age (most important)
  2. Birth weight

others: male sex, multiple births, lack of antenatal steroids

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10
Q

What should the first intervention be for infants with torticollis

A

PROM

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11
Q

What are the 5 sections of the apgar test

what is considered a normal score?

What is low?

A
  1. respiratory effort
  2. heart rate
  3. mm tone
  4. reflexes
  5. skin color (all scored 0-2)

7-10 is good

under 6 is considered low

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12
Q

What is patent ductus arteriosus (PDA)

A

failure of ductus arteriosus to close, causing heart failure, redistribution of systemic blood flow, reduced renal and cerebral flow

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13
Q

Breathing disorder in newborns caused by immature lungs w/ insufficient surfactant

rapid, shallow breathing and sharp pulling in of chest between each breath

A

Neonatal respiratory distress syndrome

need mechanical ventilation and surfactant

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14
Q

Common pregnancy complication that places mother at risk of mortality and risk of brain injury, clotting issues, and organ problems.

Marked by hypertension and protein in urine

A

preeclampsia

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15
Q

What is bronchopulmonary dysplasia

A

large alveoli and abnormal pulmonary vasculature, infant will require supplemental O2 for atleast 28 days

most common cause of chronic lung disease in infants

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16
Q

Erbs palsy causes what position of the arm

A

Waiters tip

shoulder ADD+IR

elbow Ext, forearm pronation

wrist and finger flexion

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17
Q

What is apnea of prematurity (AOP)

A

Absence of respiration for more than 20 seconds

usually accompanied by bradycardia and/or oxygen saturation

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18
Q

What are the 3 subgroups of brachial plexus injury, which is most common?

A

Upper = Erb’s palsy C5-C6 maybe C7 (MOST COMMON)

Lower = Klumpke Palsy - C7-T1 (LEAST COMMON)

Total = erb-klumpke palsy - c5-t1

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19
Q

What is the neonatal unit that provides the highest level of comprehensive care for critically ill infants

A

Level 4 neonatal intensive care

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20
Q

in the NICU case, it is stated that Tummy time should be _____ per day

A

30 minutes

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21
Q

Resolution of CMT is achieved when an infant has _________ (Discharge!)

A

Full PROM within 5 degrees of other side

midline head/trunk

symmetric AROM

Achieved age appropriate motor skills

parents have good understanding of what to monitor

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22
Q

Infant is below 10th percentile for it’s gestational age

A

Intrauterine growth restriction

Can be symmetric or head-sparing

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23
Q

A 5 month old has a 25 degree PROM restriction of L rotation with an SCM mass, what is the grade

