Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > PT management of lifelong conditions > Flashcards

PT management of lifelong conditions Flashcards

1
Q

Not a single disease; Encompasses all forms of arthritis that demonstrate onset prior to 16 years of age, last longer than 6 weeks, and have an unknown origin; Diagnosis is based on clinical presentation

A

Juvenile idiopathic arthritis (JIA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathogenesis of JIA?

A

Pathogenesis is not well understood; however, likely:

  • Autoimmune inflammatory condition
  • Activated by an external trigger
  • In a genetically pre-disposed individual
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common type of JIA?

A

Oligoarthritis

- low-grade inflammation in four or fewer joints, most commonly affects the knee; early childhood onset peaks 2-4 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the types of JIA?

A
  1. Systemic arthritis - throughout childhood; F=M
  2. Oligoarthritis - early childhood, peaks 2-4 years; F»>M
  3. Rh (+) polyarthritis - late childhood or adolescence; F»M
  4. Rh (-) polyarthritis - peaks 2-4 and 6-12 years; F»M
  5. Enthesitis-related arthritis - peaks late childhood or adolescence; M»F
  6. Psoriatic arthritis - peaks 2-4 and 9-11 years; F»M
  7. undifferentiated arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the S and S of JIA?

A
  1. Joint swelling, pain, stiffness
  2. Morning stiffness** - Indicates active disease; Hallmark sign
  3. Muscle atrophy; weakness; poor muscle endurance
  4. Acute or chronic iridocyclitis (typically in oligoarticular): asymptomatic inflammation of the eye that may lead to functional blindness. Treated with corticosteroids; Need to make sure child is seeing opthamologist
  5. Systemic manifestations - Severe in systemic JIA; Mild to moderate in polyarticula
  6. Decreased joint ROM secondary to soft tissue contracture
  7. Fatigue
  8. Decreased aerobic capacity; impaired exercise tolerance
  9. Growth abnormalities
  10. Osteopenia or osteoporosis- Increased with long term corticosteroid use
  11. Gait Impairments
  12. Difficulty with ADLs
  13. Activity & Participation Restrictions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the PT management of JIA?

A
  1. Control inflammation
  2. Preserve joint structure and function - Prevent secondary impairments at the joint
  3. Promote participation
  4. Educate the family and child
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the instrument commonly used to assess JIA?

A

CHAQ

  • looks at all 3 levels of ICF model
  • .143 indicates clinically important change from PT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What pain rating scales are good for assessing pain in children with JIA?

A
  1. Oucher scale
  2. Faces
  3. Rating scale
  4. poker chip tool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does PT intervention include?

A
  1. Address ROM (AROM, no stretching)
  2. Increase strength (isometric strengthening)
  3. Improve cardiovascular fitness - Decrease fatigue
  4. Promote appropriate gross motor skill
  5. Educate the family on the benefits of maintaining ROM and participating in aerobic activity as well as signs of systemic disease
  6. Provide family-centered care
  7. Use of modalities to control pain and maximize ROM
  8. Educate on the benefits of sleep
  9. Guided imagery for relaxation, distraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What surgical procedures are used in JIA?

A
  1. Soft Tissue Release - Common sites: hip flexor, ITB, hamstrings; Role of PT: preserve gained ROM through functional activities, splinting and ROM exercises
  2. Supracondylar osteotomy
    Arthrodesis
  3. Epiphysiodesis to prevent/correct leg length discrepencies
    - Post-Operative PT: Increase strength, ROM; Gait training; Educate on postoperative precautions set by physician
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the prognostic indicators for JIA?

A
  • Overall, improving functional outcomes over the past decade
  • Negative:
    1. Hip involvement and polyjoint involvement in systemic and oligo JIA within the first year of disease presence
    2. Rheumatoid Factor (+)
  • Positive:
    1. Oligo JIA has best prognosis for joint preservation and function
    2. Onset of symptoms >9 years of age in males
    3. Early and effective treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nonprogressive disorder characterized by multiple joint contractures and muscle weakness or imbalance; Incidence: 1 in 3000 to 4000; Suspected cause is a suspension of movement during the fetal periods of development, which results in contractures; Etiology is not well understood, but likely a genetic link; Association with other disease processes where the motor unit, including the anterior horn cells, is impaired.

A

Arthrogryposis Multiplex Congenita (AMC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the characteristics of AMC?

A
  1. Cylindric-shaped joints that lack creases
  2. Rigid joints, significant contractures
  3. Joint dislocation, especially at the hips
  4. Atrophy or absence of entire muscle groups
  5. Intact sensation, though deep tendon reflexes (DTRs) may be diminished or absent
  6. Symmetric presentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is typical presentation of AMC?

A
  1. Shoulder internal rotation
  2. Elbow flexion or extension
  3. Wrist flexion with ulnar deviation
  4. Hip flexion with internal rotation or a frog-legged posture
  5. Knee flexion or extension
  6. Equinovarus at the feet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the appropriate PT management of AMC?

