Cerebral Palsy Flashcards
Little’s disease pertains to what specific type of Cerebral palsy?
Spastic diplegic cerebral palsy
Youth are transported in a manual wheelchair in all settings.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
E. Gross Motor Functional Classification Level V
Self-mobility is severely limited, even with the use of assistive technology.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
E. Gross Motor Functional Classification Level V
Youth are limited in their ability to maintain antigravity head and trunk postures and control leg and arm movements.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
E. Gross Motor Functional Classification Level V
Youth use wheeled mobility in most settings.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
D. Gross Motor Functional Classification Level IV
Physical assistance of 1-2 people is required for transfers.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
D. Gross Motor Functional Classification Level IV
Indoors, youth may walk short distances with physical assistance, use wheeled mobility or a body support walker when positioned. They may operate a powered chair, otherwise are transported in a manual wheelchair.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
D. Gross Motor Functional Classification Level IV
Youth are capable of walking using a hand-held mobility device.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
C. Gross Motor Functional Classification Level III
Youth may climb stairs holding onto a railing with supervision or assistance.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
C. Gross Motor Functional Classification Level III
At school, they may self-propel a manual wheelchair or use powered mobility. Outdoors and in the community, youth are transported in a wheelchair or use powered mobility.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
C. Gross Motor Functional Classification Level III
Youth walk in most settings but environmental factors and personal choice influence mobility choices.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
B. Gross Motor Functional Classification Level II
At school or work, they may require a hand-held mobility device for safety and climb stairs holding onto a railing. Outdoors and in the community, youth may use wheeled mobility when traveling long distances.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
B. Gross Motor Functional Classification Level II
They perform gross motor skills such as running and jumping but speed, balance, and coordination are limited.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
A. Gross Motor Functional Classification Level I
Youth walk at home, school, outdoors, and in the community. Youth are able to climb curbs and stairs without physical assistance or a railing.
A. Gross Motor Functional Classification Level I
B. Gross Motor Functional Classification Level II
C. Gross Motor Functional Classification Level III
D. Gross Motor Functional Classification Level IV
E. Gross Motor Functional Classification Level V
A. Gross Motor Functional Classification Level I
Most common type of cerebral palsy
Spastic cerebral palsy
2nd most common type of cerebral palsy
Dyskinetic cerebral palsy
Syndrome of early hypotonia, developmental delay, hypogonadism, small hands and feet, and normal length.
A. Prader Willi Syndrome
B. Sotos Syndrome
C. Werdnig Hoffman Disease
D. Congenital Muscular Dystrophy
A. Prader Willi Syndrome
Syndrome of early hypotonia, developmental delay, large birth weight, macrosomia, megacephaly, and large hands and feet.
A. Prader Willi Syndrome
B. Sotos Syndrome
C. Werdnig Hoffman Disease
D. Congenital Muscular Dystrophy
B. Sotos Syndrome
Also known as acute spinal muscular atrophy
A. Prader Willi Syndrome
B. Sotos Syndrome
C. Werdnig Hoffman Disease
D. Congenital Muscular Dystrophy
C. Werdnig Hoffman Disease
Enumerate the 3 management that can be done to treat scoliosis in patients with cerebral palsy
- Surgery
- Bracing
- Positioning
Most common site of pressure sores in children with cerebral palsy
Occiput
-Because the head is the heaviest part
Most common site of pressure sores in adolescents with cerebral palsy
Sacrum
Additional: In adults, common site for pressure sores is the sacral area or the ischial tuberosity. In side-lying, the shoulder or trochanters are prone to sores.
Maintenance of sitting by (1)___ years and suppression of obligatory infantile reflexes by (2)___ months are good prognostic indicators of eventual walking (Molnar, p.203).
- 2
- 18
Note: However, they will still present with deficits
TRUE OR FALSE: It is generally assumed that if a child is not sitting up by himself by age of 4 or walking by age 8, he will never be an independent walker.
True
The goal then will be the use of wheelchairs
A child who starts to walk at age 3 will certainly continue to walk and will be walking when he is ___ years old unless he has a disorder other than cerebral palsy.
13
Bleck’s Prognosis for Walking
Child has cerebral palsy and findings show (+) Moro (Startle) reflex and (+) parachute / protective extension reaction. What is the child’s prognosis?
A. Poor prognosis
B. Guarded prognosis
C. Good prognosis
B. Guarded prognosis
Score of 1 (due to presence of Moro reflex)
Bleck’s Prognosis for Walking
Child has cerebral palsy and findings show (+) Asymmetric tonic neck reflex, (+) extensor thrust, and (-) foot placement reaction. What is the child’s prognosis?
A. Poor prognosis
B. Guarded prognosis
C. Good prognosis
A. Poor prognosis
-Score of 2 or more. In this case, the score is 3.
Bleck’s Prognosis for Walking
Child has cerebral palsy and findings show (+) neck righting reflex and (+) symmetric tonic neck reflex. What is the child’s prognosis?
A. Poor prognosis
B. Guarded prognosis
C. Good prognosis
A. Poor prognosis
Bleck’s Prognosis for Walking
Child has cerebral palsy and findings show (+) parachute / protective extension reflex. What is the child’s prognosis?
A. Poor prognosis
B. Guarded prognosis
C. Good prognosis
C. Good prognosis
-Score of 0
Management includes Positioning, Braces, Surgery, and Soft tissue releases (e.g., for hip adductors or for the iliopsoas)
A. Contractures
B. Scoliosis
C. Hip dislocation (hip dysplasia)
D. Pressure sores
C. Hip dislocation (hip dysplasia)
Additional: Dislocations may be caused by spasticity
Management includes turning schedule and proper positioning, proper hygiene (keep area dry in perineal & anal area), modalities (i.e. UVR), and topical medications
A. Contractures
B. Scoliosis
C. Hip dislocation (hip dysplasia)
D. Pressure sores
D. Pressure sores
TRUE OR FALSE: Management for spasticity and contractures include physical and occupational therapy, exercises, neurofacilitatory techniques/stretching, electrical stimulation, heating modalities (e.g. ultrasound) or icing, proper positioning, bracing, casting, and splints.
True
Additional: Heating modalities or icing have effects of relaxation of spasticity. In using ultrasound in children, caution must be observed.
TRUE OR FALSE: Orthopedic Surgery for lengthening will not reduce spasticity but is done to lengthen the tendon of Achilles, adductor or hamstring muscles to improve range of motion.
True
The only anti-spasticity medication that acts on the periphery (i.e. muscles)
Dantrolen Na
Botulinum toxin (botox injections) are injected intramuscularly, and are used to stop muscle contractions. Botox injections are done every how many months?
3-4 months
-Can also be taken every 4-6 months
TRUE OR FALSE: Selective ventral rhizotomy is the surgical management for spasticity in patients with cerebral palsy. It is done by operating on the anterior horn cells in spinal cord to decrease spasticity.
False, it’s selective dorsal rhizotomy
Anatomical structure affected in ataxic cerebral palsy
Cerebellum
Anatomical structure affected in dyskinetic cerebral palsy
Basal ganglia
Anatomical structure affected in spastic cerebral palsy
Corticospinal tract
The pathogenesis of periventricular leukomalacia arises from infection/inflammation and ______.
Ischemia/hypoxia
The premature neonatal brain is susceptible to two main pathologies in the development of cerebral palsy. Enumerate both.
- Intraventricular hemorrhage (IVH)
- Periventricular leukomalacia (PVL)
What is the single strongest risk factor for the development of CP?
Twinning
TORCHS is an acronym that stands for?
Toxoplasmosis
Other infections (varicella zoster, adenovirus, enterovirus)
Rubella
Cytomegalovirus
Herpes simplex virus
Syphilis
English surgeon who was the first to describe cerebral palsy in 1862. This individual described hemiplegic, rigid, paraplegic, and generalized types.
William John Little
Group of nonprogressive but often changing motor impairment syndromes that may or may not involve cognitive and sensory deficits that is caused by a nonprogressive defect, lesion, or anomaly of the developing brain
Cerebral palsy
The cause of cerebral palsy may occur in utero, near the time of delivery, or within the first ___ years of life.
