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Pediatrics > Cerebral Palsy > Flashcards

Cerebral Palsy Flashcards

1
Q

Corrected Age for Development

A
  1. Use: plot growth parameters (don’t use past 2 years) and developmental parameters
  2. Calculate: (40 weeks - gestational age) = result
    - take Age - result = corrected age
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2
Q

What patient wants to get out of interview?

A

make sure the patient gets what they want out of the interview

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3
Q

Common questions about walking in toddlers

A

When should they walk? –> 9-17 months
Pigeon-toed normal? –> YES
Flat feet? –> NORMAL
Use walker? –> NO

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4
Q

Developmental categories

A 
Gross motor
Fine motor
Social/communication
Cognitive/language
\+/- problem solving
*USE A QUESTIONNAIRE (bright futures)
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5
Q

Developmental screening timeline

A 
9 months
18 months
30 months
- document stuff and make sure to ID risks
*tons of questionnaires out there
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6
Q

Developmental delays

A

Autism - primarily social interactions
CP - motor dysfunction and other domains
Genetic/metabolic - global delays
*Psychostressors can cause delays too

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7
Q

Autism Spectrum Disorder

A
  1. 6% prevalence - mean age of diagnosis is 48 months
    - recommended screening at 12 & 24 months
    - use M-CHAT to screen for it
    - early intervention = best prognosis
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8
Q

Risks of developmental delay in preterms?

A

and severity of delays correlates with decreasing gestational age

  1. Bronchopulmonary dysplasia
  2. Retinopathy of newborn
  3. Hyperbilirubinemia
  4. Periventricular leukomalacia
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9
Q

Bronchopulmonary dysplasia

A

poor growth due to increased caloric requirements, recurrent infections, or CHF

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10
Q

Retinopathy of newborn

A

all premies at risk for this

- extraretinal fibrovascular proliferation = can cause retinal detachment

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11
Q

Hyperbilirubinemia

A

Bilirubin is potential neurotoxin = can lead to kernicterus

- abnormal motor development and sensorineural hearing loss

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12
Q

Periventricular leukomalacia

A

damage of white matter around ventricles –> hypoxia, ischemia, inflammation
- correlated with intraventricular hemorrhage

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13
Q

Family pedigree

A

Determine if there are conditions that run in families and which members have been affected

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14
Q

Stressors on kids

A

can act as regression of milestones, tantrums, sleep problems, eating problems

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15
Q

Measuring head circumference

A

measure around most prominent parts of frontal and occiput

- may need to measure more than once

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16
Q

Toddler neuro exam

A

OBSERVATION IS MOST IMPORTANT

  1. Mental Status - interaction, sleepy, arousable
  2. CN exam - flashlight, facial symmetry, hearing, voice
  3. Muscle tone and strength - watch them walk, feel extremities, note any weakness
  4. DTR - note any hyperreflexia or asymmetry
  5. Babinski - thumb on bottom of foot (L5-S1)
  6. Cerebellar - balance, smooth movements
17
Q

Cerebral Palsy

A

hetergeneous disorders characterized by motor and postural dysfunction (wide range of severity)

  • 2/1000 kids
  • need therapy with speech, mobility, and self-care
18
Q

Spastic Quadriplegia

A
  1. entire body involved

2. Global brain abnormalities

19
Q

Spastic diplegia

A
  1. Legs greater than arms

2. periventricular white matter abnormalities

20
Q

Dyskinetic cerebral palsy

A
  1. variable, often entire body

2. basal ganglia, cerebellum, thalamus

21
Q

Spastic hemiplegia

A
  1. arm and leg on one side

2. unilateral UMN abnormalities

22
Q

Ataxic cerebral palsy

A
  1. entire body

2. cerebellar abnormalities

23
Q

Learning 2 languages at once

A

Probably causes a slight delay in expressive language in kids –> but helps them with language acquisition later in life

24
Q

Risks for CP

A
  1. Prematurity
  2. IUGR
  3. Perinatal asphyxia
  4. Intrauterine infections
25
Q

Assessment of CP

A
  1. Complete H&P
  2. Screening for hearing, vision, or speech problems
  3. Neuroimaging - MRI for baseline
  4. Referral for formal developmental testing
26
Q

MRI findings consistent with CP

A
  • irregularly shaped ventricles and periventricular leukomalacia
  • thinned corpus callosum
27
Q

Therapy for CP

A

The more = the better, earlier = better

PT, OT, speech and language

Pediatrics (36 decks)

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