A
  1. Passive stretching - NOT forceful– could result in joint damage; Maintain range with splints
  2. Positioning
  3. Serial casting and splinting
  4. Strengthening
  5. Promote development of motor skills - Mobility (Usually through power mobility)
  6. Post-operative rehabilitation
  7. Adaptive Equipment prescription
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the goals of PT intervention of AMC?

A
  1. Maintain range of motion
  2. Increase strength
  3. Promote participation through providing a primary mobility means
17
Q

Congenital Disorder of the Type I collagen synthesis that affects all of the connective tissues in the body; Incidence: 1 in 15,000 to 1 in 100,000

A

Osteogenesis imperfecta (OI)

18
Q

What are the characteristics of OI?

A
  1. Systemic Osteoporosis
  2. Excessive fractures at birth
  3. Bowing of the long bones
  4. Spinal Deformities
  5. Muscle weakness
  6. Ligamentous laxity -Subluxation or dislocation of joints
    - also associated with blue sclera of eyes, dentinogensis imperfecta, hearing loss, growth deficiency, cardiopulm abnormalities, easy bruising, excessive sweating
19
Q

What is the PT intervention of OI?

A
  1. Education on safe handling techniques
  2. Positioning
  3. Standing programs to promote bone mineral density
  4. Active strengthening programs
  5. Aquatic therapy!
  6. Emphasis on development of head control - Kids with OI generally have large heads
  7. Development of appropriate gross motor abilities
  8. Gait training should occur with an assistive device
  9. Prevent secondary comorbidities - Hip flexion contractures common
  10. Provide independent mobility - Manual or power wheelchair
  11. Whole Body Vibration - Assists with improving bone mineral density
20
Q

What are the goals of PT treatment of OI?

A
  1. Prevent deformity
  2. Maximize cardiorespiratory status
  3. Maximize child’s ability to engage in safe mobility and physical activity
21
Q

What are the most common childhood cancers?

A
  1. Leukemia
  2. Brain tumor
  3. Lymphoma
  4. Wilms tumor
  5. Neuroblastoma
  6. Retinoblastoma
  7. Rhabdomyosarcoma
  8. Osteosarcoma
  9. Ewing sarcoma
22
Q

Leukemia:
- Accounts for 25% of cancers in children under 15
– Classified by type of cancerous cell: ____ or ____
- Classified by how quickly the neoplasm replicates: ___ (Fast) or ____ (Slow)
Example: Acute Lympoblastic Leukemia (72% of all leukemias)

A

Lymphoid; Myeloid; Acute; Chronic

23
Q

CNS tumors:

  • Accounts for 25% of cancers in children under 10
  • Treatment = Surgery, radiation, chemotherapy

List the 6 Types (most frequent to least frequent)

A
  1. Astrocytoma
  2. Primitive Neuroectodermal tumors
  3. Medulloblastoma
  4. Brainstem glioma
  5. Ependymoma
  6. Craniopharyngioma
24
Q

Develop from the primordial neural crest cells; Responsible for 50% of infant malignancies; 2/3 of kids diagnosed with neuroblastoma are under 5 - Improved survival rates in those diagnosed younger; Generally recognized as a palpable, fixed, hard mass in the neck or abdomen; Common sites: adrenal glands, sympathetic nervous system, abdominal ganglia, sympathetic ganglia of the chest or neck; Medical Treatment: surgery, chemotherapy, radiation

A

neuroblastic tumors

25
Q

Of mesenchymal origin- Meschyme gives rise to skeletal muscle, smooth muscle, fat, fibrous tissue, bone and cartilage; Medical Treatment: neoadjuvant chemotherapy (pre-surgical), adjuvant chemotherapy (post-surgical), surgery, radiati

A

Sarcomas

26
Q

Name the types of sarcomas

A
  1. Osteosarcoma: bone tumor, most common in the long bones; teenagers at greatest risk
  2. Ewing sarcoma: bone tumor originating from neural crest cells; commonly effects the vertebral column, pelvis, ribs, and long bones
  3. Rhabdomyosarcoma: soft tissue sarcoma; commonly effects the head and neck, urinary and reproductive organs, extremities and trunk
27
Q

Name the benefit of exercise in children with cancer

A
  1. Improved hemoglobin
  2. Reduced duration of neutropenia and thrombocytopenia
  3. Reduced severity of diarrhea and pain
  4. Reduced duration of hospitalization
  5. Reduced reports of nausea
  6. Decreased emotional stress
  7. Improved lean body weight
  8. Improved physical performance
  9. Improved functional capacity
  10. Improved quality of life index
  11. Improved flexibility
  12. Decreased fatigue
  13. Improved concentration (attention)
  14. Increased skeletal mass

Pediatrics (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions