Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DPT 772 - Pediatrics II > Exam 1 Questions > Flashcards

Exam 1 Questions Flashcards

1
Q

Which of the following is a defining characteristic of spina bifida occulta?

  • A. Cyst-like protrusion through the posterior vertebral arch
  • B. Non-fusion of the posterior vertebral arch with intact neural tissue
  • C. Sac containing meninges, CSF, and spinal cord protruding through a defect
  • D. Fatty mass over the lumbar or sacral spine
A

Correct Answer: B

Rationale: Spina bifida occulta involves non-fusion of the posterior vertebral arch without neural tissue disturbance. It is often indicated by a tuft of hair or pigmentation at the site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A sac containing meninges, cerebrospinal fluid (CSF), and spinal cord protruding through a vertebral defect is termed:

  • A. Meningocele
  • B. Lipomeningocele
  • C. Myelomeningocele
  • D. Spina bifida occulta
A

Correct Answer: C

Rationale:

  • Myelomeningocele is characterized by a sac containing meninges, CSF, and neural tissue.
  • This is the most severe form of spina bifida cystica.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which prenatal diagnostic test is used to detect neural tube defects (NTDs) with a detection rate of approximately 89%?

  • A. Amniocentesis combined with blood tests
  • B. Alpha-fetoprotein (AFP) levels
  • C. Cranial ultrasound
  • D. MRI
A

Correct Answer: A

Rationale:

  • Amniocentesis combined with maternal blood tests (e.g., AFP levels) can detect approximately 89% of NTDs.
  • AFP levels alone are less accurate.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hydrocephalus in children with spina bifida is primarily caused by:

  • A. Overproduction of cerebrospinal fluid
  • B. Underproduction of cerebrospinal fluid flow
  • C. Decreased absorption of cerebrospinal fluid
  • D. Deformity of the cerebrum
A

Correct Answer: A

Rationale:

  • Hydrocephalus in spina bifida is an overproduction of CSF, CSF absorption failure, or obstruction in CSF flow through brain structure and spinal cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

All of the following are signs of increased intracranial pressure (ICP) in infants except:

  • A. Bulging anterior fontanel
  • B. Separation of cranial sutures
  • C. Decreased head circumference
  • D. Downward eye deviation (‘sunsetting’)
A

Correct Answer: C

Rationale:

  • Decreased head circumference is not a sign of increased ICP.
  • Signs include a bulging anterior fontanel, sutural separation, and ‘sunsetting’ of the eyes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which of the following is the most common surgical treatment for hydrocephalus in children with spina bifida?

  • A. Posterior fossa decompression
  • B. Cervical laminectomy
  • C. Ventriculoperitoneal (VP) shunt
  • D. Ventriculoatrial (VA) shunt
A

Correct Answer: C

Rationale:

  • A Ventriculoperitoneal (VP) shunt shunt is the preferred treatment for hydrocephalus, diverting excess CSF from the ventricles to the peritoneal cavity.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which motor level in spina bifida is associated with minimal hip flexion and adduction, weak quads, and the need for HKAFOs or RGOs?

  • A. Thoracic level
  • B. High lumbar (L1-L3)
  • C. Low lumbar (L4-L5)
  • D. Sacral level
A

Correct Answer: B

Rationale:

  • High lumbar lesions (L1-L3) present with minimal hip flexion and adduction, weak quads, and require high-level orthoses like HKAFOs or RGOs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A tethered cord in spina bifida is caused by:

A. Excess cerebrospinal fluid in the ventricles
B. Adhesions anchoring the spinal cord at the site of the lesion
C. Progressive scoliosis due to muscle imbalance
D. Herniation of the cerebellum through the foramen magnum

A

Correct Answer: B
Rationale:

  • Tethered cord occurs when adhesions anchor the spinal cord at the lesion site, preventing upward movement and causing metabolic and ischemic changes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A child with spina bifida presents with scoliosis above the level of paralysis and progressive lower extremity weakness. The most likely cause is:

  • A. Hydromyelia
  • B. Tethered cord syndrome
  • C. Arnold-Chiari malformation
  • D. Lumbar lordosis
A

Correct Answer: B

Rationale:

  • Tethered cord syndrome can lead to scoliosis above the level of paralysis and progressive weakness due to stretching and ischemia of the neural tissue.
  • TCS occurs when adhesions anchor the spinal cord at the site of the original lesion.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following orthoses is appropriate for a child with sacral-level spina bifida and weak plantar flexors?

