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CPS > Active living > Flashcards

Active living Flashcards

1
Q

how much exercise if needed for children 1-4yrs?

A

180 min of structured or unstructured

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2
Q

how much screen time should 2-4 year olds have?

A

< one hour , not recommended for less than 2yrs

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3
Q

how is screen time related to obesity

A

if watch greater than 2 hours - 2X likely to be overweight
worse if low SES
if TV in bedroom

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4
Q

How much time should 5 yr old and on be spending on screen time?

A

2 hours

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5
Q

if athlete has temp or symptoms below the neck, when can they return to play?

A

until symptoms have resolved for period of 7-14 days

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6
Q

if diagnosed with mono, when can pt return to play?

A

min 3 weeks - highest risk of spleen rupture
no symptoms
normal BW
no splenomegaly - if possible on US, if not, wait another 1-2 weeks
resolution of any complications - fatigue, hepatitis…
then can return to 50% of pre illness sports

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7
Q

what is spondolysis and how does it present?

A

stress fracture of pars interarticularis
Worse with impact activity
PE: hyperlordosis, paraspinal muscle spasm, hamstring tightness

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8
Q

what is posterior element overuse syndrome

A

mechanical/muscular back pain
CP: focal tenderness at lumbar spine and paraspinal muscles, extension related pain
MGNT: Ice and NSAIDS and PT, +/- brace
PT for 4-8 weeks

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9
Q

what is vertebral apophyseal fracture?

A

repetitive flexion/extension that injures the ring apophysis
volleyball, gym, wgt lifting
need CT if think displaced
3-6 mo

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10
Q

what is the definition of concussion?

A

complex path process affecting the brain, induced by biomechanical forces and results in rapid onset of short lived impairment of neuro fct that resolves spontaneously

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11
Q

what are symptoms and signs of a concussion

A 
headache
N/V
dizziness
LOC
phonophobia
photophobia
visual disturbances
amnesia
poor coordination
decreased playin abilities
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12
Q

what are behavioural changes associated with a concussion

A 
irritable
emotional labile
sad
anxious
inappropriate
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13
Q

what are cognitive impairments associated with concussion

A 
slow reaction
poor concentration
memory issues
confusion
feeling dazed or in a fog
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14
Q

what are sleeping disturbances associated with a concussion

A

drowsiness
trouble falling asleep
sleeping more or less than usual

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15
Q

who is at risk of prolonged recovery from a concussion

A 
Hx of head/face injuries and/or concussion
ADHD or learning disabilities
migraines or family Hx
Psych issues
sleeping difficulties
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16
Q

what are the gratduated return to learn steps (5)

A
  1. cognitive rest and limited screen. no school
  2. light congnitive act lasting 15-20 min
  3. start school - half day, avoid gym, music, shop
  4. try full days, unlimited time for test
  5. Back to full
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17
Q

what are the 6 steps to return to play

A
  1. no activity
  2. light aerobics
  3. sports specific exercise
  4. non contact training
  5. full contact practice
  6. return to play
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18
Q

what are common post concussion symptoms?

A 
HA
neck pain
dizziness
sleep issues
depression or anxiety
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19
Q

what are complications of smoking during pregnancy?

A 
inc # perinatal death
placental problem
preterm
fetal growth retardation
gastroschisis
SIDS
misscarriage
learning disability
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20
Q

what are postnatal complications due to 2nd hand smoking?

A 
inc rate of LRTI
decreased lung growth
inc otitis media
inc risk of SIDS
inc risk of asthma
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21
Q

what are the 5 steps for smoking cessation?

A 
gt ready
get support
learn new skills and behaviour
get meds and use them correctly
be prepared for relapse and difficult situation
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22
Q

how do you assess if pt is ready to quit smoking

A 
5 A's
Ask about tobacco use
Advise to quit
Assess willingness
Assist 
Arrange FU
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23
Q

How do you diagnose exercise induced bronchospasm?

A

10-15% drop in FEV1 from baseline following vigorous exercise at 6-8 min and a response to beta 2 agonist

for athletes - ned eucapnic voluntary hyperventilation technique

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24
Q

what are physical signs of insulin resistance?

A 
PCOS
acanthosis nigricans
HTN
dyslipidemia
steatohepatitis
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25
Q

who should get type 2 DM screening?

A

if aboriginal AND
BMI > 85% AND
> 10 years

and >=1 :
sedentary
GDM
FHX of type 2 - first or second degree
acanthosis
dyslipidemia
HTN
PCOS
26
Q

what are the screening methods for type 2 DM

A

fasting NG > 7
random BG > 11.1
OGTT may be considered

27
Q

what are the 6 Es of injury prevention

A 
education
empowerment
enabling
engineering
enforcement
employment
28
Q

what are the effects of exercise on the immune system

A

“open Window” - brief immunosuppression post intense exercise:

  • increase neutrophils
  • increase lymphocytes
  • Increase NK cell activity
  • Ratio of CD4/CD8 decrease - ? leads to infection
  • Decrease in salivary IgA levels
  • decreased chemotaxis of neutrophils - high endurance
  • Decreased phagocytosis - high endurance
29
Q

what is the relationship between exercise and risk of infection?

A

J curve
some exercise may help prevent URTI
but high endurance athletes tend to have more URTI

30
Q

when can an athlete return to play

A
  1. “neck check” - if above the neck, can try for 10-15 min but if worsen, must stop
31
Q

if an athlete had temp, myalgia and diarrhea, when can they return to play?

A

no sports until symptoms resolve

gradual reintroduction back to play

32
Q

what is the most important complication of mono

A

splenic rupture
usually spontaneous
highest risk - d4-21

33
Q

when should an athlete with mono return to play?

A 
not for a min of 3 weeks
then resume low impact non contact at 50% pre-illness level IF:
- resolution of symp
- normalization of labs
- resolution of splenomegaly
- resolution of any complication
34
Q

what are useful tips for athletes to prevent illness

A 
eat well
get sleep
avoid over training
allow recovery time
avoid sick contavcts
wash hands frequently
do not share water bottles
get proper vaccinations
35
Q

what type of exercise can a child with JIA do?

A

aquatic and land based weight bearing exercise

36
Q

what are potential benefits of exercise for a child with JIA

A
  1. better muscle strength and fct
  2. decreased disease activity
  3. improves self efficacy
    improves energy level and QOL
    reduces pain and med use
37
Q

what are recommendations regarding exercise for a pt with hemophilia?

A
  • need apporpriate factor prophylaxis to reduce risk
  • careful assessment before being allowed to participate in contact sports
  • needs written strategies to prevent and treat bleed for coach…
  • need protective wear
  • if get a bleed, must wait until pain and swelling fully resolved
38
Q

during exercise, when does excercise induced asthma usually present

A

after 8-15 min

resolves within 60 min

39
Q

how do you Dx exercised induced bronchospasm

A

Exercise challenge:
A drop of 10% to 15% in forced expiratory volume (FEV1) from baseline, following vigorous exercise for approximately 6 min to 8 min, is diagnostic of EIB.
AND
a positive response to beta2 agonist

40
Q

how is exercise good for asthmatics

A

swimming decreases asthma morbidity
improved areobic abilities
decrease EIB severity

NO CHANGE IN PFTs!!!!!!!!!!!!!

41
Q

who is not allowed to scuba dive?

A

asthmatics with symptoms
asthmatic with abnormal PFTs
CF

42
Q

what are the benefits of exercise for pt with CF?

A 
slower deterioration in lung fct
greater survival rate
enhanced mucus clearance 
strength training inc mass and muscle strength
improved FEV1
43
Q

what are potential risks of exercise in CF

A

if severe disease, exercise may effect oxygenation and ventilation
increased bronchospasm
inc risk of hyponatremic dehydration
avoid contact if organomegaly

44
Q

why are teens predisposed to back injury?

A

inflexibility
muscle imbalance
improper training
structural differences of the spine

45
Q

what are 2 causes of back pain worse with extension?

A

spondylolysis

posterior element overuse

46
Q

what are 2 causes of back pain worse with flexion?

A

vertebral avulsion fracture

disc herniation

47
Q

how do you Dx spondylolysis?

A

Xray - scottie dog

bonse scan - uptake

48
Q

how do you manage spondylolisis

A

avoid painful mov
abdo strengthening
hip flexor and hamstring stretches
antilordotic exercises with physio
if brace - 4-8 wks and weaned over a few months
if no brace - restrict act for 3 - 6month or until pain free

49
Q

who gets avulsion fractures

A

volleyball
gymnastics
wgt lift

50
Q

how does a vertebral avulsion fracture present?

A

acute flexion related lumbar pain
limitation of flex/ext
paraspinal muscle spasm
NEED CT for Dx

51
Q

how do you manage a vertebral avulsion #

A

rest for 3-6 month!
heat
NSAIDS

52
Q

how does a disc herniation present?

A 
acute
flexion related 
hamstring tightness
butt pain
PE: decreased flexion, + straight leg raise, may have decreased rflx and strength of lower limbs
53
Q

how do you Dx and treat disc herniation

A

MRI
rest
PT for 3-6 mo
Sx if bad

54
Q

what are red flags for back pain?

A 
fever
night pain
weight loss
neuro abn
malaise
55
Q

when should an athlete consider retiring or switching to a less contact sport

A

if concussion occurs with less forcer
if results are more severe
if pt has learning disability
if due to pt playing style

56
Q

if pt has persistent HA post concussion, what are possible treatment options

A

lifestyle - hydration, sleep
avoid Tylenol/advil overuse
prophylactic treatment if magaines
neurology referral

57
Q

what can protect an athlete from concussion

A

not much

Helmets … only protect against other head injuries - skull fracture

58
Q

hypoglycemia symp at school

A 
SHort term:
affects concentration
thought porcess
behaviour 
May take 45v min for intellectual fct to return
59
Q

hyperglycemia symptoms at school

A

cognitive slowing
increased error
slow responses

60
Q

what are CPS recommendations for schools with Pt with DM

A
  • schools need at least 2 trained personale to provide support
  • each school should be provided with info on mgnt of theses pt
  • kids should be provided with clean/convenient and safe area
  • need individual care plan
  • designated staff to monitor meal
  • Do not leave them alone if hypo
  • teach what hypo looks like to staff
  • if low during test - gets 30-60 min extra
  • allow for Dr appointments

CPS (10 decks)

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