Cerebral and Musculoskeletal

Question 1

what factors can impact early fetal CNS development

Answer 1

infection
trauma
malnutrition
teratogens

Question 2

preventing neural tube defects

Answer 2

folic acid supplements
avoid cannabis

Question 3

why is high fat diet important for babies?

Answer 3

nerves are not yet fully myelinated, need fat for myelin sheath formation

Question 4

normal head growth during first year of life

Answer 4

1 cm per month

Question 5

moro reflex

Answer 5

startle reflex - lift by arms and let go
stops around 3-6 months

Question 6

palmar reflex

Answer 6

curl and grasp
stops around 3-6 months

Question 7

rooting reflex

Answer 7

turn and open mouth when cheek is stimulated
stops around 4 months

Question 8

stepping reflex

Answer 8

walking motion when held upright
present for 6-8 weeks

Question 9

fencing reflex

Answer 9

one arm stretches out and one arm bends when head turns to side
stops around 5-7 months

Question 10

babinski reflex

Answer 10

toes flare when bottom of foot is tickled
present until 6-24 months

Question 11

period of purple crying

Answer 11

babies cry a lot between 2 weeks and 3-4 months

Question 12

shaken baby syndrome

Answer 12

comes from violent shaking
does not come from gentle bouncing or bumpy car ride
causes death 25% of the time
peaks during period of purple crying

Question 13

risk factors for shaken baby syndrome

Answer 13

young parents
financial stress
premature or disabled baby
parental depression
parent abused as child

Question 14

red flags for suspecting shaken baby syndrome

Answer 14

inconsistent story
no witness of injury
delay in seeking care
history of injuries
high risk social situation

Question 15

causes of increased ICP

Answer 15

tumors
accumulation of fluid
bleeding

Question 16

clinical manifestations of increased ICP in infants

Answer 16

bulging fontanel
irritability
restless
drowsiness
poor feeding
“setting sun” bulging eyes

Question 17

clinical manifestations of increased ICP in children

Answer 17

headache
N/V
blurred vision
seizures
declining school performance
increased sleeping

Question 18

late signs of increased ICP

Answer 18

bradycardia
poor motor and sensory response
decorticate or decerebrate posturing
optic nerve swelling

Question 19

what is scoliosis

Answer 19

lateral bend in spine
causes rib asymetry

Question 20

scoliosis risk factors

Answer 20

female sex
8-15 years
monozygotic twins
neuromuscular disorders: SB, CP, muscular atrophy or dystrophy
family history
high risk sports - gymnastic and ballet

Question 21

clinical manifestations of scoliosis

Answer 21

uneven shoulders, hips
one side of back higher when bending over

Question 22

how is scoliosis diagnosed?

Answer 22

xray of Cobb angle >10º

Question 23

when is bracing indicated for scoliosis?

Answer 23

20º-49º
skeletal immaturity

Question 24

when is surgery indicated for scoliosis?

Answer 24

> 50º

Question 25

what is cerebral palsy?

Answer 25

abnormal muscle tone and coordination can be spastic, dyskinetic, or ataxic

Question 26

possible causes of CP

Answer 26

oxygen deprivation during labor CNS maldevelopment in utero bacterial meningitis or viral encephalitis TBI

Question 27

what is spastic CP?

Answer 27

most common type muscles are stiff from motor cortex damage paralysis and muscle atrophy

Question 28

what is dyskinetic CP?

Answer 28

involuntary movements from basal ganglia damage slow and jerky movement

Question 29

what is ataxic CP?

Answer 29

shaky movement and poor balance from cerebellum damage gait disturbance

Question 30

early signs of CP

Answer 30

failure to meet developmental milestones persistant infant reflexes poor ability to feed or clear secretions abnormal or rigid posturing asymmetrical movement and hand preference communication impairments seizures

Question 31

med management of CP

Answer 31

muscle relaxants benzos botox dopaminergics anticonvulsants

Question 32

what is the most common cause of meningitis?

Answer 32

viral infection

Question 33

risk factors for meningitis

Answer 33

children under 5 immunocompromised - chemo, recent surgery or organ transplant

Question 34

common viruses that cause meningitis

Answer 34

enterovirus mumps influenza HSV

Question 35

clinical manifestations of meningitis in infants

Answer 35

fever irritability poor feeding pin prick rash lethargy seizures

Question 36

clinical manifestations of meningitis in children

Answer 36

fever headache photophobia and nuchal rigidity N/V difficult to wake diminished appetite

Question 37

what is hydrocephalus?

Answer 37

increased cerebrospinal fluid in cerebral ventricles that puts pressure on the brain

Question 38

what is noncommunicating hydrocephalus?

Answer 38

obstruction of flow of cerebrospinal fluid

Question 39

what is communicating hydrocephalus?

Answer 39

too much absorption of cerebrospinal fluid

Question 40

what can cause hydrocephalus?

Answer 40

head trauma stroke tumors meningitis aqueductal stenosis infection during pregnancy that can cause inflammation of brain tissue

Question 41

clinical manifestations of hydrocephalus

Answer 41

prominent scalp veins increased head circumference sunset eyes enlarged fontanelles

Question 42

what are the more common types of fracture in ped population?

Answer 42

greenstick and compression fracture complete break is much less common

Question 43

what is compartment syndrome

Answer 43

pressure within localized area compromises circulation to muscles and nerves

Question 44

what are the 3 major causes of brain injury in children?

Answer 44

falls car accidents bike and sports injuries

Question 45

initial treatment for concussions

Answer 45

rest for 48 hours

Question 46

when can child go back to school after concussion?

Answer 46

when they are able to get up and get ready for school without needing help and without experiencing symptoms

Question 47

when can child go back to sports after concussion?

Answer 47

no symptoms for 24 hours not taking meds for concussion able to do full work load at school

Question 48

what is second impact syndrome?

Answer 48

second concussion before first one heals rapid swelling

Question 49

infant symptoms for meningitis

Answer 49

fever or hypothermia poor feeding bulging fontanel

Question 50

child symptoms for meningitis

Answer 50

headache, fever, vomiting, severe headache sudden onset

Question 51

what is the most common cause of meningitis?

Answer 51

viral