3
Most common cause of motor disability in childhood
Cerebral palsy
Additional: CP is the second leading cause of (developmental) disability
Leading cause of (developmental) disability
Autism spectrum disorder
Cerebral palsy (CP) is a term used to describe a problem with (1)___ & (2)___ that makes certain activities difficult
movement and posture
TRUE OR FALSE: About 10,000 babies and infants are diagnosed with cerebral palsy each year.
True
Additional: 2:1000 newborn children develop cerebral palsy and around 40% of those born with cerebral palsy will have a severe case.
Risk factors for cerebral palsy
- Birth asphyxia
- Head trauma
- Intrauterine infections
A. Antenatal
B. Perinatal
C. Postnatal
- B
- C
- A
Risk factors for cerebral palsy
- Meningitis/encephalitis
- Prematurity and low birth weight
- Complicated labour and delivery
A. Antenatal
B. Perinatal
C. Postnatal
- C
- A
- B
Risk factors for cerebral palsy
- Non-accidental injury
- Multiple gestation
- Cardio-pulmonary arrest
- Pregnancy complications
A. Antenatal
B. Perinatal
C. Postnatal
- C
- A
- C
- A
Most common perinatal risk factor for the development of cerebral palsy
Birth asphyxia: lack of oxygen in the brain during delivery that can be due to cord coiled around fetus’ head, arrested in labor
Most common antenatal risk factor for the development of cerebral palsy
Prematurity
TRUE OR FALSE: Underdeveloped fetal brains are more susceptible to inflammation and inflammatory cytokines. These cytokines are hypothesized to be responsible for the development of periventricular leukomalacia.
True
Fetoplacental and uterine infection or inflammation can cause initiation of ____, which can lead to CNS injury and CP.
preterm labour
What are the two membranes surrounding the developing fetus?
Chorion and amnion
The most frequently associated maternal infection in cerebral palsy
Chorioamnionitis
-Infection of the chorion and amnion
Associated with kernicterus due to Rh disease, which manifests as early jaundice d/t hyperbilirubinemia.
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
B. Dyskinetic cerebral palsy
Intelligence is often normal, and one can go to regular schools
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
B. Dyskinetic cerebral palsy
There is no movement by the pt, floppy limbs
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
C. Hypotonic cerebral palsy
Note: Must be differentiated from neonates with hypotonia such as muscle disease, metabolic disease, and genetic syndromes. Rule out spinal muscular atrophy (SMA) and muscular dystrophy.
Must be closely monitored for hip dislocation and scoliosis
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
A. Spastic cerebral palsy
Additional: Spastic muscle imbalance lead to infantile coxa valga and femoral anteversion
Manifestations include hyperreflexia, clonus, (+) Babinski’s reflex (up to 2 yrs), persistent primitive reflexes, overflow reflexes (cross adductor reflex), and extensor or flexor posturing
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
A. Spastic cerebral palsy
Affects 75% of children and more than half are moderately impaired so complete independence is unlikely
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
A. Spastic cerebral palsy
Athetosis, dysarthria, sensorineural deafness, paralysis of upward gaze are usual signs
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
B. Dyskinetic cerebral palsy
Additional: Deafness is associated with hyperbilirubinemia
All four limbs are involved equally; severe type of CP; also called total body involvement
A. Double hemiplegia
B. Pentaplegia
C. Quadriplegia
D. Diplegia (Little’s disease)
C. Quadriplegia
Has the highest incidence of significant cognitive disability, mentally impaired
A. Double hemiplegia
B. Pentaplegia
C. Quadriplegia
D. Diplegia (Little’s disease)
C. Quadriplegia
All four limbs are involved, but the upper limbs are weaker than the lower limbs
A. Double hemiplegia
B. Pentaplegia
C. Quadriplegia
D. Diplegia (Little’s disease)
A. Double hemiplegia
All four limbs are involved, with neck and head paralysis often accompanied by eating and breathing complications
A. Double hemiplegia
B. Pentaplegia
C. Quadriplegia
D. Diplegia (Little’s disease)
B. Pentaplegia
Characterized by muscle stiffness & weakness mainly in the legs, the arms are less affected or unaffected.
A. Double hemiplegia
B. Pentaplegia
C. Quadriplegia
D. Diplegia (Little’s disease)
D. Diplegia (Little’s disease)
Most children with this CP type can ambulate but might have difficulty walking (scissoring gait)
A. Double hemiplegia
B. Pentaplegia
C. Quadriplegia
D. Diplegia (Little’s disease)
D. Diplegia (Little’s disease)
Most common in premature babies
A. Double hemiplegia
B. Pentaplegia
C. Quadriplegia
D. Diplegia (Little’s disease)
D. Diplegia (Little’s disease)
Symmetric involvement of the lower limbs and marked asymmetric involvement of the upper limb
A. Triplegia
B. Hemiplegia
C. Monoplegia
A. Triplegia
Most common: involvement of both LE and one UE
Results from focal perinatal injury (usually in the MCA)
A. Triplegia
B. Hemiplegia
C. Monoplegia
B. Hemiplegia
Most common presentation of hemiplegic cerebral palsy is failure to use the involved ____
hand
Type of paralysis that impacts one limb, such as an arm or leg on one side of your body.
A. Triplegia
B. Hemiplegia
C. Monoplegia
C. Monoplegia
Patients with hemiplegic cerebral palsy can ambulate by ____ years old (best ambulators)
2
Origin of fetal brain cells
Subependymal matrix
The risk of cerebral palsy [increases/decreases] with the severity of intraventricular hemorrhage
Increases
Stroke: bleed → ischemia → brain pressure
It is the bleeding from the subependymal matrix into the ventricles of the brain.
Intraventricular hemorrhage
Lack of sitting after ___ months is the most common initial recognized deficit of gross motor delay.
Six
Handedness at less than ____ y/o is an abnormal motor characteristic that can be observed in patients with cerebral palsy
One
Note: Handedness (hand dominance) emerges at 18 months and is established at 2 years of age
Death of a co-twin in utero has been shown to induce neuropathologic changes that can lead to CP in the surviving twin. The prevalence of CP in the surviving twin was found to be 15x lower than average.
A. Only the 1st statement is true
B. Only the 2nd statement is true
C. Both statements are true
D. Both statements are false
A. Only the 1st statement is true
The prevalence of CP in the surviving twin is 15x higher than average.
___ increases the risk of antenatal complications, such as preterm labor, growth restriction, low birth weight, and co-twin death.
Multiple gestation
Thrombophilias can lead to placental vascular injury and clotting of the fetal vessels.
Blood clotting is easier in the placenta because of the presence of what hormone?
estrogen
Determine the corresponding gestational toxins that can lead to types of CP
- Quadriplegia
- Hemiplegia
- Diplegia
A. Organic Mercury
B. Iodine
C. Intrauterine subdural hemorrhage
- A
- C
- B
Dyskinetic cerebral palsy: Slow writhing involuntary upper distal extremity movements. It usually affects the limbs only.
A. Athetoid
B. Chorea
C. Dystonia
D. Ballismus
E. Choreoathetoid
A. Athetoid
Dyskinetic cerebral palsy: Abrupt, irregular, jerky movements usually in the head, neck, and extremities. It affects the face and neck.
A. Athetoid
B. Chorea
C. Dystonia
D. Ballismus
E. Choreoathetoid
B. Chorea
Dyskinetic cerebral palsy: Slow rhythmic movement usually affecting the trunk with snake-like movements
A. Athetoid
B. Chorea
C. Dystonia
D. Ballismus
E. Choreoathetoid
C. Dystonia
Dyskinetic cerebral palsy: Sudden violent involuntary flinging high amplitude movement in the ipsilateral arm and leg
A. Athetoid
B. Chorea
C. Dystonia
D. Ballismus
E. Choreoathetoid
D. Ballismus
Dyskinetic cerebral palsy: Large amplitude involuntary movements that are a combination of athetosis and choreiform movements
A. Athetoid
B. Chorea
C. Dystonia
D. Ballismus
E. Choreoathetoid
E. Choreoathetoid
Dyskinetic cerebral palsy starts with hypotonia, followed by abnormal movements in affected extremities by ___ months
18
In dyskinetic cerebral palsy, writhing involuntary movements are first noted in which body structure/s?
hands and fingers
Presents with problems with balance and coordination. They are unsteady when they walk, have difficulty with quick movements or movements that need a lot of control, and have difficulty controlling their hands or arms when they reach for something.
A. Spastic cerebral palsy
B. Dyskinetic cerebral palsy
C. Hypotonic cerebral palsy
D. Mixed cerebral palsy
E. Ataxic cerebral palsy
E. Ataxic cerebral palsy
The most common type of mixed cerebral palsy
Spastic-dyskinetic cerebral palsy
- UE: athetoid & LE: spastic
Presence of primitive reflexes after ____ months is deemed abnormal
6
TRUE OR FALSE: In cerebral palsy, alteration of tone is characterized by early hypotonia that gives way to later hypertonia
True
Mental retardation is most severe in rigid, atonic, and severely spastic quadriplegia. In contrast, the brightest and most intelligent are those with dyskinetic CP.
A. Only the 1st statement is true
B. Only the 2nd statement is true
C. Both statements are true
D. Both statements are false
C. Both statements are true
Additional: Mental retardation is mild in diplegia and hemiplegia
Associated problem in cerebral palsy that is most frequent in hemiplegia and spastic quadriplegia
Seizures
Strabismus, refractory errors, and hemianopsia are common in diplegia and quadriplegia. Esotropia, exotropia or hyperopia is common in hemiplegia.
A. Only the 1st statement is true
B. Only the 2nd statement is true
C. Both statements are true
D. Both statements are false
D. Both statements are false
Interchange manifestations to make both statements true
TRUE OR FALSE: Poor lip closure, tongue thrust, drooling, and dysarthria are common in spastic quadriplegia and dyskinetic cerebral palsy.
True
Diagnostic tool to rule out seizures
Electroencephalogram (EEG)
most important and most common goal in the management of cerebral palsy
Gait
most common problem in patients with cerebral palsy
Delayed motor development/weakness
Usually referred to as neuro-developmental treatment
A. Ayres
B. Rood
C. Vojta approach
D. Patterning therapy Doman-Delacato
E. Bobath
E. Bobath
Management used in cases of hypotonia to retard atrophy
Electrical stimulation
Based on the brain’s ability to reorganize and recover after neurological insult (neuroplasticity). Its goals are to normalize tone, inhibit primitive reflexes & facilitate automatic reactions, and normal movement patterns. Treatment involves doing repetitive actions.
A. Ayres
B. Rood
C. Vojta approach
D. Patterning therapy Doman-Delacato
E. Bobath
E. Bobath
Sensory integration approach to improve efficiency of neural processing and to better organize adaptive responses
A. Ayres
B. Rood
C. Vojta approach
D. Patterning therapy Doman-Delacato
E. Bobath
A. Ayres
The goals are to activate postural responses and activate mobility once stability is achieved
A. Ayres
B. Rood
C. Vojta approach
D. Patterning therapy Doman-Delacato
E. Bobath
B. Rood
Goal is to achieve independent mobility, improve motor coordination and communication disorders, enhance intelligence
A. Ayres
B. Rood
C. Vojta approach
D. Patterning therapy Doman-Delacato
E. Bobath
D. Patterning therapy Doman-Delacato
The goal is to prevent cerebral palsy in infants at risk and to improve motoric behavior in infants with fixed CP
A. Ayres
B. Rood
C. Vojta approach
D. Patterning therapy Doman-Delacato
E. Bobath
C. Vojta approach
Odd one out:
Baclofen, Diazepam, Clobazam, Tizanidine, Clonazepam
Clobazam (A medication for seizures)
-All other choices are anti-spasticity medications acting centrally on the CNS to control movement.
TRUE OR FALSE: The goals of PT for cerebral palsy are to decrease complications, enhance or improve the acquisition of new skills, independence in ADLs and mobility, and parent and caregiver education.
True
TRUE OR FALSE: Bilirubin encephalopathy or Kernicterus can cause hearing impairments.
