Abnormalities Flashcards
1
Q
A delay in gross motor skills during the Denver II test is indicative of what abnormality?
A
Cerebral Palsy
2
Q
The abnormality that includes non-progressive lesions in the brains motor system?
A
Cerebral Palsy
3
Q
impaired movements abnormality
A
cerebral palsy
4
Q
Cerebral palsy delays what part of development and produces what kind of abnormal performance?
A
delays gross motor development and abnormal motor performance
5
Q
Abnormal postures such as when prone: arms & legs under the body and when supine: scissoring of the legs are observed in which abnormality?
A
cerebral palsy
6
Q
Cerebral palsy affects what two areas of the mouth?
A
poor sucking and continue to tongue thrust
7
Q
name 5 abnormals related to the body with cerebral palsy
A
no control of body movements spastic floppy reflexes abnormal stiffness, rigidity
8
Q
what 3 infantile reflexes after 6 months are still present in an infant when there shouldn’t be?
A
tonic-nec
moro reflex
palmar grasp
9
Q
what type of walking is present in cerebral palsy
A
tip-toe walking
10
Q
describe the crawling for an infant with cerebral palsy
A
crawling using only arms and not legs
11
Q
describe the arms for an infant with cerebral palsy
A
arms are abducted and flexed
12
Q
main cause in cerebral palsy
A
cerebral anoxia
13
Q
pre-existing brain abnormalities are present with what abnormality?
A
cerebral palsy
14
Q
name the 6 high-risk items an infant with cerebral palsy may have
A
LBW, ELBW, prematurity, low APGAR scores at 5 minutes, intracranial hemorrhage, infection.
15
Q
the most common type of cerebral palsy?
A
spastic
16
Q
describe the muscles in spastic cerebral palsy and its consequence if not corrected.
A
muscles are in continuous muscle contraction and if not treated, causes contractures leading to bone deformities
17
Q
describe the infant with cerebral palsy motor performance and abnormal posture.
A
child stands & walks on toes
when prone: hips higher than trunk with legs & arms flexed and drawn up
when supine: scissoring
18
Q
loss of what is present with cerebral palsy?
A
loss of normal movement
19
Q
due to what 3 things is associated with spastic cerebral palsy?
A
due to: hypoxia, hemorrhage, poor muscle tone
20
Q
name the 6 types of spastic cerebral palsy
A
hemiparesis quadriparesis diplegia monoplegia triplegia paraplegia
21
Q
hemiparesis spastic CP
A
one side affected in the body
22
Q
quadriparesis spastic CP
A
all 4 limbs affected
LE>UE
and trunk affected
23
Q
which of the 6 spastic types of CP is the most severe disability?
A
quadriparesis
24
Q
the type of spastic cp in which similar parts on both sides of the body (i.e. both arms); bunny hop. All 4 extremities, legs more than arms
A
diplegia
25
affects only one extremity in spastic CP
monoplegia
26
affects only the lower extremities in Spastic CP
paraplegia
27
Classes of CP (name both)
athetoid and dyskinetic/dystonia
28
the class of CP that includes abnormal involuntary movements that are slow, wrathing, and involve all extremities (includes face, neck, etc)
athetosis
29
describe dyskinetic class of CP
disorder in the muscle tone/jerkings/increased when the child is tired, excited, or irritated.
30
give the difference b/t athetosis and dystonia (dyskinetic) class of CP
athetosis: slow & continuous (worm-like)
| dystonia/dyskinetic: abnormal sudden movements
31
give another class of CP
ataxis
32
describe ataxis class of CP
disturbed coordination
wide-based gait
lack of balance & coordination
difficult to do anything
33
what is the cause of ataxis class of CP?
cause: defect in cerebellum
34
name the 5 associated disabilities with CP
```
intellectual impairment
seizures
vision px
hearing px
communication/speech
```
35
give the percentage for intellectual impairment associated with CP
70% NL
36
give the age range for children with CP that are bound to experience seizures
ages 2-6
37
the kind of seizures a child with CP would get
spastic seizures
38
give the two vision px while a child that has CP
amblyopia & nystagmus
39
treatment for CP
very individualized for each patient
40
name some tx for CP concerning communication & locomotion
speech therapy, braces, wheelchair (quadriplegia)
41
medications for CP
antiepileptics
| muscle relaxants
42
name the 4 common muscle relaxants medications for CP
baclofen
botox (Botulinum toxin type A for paralysis)
Diazepam (valium)
Phenytoin?
43
name the two treatments for CP that promote optimal motor functioning.
Physical therapy & OT
44
correcting defects for children with CP include what two things?
tendon lengthening & correcting scoliosis.
45
the last treatment option you can do for someone with CP
provide educational opportunities
46
give the cause of congenital hypothyroidism
typically caused by underdeveloped thyroid
47
what organ does not stimulate thyroid in congenital hypothyroidism?
the pituitary
48
there is a deficiency in what with congenital hypothyroidism?
iodine deficiency
49
moms use of what drug during pregnancy can cause congenital hypothyroidism?
anti-thyroid drugs
50
12 symptoms associated w/congenital hypothyroidism
```
"Good baby syndrome"
poor feeding
weight gain
lethargy
hoarse cry
dry hair/skin
large anterior fontanel
short
puffy eyes
large protruding tongue
hypotonia
constipation
```
51
first thing affected without early detection of hypothyroidism
intellectual disability
52
neonatal screening of what item helps detect hypothyroidism
screening for T4
53
treatment drug for hypothyroidism
levothyroxine (Synthroid)
54
one thing associated with taking thyroid hormone?
life-long replacement of the drug
55
give the dose proportion, and time the drug levothyroxine has to be give to a child with hypothyroidism
proportionally larger than adult and it has to be given as a single dose every morning at the same time
56
give levothyroxine before how much time before eating breakfast?
30 minutes before feedings
57
give the child's dose for levothyroxine
25-50 mcg/kg/day
58
how to prep levothyroxine
crush drug, use medicine dropper
59
do not give levothyroxine with what?
soy, calcium, iron, or formula
60
give 7 toxic symptoms associated with hypothyroidism
```
weight loss
tachycardia
fever, sweats
irritability
S&S of hyperthyroidism
insomnia
dyspnea
```
61
give 6 symptoms that will indicate insufficient thyroid hormone
```
weight gain
sleepiness
decreased appetite
constipation
S&S of hypothyroidism
creatinism
```
62
give the condition that indicates genetic, autosomal recessive trait
PKU (phenylketonuria)
63
babies with PKU are missing what enzyme to do what drug
missing the enzyme that converts phenylalanine to tyrosine
64
what enzyme in PKU when in large quantities can cause seizures?
Phenylalanine
65
what enzyme (related to PKU) aids in CNS development?
tyrosine
66
without tyrosine, what is not produced in the body?
melanin
67
children with PKU have a problem with?
pigmentation
68
describe what a child with PKU would look like
blonde
blue eyes
susceptible to skin problems
69
give the characteristic a child with PKU would give in sweat an urine
a musty, mousey odor
70
8 signs & symptoms of PKU
```
intellectual diability
frequent vomiting
FTT
seizure activity
tremors
jerky movements
hyperactive
irritability
```
71
a lab value greater than what will result in intellectual disability with PKU?
greater than 15 mg/dL
72
you want results for phenylalanine in PKU to be what?
73
PKU is diagnosed using what test at birth?
Guthrie Test
74
what must you make sure of before the test for PKU is given?
baby must have several feeding of formula/breast milk before the test
75
give the time range for testing for the presence of PKU
48-72 hours after birth
76
when does the test for the presence of PKU usually occur?
typically until day that the baby goes home
77
what action will you take if the test for PKU comes back positive?
repeat the exam
78
treatment for PKU
lifelong; controlling the intake of phenylalanine in diet
79
what is the goal range in controlling phenylalanine in diet for life?
3-10 mg/dL for life
80
what should you avoid if you have PKU?
avoid dietary proteins
81
what two foods given is low in phenylalanine?
fruits & juices
82
what foods are high in phenylalanine and should be avoided in those with PKU?
meats, dairy, eggs, nutrasweet, artificial sweeteners, and asparatime
83
what substance can be given to infants d/t they cannot eat solids
Lofenelac
84
when eating solids, how should one keep his diet who has PKU?
Phenyl-free when eating solids
85
pregnant women will have to do what if they have PKU?
due to high maternal phenylalanine levels having a teratogenic effect, pregnant women will have to go back on diet
86
what problems will be evident in infant if mom during pregnancy does not control her intake of phenylalanine?
microcephaly
| intellectual problems
87
mental retardation has been replaced with what term now?
intellectual disability
88
give the range for mild intellectual disability
55-70
89
give the 3 criteria/items in mild intellectual disability?
slow development
can learn with special education
can achieve social/vocational self-maintenance
90
give the range for moderate intellectual disability
40-55
91
give the 4 criteria/items under moderate intellectual disability
delays in motor development
responds to training
poor communication
sheltered
92
determining intellectual disability is based on what test?
IQ test
93
give the range for severe intellectual disability
25-40
94
give the 4 criteria/items under severe intellectual disability
helps self minimally
habit training
some understanding of speech
dependent on others
95
give the range for profound intellectual disability
under 25
96
give the four criteria/items under profound intellectual disability
minimally functional
shows basic emotional responses
unable to care for self
requires nursing care
97
name the condition that is the most common chromosomal disability
down syndrome
98
trisomy 21 is associated with what condition?
down syndrome
99
down syndrome is more likely to occur when?
increased r/o getting down when mom has children past the age of 35
100
major symptom in down syndrome?
intellectual disability
101
symtoms/signs in down syndrome (8)
```
low set ears
slanted eyes
transverse palmar creases
flat nasal bridge
protruding tongue
epicanthal folds
hypotonia
small square head
```
102
in what 3 ways could you increase development potential with down syndrome
increase stimulation
increase praise
increase participation in stimulation
103
at what age range in development could you see down syndrome affecting?
1-4 years
104
if child is hospitalized and the child has down syndrome, what should you continue to do?
maintain his normal routine when hospitalized
105
Down syndrome children will require what during their lifetime (give % & the defect)
30-40% will have congenital heart defects requiring surgery
106
as children with down grow name the symptoms that may arise (7)
```
dementia
cataracts
hearing loss
feeding difficulties
respiratory px
males are usually infertile
females may be able to have children (50%) but there is a r/o child born with down as well
```
107
name the condition with x-linked recessive disease (more common in what sex)
muscular dystrophy (more common in boys)
108
clinical manifestations in muscular dystrophy
Lordosis
109
lordosis, manifested in muscular dystrophy is defined as what?
abnormal curvature of the spine
110
name the 5 items you will see in a boy will muscular dystrophy concerning his gait
```
wadding gait
toe walking
frequent falls
difficulty in rising from floor
difficulty in climbing stairs
```
111
gowers sign is related to what condition and is manifested as what?
muscular dystrophy and is manifested as hands are walking up the childs legs to help him get into a standing position
112
in muscular dystrophy what is evident about the boys calf?
fat deposits replaced wasted calf (gastrocnemius) & muscle-pseudohypertrophy
113
clinical manifestations concerning the eye and lungs with muscular dystrophy
drooping of the eyelid later in life and respiratory px late in life
114
muscular dystrophy (occurs commonly in boys) is due to the increase of what enzyme?
Creatinine phosphokinase (CK)
115
what kind of testing can be done in muscular dystrophy?
genetic testing
116
delayed what in muscular dystrophy and what age does it occur?
delayed motor development at 2-6 years in boys with muscular dystrophy
117
most common and the worse type of muscular dystrophy
Duchenne's
118
muscular dystrophy is due to the deficiency or absence of what enzyme?
dystrophia
119
degeneration of muscles is associated with what abnormality?
muscular dystrophy
120
the degeneration of muscles in muscular dystrophy causes what?
muscles atrophied, become woody d/t fatty infiltrates
121
name 4 diagnostic tests that can be performed with muscular dystrophy
muscle biopsy
serum enzyme measurement
serum CK in early disease
genetic testing
122
give the age range in which delays for boys with muscular dystrophy will occur
2-6 years
123
progression of muscular dystrophy will have the boy likely to be wheelchair bound at what age?
12 years
124
death is likely to occur at what age with boys that have muscular dystrophy? by what complication?
death will likely occur to boys with muscular dystrophy at age 20 due to respiratory infections
125
treatment for boys with muscular dystrophy (5)
```
supportive-rehab
respiratory px
range of motion
avoid obesity
steriods- predisone
```
126
floppy infant syndrome is also known as?
spinal muscular dystrophy type I "SMA"
127
autosomal recessive for both male & female abnormality is called what?
Werding-Hoffman Disease
128
what abnormality destroys motor neurons controlling voluntary muscle movements?
Werding-Hoffman disease
129
symptoms for this abnormality occur at 6 months
Werding-Hoffman disease
130
Males/Females will Werding-Hoffman disease will likely experience death at what age?
most die before the age of 2
131
Respiratory failure will cause death in this abnormality
Werding-Hoffman Disease