A

Early grade 3 severe

early because 6 months

grade 3 severe because SCM mass present

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24
Q

Risk factors for CMT

A

Large baby

Breech Birth

Decreased intrauterine space

primiparity

male

foreceps/vacuum delivery

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25
What is Cranial Vault Asymmetry?
Measurment of cranial asymmetry by obtaining the shortest and longest diagnol from the forehead to posterior skull (Longest-shortest)/Longest gives you the fraction of asymmetry
26
What kind of brace is used to treat equino varus/clubfoot
Foot abduction brace. Straightlaced shoes or boots connected w/ attachment bar allowing LE to be held in 70 degrees hip ER and 10 degrees of ankle DF
27
what is craniosynostosis
premature closure of cranial suture requires referal to neuro surgeon
28
What is the muscle function scale
6 point scale used to measure lateral cervical flexion strength in infants older than 2 months
29
When an infant with CMT should be referred to a specialist: When condition is the same after ______ of treatment __________ months of treatment with only moderate results infant older than _________ infant has __________ restriction of ROM Infant is ____________ or older with a SCM mass
4-6 weeks 6 months older than 1 year 10-15 degrees 7 months
30
Ponseti method for correcting club foot
Serial casting technique to realign talus in TC joint Several above knee casts -> percutanous achilles lenghtening -> joint is casted for 3 weeks -> child wears foot adduction brace for 23 hours a day for 3 months they will wear this brace up to 5 years old for atleast 10-12 hours a day
31
What are the indicators that an infant needs surgery for OBP injury
Lack of bicep function lack of shoulder ER and forearm supinators
32
Precaution for kids with club foot in PT
Stress fractures after serial casting avoid high impact activities (running, jumping, hopping) identify and prevent compensatory strategies during high level WB activities
33
What is the arm position and what muscles arent working in a child with Klumpke palsy (lower OBPP)
Intact shoulder and elbow Paralysis of wrist flexors, extensors, and hand muscles involved arm is held in supination with a poor grasp
34
What bacterial infection present in a woman can be passed to infant during delivery if infant is infected they are at risk for pneumonia, sepsis, and meningitis
Group B streptococcal infection
35
What is a TOT collar?
tubular orthosis for torticollis provides noxious stimulus to lateral aspect of skull to promote midline head position
36
What are the 2 biggest predictors of outcome in a premature population?
1. (most important) Gestational age 2. birth weight
37
Infants receiving treatment for CMT prior to age of ______ have excellent outcome
3 months
38
contraindications and precautions for treating children with OBPP
Any movement or PT assessment of UE during rest period (7-10 days after birth) Aggressive movements that overstretch UE Treatment and HEP: precaution related to joint dislocation/sublux
39
precautions related to premature infants
1. monitor vitals and behavioral cues 2. monitor medical lines and tubes 3. determine whether physiologic cost of exam outweights benefits
40
Will a child with clubfoot be able to squat well?
No they will have secondary complications due to hip and knee weakness even later on
41
precautions for CMT
passive stretching of cervical structures may be contraindicated if other conditions present passive stretching can cause snapping of SCM in 8% of infants
42
common gait pattern that indicates relapsing clubfoot
early heel rise after inital contact with intoeing during stance phase
43
anatomical position of club foot that is not completely corrected
Retracted PF first ray, forefoot adduction that does not correct past neutral prominent base of the fifth met on palpation
44
Appropriate HEP to give a child with clubfoot
balance on one foot
45
club foot position
Talus rotated medially on calcaneus short medial longitudinal arch long lateral column of the foot
46
AIMS is for children of what age
0-18 months
47
signs and symptoms of clubfoot
difficulty to squat early heel rise, weight shift onto uninvolved side intoeing during stance phase (IR Is never normal in the gait pattern)
48
What is a breech birth
baby comes out feet or bottom first
49
What is oligohydramnios
decreased amount of amniotic fluid during pregnancy
50
next step for ITW if conservative treatment doesn't work
serial casting
51
four criteria to have a formal diagnosis of DCD
below age average performance in daily activity requiring motor coordination motoric disturbances interfere with academic performance or ADLs all other conditions causing coordination problems ruled out coordination difficulties are significantly more than developmental cognitive level
52
precautions for treating ITW
pain or spasms related to overstretching plantarflexors (especially in serial casting)
53
What is dyspraxia
impaired ability to perform coordinated movement
54
What 2 neuro behavioral disorders occur with DCD
ADHD and ADD
55
How long should a child wear a foot adduction brace after corrected through ponseti method
up to 5 years noncompliance can cause reoccurrence of clubfoot
56
What muscles are short and what muscles are long in clubfoot?
Long: fibularis muscles Short: medial muscles
57
What is the first indication of clubfoot relapse
intoeing during gait
58
precautions for PT for kids with DCD
close positioning of PT to child during training of gross motor skills safety during all movements due to potential impulsivity
59
Involuntary movements that occur when a person is engaged in difficult movement typically observed in children up to 8. After this time, these movements indicate CNS damage
associated reactions
60
What is the CO-OP program
designed to remediate motoric skills in children with developmental coordination disorder by using motor learning and dynamic systems framework
61
approach designed to address posture and movement disorders encourages inhibition of atypical or abnormal movement patterns and facilitation of typical patterns to promote skill development
NDT neuro developmental treatment
62
What apgar scores are associated with CP
Scores of 6 and below taken at 1 and 5 minutes after birth
63
3 clusters of DCD
Ideomotor dyspraxia with movement deficits, problems with imitation, dynamic balance, and handwriting visual spatial and visual construction dyspraxia, deficits in both visual motor skills and handwriting mixed dyspraxia
64
classification system for self initiated mobility for kids with CP
Gross motor functional classification system includes sitting, walking, and wheeled mobility
65
What is the federal legislation that establishes school based services for students 3-21 years with disabilities
Individuals with disabilities education improvement act PART B (IDEA)
66
for infants/toddlers with IDEA PART C services, what is the multidisciplinary assessment of family resources, priorities, and needs of child and individual service plan to meet these needs
individualized family service plan IFSP Reviewed every 6 months, evaluated once a year
67
Best therapy approach for kids with DCD
task-oriented
68
the prevalence of CP is higher in babies born before ________ gestation
28 weeks
69
What is the federal service that established early intervention for services for toddlers and infants w/ disabilities 0-3 and their families
IDEA part C
70
PT precautions for kids with CP
monitor skin integrity closely be close to child during gait/transfers safeguard due to potential impulsivity
71
Though CP is not a progressive disorder, what secondary complications can progress overtime
Contractures skeletal deformities decreased strength limited endurance osteopenia/porosis
72
for children who are non-ambulatory, _________ reduces spasticity, improves bone density, hip stability, social interaction, and alertness (Grade B evidence)
supported standing programs
73
Valid tool to assess participation for young kids with CP valid tool for assessing difficulty of caregiving for kids with CP
Child engagement in daily life CEDL Ease of caregiving for children measure
74
4 diagnoses to rule out for ITW?
CP Duechennes muscular dystrophy Autism Sensory Processing disorder
75
_______ supplementation has significantly reduced the incidence of spina bifida, and lack of said nutrient is a risk factor for spina bifida
Folic acid
76
mild asymptomatic form of spina bifida
spina bifida occulta (no herniation of meninges)
77
what is the most severe form of spina bifida
spina bifida myelomeningocele (part of the spinal cord has herniated out)
78
What is the most common sign of VP shunt failure
headache
79
Complications due to ________ are the leading cause of death in people with spina bifida
arnold chiari malformation note: second most common cause of decline (not death) in children is tethered cord syndrome
80
The most common orthopedic problems associated with spina bifida are...
Foot deformities Scoliosis
81
T or F: Children with spina bifida causing hydrocephalus have lower IQ and impairments in social language and peer interactions
T
82
What kind of PT treatment is best for children with spina bifida who struggle with wheelchair mobility
strengthening of UE
83
The _______ is a reliable and valid assessment tool that can measure change in function over time in the functional ability of children with spina bifida.
WeeFIM
84
Which of the following is true about ambulation in children with spina bifida? A. They are never able to ambulate and rely on wheeled mobility to access the community. B. They can ambulate independently with an assistive device. C. Their ability to ambulate is dependent on the level of the spinal cord lesion. D. Their ability to ambulate is related to the presence of hydrocephalus.
C, their ability to ambulate is dependent on the level of spinal cord lesion
85
What is Pervasive Developmental Disorder Not otherwise specified PDD-NOS
Classification for children with atypical autism not otherwise specified
86
What is stereotypy
Ritualistic movement pattern seen in children with ASD Secondary to ASD diagnosis
87
Precautions for ASD in PT,
Cues and warnings may be needed for transitioning between activities to avoid overstimulating child
88
Children with ASD have been noted to have difficulty with what motor movement
Head lag in infancy Motor coordination deficits Low muscle tone Difficulty with symmetrical movements Apraxia
89
What outcome measure is used for children with autism
Movement assessment battery for children - good for balance BOT 2- good for biannual coordination
90
What are two methods of therapy that have gained popularity with treating ASD
Aquatic therapy Riding therapy Also: repetitive play activities
91
Which outcome measure is reliable for evaluating bilateral coordination in children with ASD
BOT-2
92

Pediatrics (28 decks)

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