True
Dramatic abnormal posture due to spastic contraction of the extensor muscles of the neck, trunk, and lower extremities that produces a severe backward arching from neck to heel
opisthotonic posture
Abnormal movement pattern such as posterior pelvic tilt is due to tightness of what muscle?
hamstring
Abnormal movement pattern characterized by excessive ankle dorsiflexion, knee and hip flexion during the stance phase
Crouch gait
Abnormal movement pattern characterized by sitting on their bottom with their knees bent and feet positioned outside of their hips
W sitting
- bacterial disease of calcified tissues of teeth, leads to teeth breakdown
- overgrowth of gum tissue around the teeth
- upper and lower teeth don’t align when closing mouth
A. Enamel dysgenesis
B. Malocclusion
C. Caries
D. Gingival hyperplasia
- C
- D
- B
Chronic lung disease that affects newborns, lungs and the airways are damaged, causing tissue destruction in the tiny air sacs of the lung
A. Deficient ventilation
B. Bronchopulmonary dysplasia
C. Microaspiration
B. Bronchopulmonary dysplasia
An APGAR score of less than ___ at 20 minutes poses a high risk of CP
3
Obstetrical (Protective) Care: used to treat bacterial vaginosis that may reduce the rate of preterm delivery
A. Magnesium sulfate
B. Antibiotics
C. Corticosteroids
B. Antibiotics
Obstetrical (Protective) Care: In women with premature rupture of membranes, this reduces the risk of chorioamnionitis.
A. Magnesium sulfate
B. Antibiotics
C. Corticosteroids
B. Antibiotics
Obstetrical (Protective) Care: reduces the risk of CP by inhibiting cytokine production, thus preventing periventricular leukomalacia.
A. Magnesium sulfate
B. Antibiotics
C. Corticosteroids
C. Corticosteroids
Obstetrical (Protective) Care: used for preterm labor and to increase the seizure threshold in mothers with preeclampsia. helpful for both the baby and the mother
A. Magnesium sulfate
B. Antibiotics
C. Corticosteroids
A. Magnesium sulfate
Obstetrical (Protective) Care: Injected to mother if preterm/contraction of uterus when baby is not yet viable
A. Magnesium sulfate
B. Antibiotics
C. Corticosteroids
A. Magnesium sulfate
Most common predictive sign for development of CP
periventricular leukomalacia (PVL)
Additional: MRI is the ancillary procedure to check for PVL. PVL is also the leading cause in preterm infants; may use CT Scan if there is a feeling of a probable PVL.
TRUE OR FALSE: Birth weight under 800 g, Grade III and IV intraventricular hemorrhage, and prolonged seizures are risk factors for CP in premature infants.
True
TRUE OR FALSE: Abruptio placenta, placenta previa, and
meconium aspiration causing asphyxia can cause CP in term infants.
True
TRUE OR FALSE: Hemorrhage and preeclampsia (placental abruption, placenta previa, and other causes of third trimester bleeding) seem to lead to premature delivery, conferring the same risks for CP as a premature infant
True
The blood vessels around the ventricles develop late in the ___ trimester, thus preterm infants have underdeveloped periventricular blood vessels, predisposing them to increased risk of intraventricular hemorrhage.
third
PVL describes ___ matter in the periventricular region that is underdeveloped or damaged.
white
The white areas are watersheds in the brain (areas in the brain where blood supply is decreased; ischemia can occur in these areas).
Both IVH and PVL cause CP because the ____, composed of descending motor axons, course through the periventricular region. Affectation of this structure leads to motor sx, which can cause hemiplegia.
corticospinal tracts
The following are causes of cerebral palsy, EXCEPT:
A. Neonatal encephalopathy
B. Shaken infant syndrome
C. Stroke (young stroke)
D. Traumatic brain injury
E. Hypoxic brain injury
F. None of the above
F. None of the above
Hyperbiliribinemia secondary to Rh, G6PD, and ___ incompatibility can lead to jaundice in the 1st hour after birth.
ABO
CP pathophysiology: postnatal
- Meningitis/encephalitis
- Drowning
- Cerebral malaria
- Ruptured AV malformation
- Cardiopulmonary arrest
A. Traumatic cause
B. Non-traumatic cause
- B
- A
- B
- B
- B
The following are conditions for differential diagnosis of CP, EXCEPT:
A. Congenital neuromuscular disease (e.g., Werdnig Hoffman disease, congenital muscular dystrophy)
B. Metabolic disorders (e.g. thyroidism, endocrine, infant
of diabetic mother)
C. Nonprogressive central nervous system diseases
D. Storage disorders
E. Syndromes of early hypotonia and developmental delay
F. None of the above
C. Nonprogressive central nervous system diseases