Atypical Development

Question 1

What is key for POC for toe walkers?

Answer 1

PROM

Question 2

When is eye dominance typically established?

Answer 2

6 years

Question 3

When is hand dominance established?

Answer 3

4-6 years

Question 4

When is leg dominance established?

Answer 4

6 years

Question 5

When can you do MMT?

Answer 5

8 years
(Usually not before 5 years)

Question 7

What pain scale is used for age 3 and older?

Answer 7

Wong-Baker Faces Pain Rating Scale

Question 8

What age is the verbal analog scale for?

Answer 8

10+

Question 9

What ages is the FLACC observation scale for?

Answer 9

Infants, preschoolers, and non-verbal

Question 10

What is CMT?

Answer 10

Nonprogressive unilateral contracture of SCM

Question 11

Asymmetries of ___ to ___ deg in hip abduction may indicate hip dysplasia

Answer 11

5-10 deg

Question 12

Prognosis for CMT is considered to be better if conservative treatment is begun before ___

Answer 12

1 year

Question 13

WS activities on ball should be done for CMT after/around ____ months.

Answer 13

3-4 months

Question 14

Plagiocephaly vs. brachycephaly

Answer 14

Plagiocephaly - mishappen
Brachycephaly - flatten

Question 15

When does the anterior fontanelle close?

Answer 15

7-18 months

Question 16

When does the posterior fontanelle close?

Answer 16

1-2 months

Question 17

Mechanical factors for DDH?

Answer 17

Small intrauterine space
Breech
Fetal hip against mom’s sacrum

Question 18

Physiologic factors for DDH?

Answer 18

Maternal estrogen and relaxin

Question 19

Incidence of subluxation vs dislocation DDH

Answer 19

Subluxation - 1/100
Dislocation - 1/1000

Question 20

What is the gold standard for confirming hip dysplasia?

Answer 20

Ultrasound

Question 21

What is the most consistent clinical sign of hip dysplasia in neonates?

Answer 21

Hip abduction limitation or asymmetry

Question 22

____% incidence of CMT with DDH
____% incidence of clubfoot with DDH

Answer 22

CMT - 20%
Clubfoot - 10%

Question 23

How to Eval DDH

Answer 23

Galeazzi - uneven knees in hooklying
Barlow - flex & abduction to adduction with posterior force —> dislocate
Ortolani - flex & adduction to abduction with traction force —> reduce

Question 24

Barlow and Ortolani are typically done until ___ months of age

Answer 24

6 months

Question 25

Most infants have _____ deg of abduction

Answer 25

75-90

Question 26

When is a closed reduction and splica cast used?

Answer 26

3-6 mo (following unsuccessful Pavlik harness) Or if DDH found at 9 mo

Question 27

DDH diagnosed between ______ months of age usually require surgery

Answer 27

6-18 months

Question 28

Medical interventions (surgery) for hip dislocation dx after ambulation

Answer 28

Femoral osteotomy Femoral shortening Periacetabular osteotomy

Question 29

Alternative to Pavlik for 9 mo that is ambulating

Answer 29

Hip abduction orthoses

Question 30

Dx of hip dislocation of a child ____ old is generally considered to mandate open reduction

Answer 30

2 years or older