  • A. HKAFO
  • B. KAFO
  • C. AFO
  • D. Supra-malleolar orthosis (SMO)
A

Correct Answer: C

Rationale:

  • An AFO with ground reaction force control supports weak plantar flexors and improves alignment during gait, suitable for sacral-level involvement.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which of the following interventions is most important to prevent hip subluxation in children with high lumbar (L1-L3) spina bifida?

  • A. Nightly total contact orthoses
  • B. Daily passive range of motion (PROM)
  • C. Early surgical hip relocation
  • D. Standing programs with abduction positioning
A

Correct Answer: B

Rationale:

  • Daily PROM is crucial to maintain hip mobility and prevent contractures that contribute to subluxation.
  • Surgical relocation is often avoided due to complications.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The ‘lemon sign’ on fetal ultrasound, indicative of spina bifida, refers to:

  • A. Flattening of the occipital bone
  • B. Flattening of the frontal bones
  • C. Enlargement of the ventricles
  • D. Herniation of brain tissue
A

Correct Answer: B

Rationale:

  • The ‘lemon sign’ refers to the flattening of the frontal bones, often visible before 24 weeks gestation and associated with spina bifida.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adaptive equipment is classified into all of the following categories except:

  • A. Assistive technology
  • B. Alternative technology
  • C. Augmentative technology
  • D. Replacement technology
A

Correct Answer: D

Rationale:

  • Replacement technology is not a recognized classification.
  • The three primary classifications are assistive (enhances function), alternative (substitutes for a function), and augmentative (supplements a deficient function).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which of the following is an example of low-tech adaptive equipment?

  • A. Eye gaze communication device
  • B. Powered wheelchair
  • C. Pencil grip
  • D. Computer with voice recognition
A

Correct Answer: C

Rationale:

  • Low-tech devices are simple, cost-effective, and non-electronic solutions like pencil grips or footrests.
  • The other options fall into mid-tech (e.g., powered toys) or high-tech (e.g., computers with voice recognition).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A child with severe trunk instability and hypotonia who struggles to maintain an upright posture during feeding would most benefit from a:

  • A. Prone stander
  • B. Supportive seating system with lateral trunk supports
  • C. Sit-to-stand device
  • D. Static supine stander
A

Correct Answer: B

Rationale:

  • Children with trunk instability benefit from seating systems with lateral supports to provide a secure base of support, improving function and participation in activities like feeding.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If a child requires a device to supplement speech due to inadequate verbal communication, which of the following adaptive technologies is most appropriate?

  • A. Alternative technology
  • B. Assistive technology
  • C. Augmentative technology
  • D. High-tech technology
A

Correct Answer: C

Rationale:

  • Augmentative technology, such as speech-generating devices, supplements existing but insufficient verbal communication capabilities.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

All of the following are benefits of adaptive equipment in pediatric physical therapy except:

  • A. Reinforces movements and skills learned during therapy
  • B. Reduces the need for caregiver assistance at home
  • C. Improves functional independence with limited reliance on PT
  • D. Permanently corrects underlying musculoskeletal deformities
A

Correct Answer: D

Rationale:

  • Adaptive equipment supports functional independence and reinforces therapy skills but does not permanently correct deformities.
  • Surgical or other medical interventions may be required for structural changes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A child with retained primitive reflexes, such as ATNR or TLR, might need adaptive equipment designed to:

  • A. Restrict or inhibit the influence of reflexes
  • B. Increase ROM through prolonged static stretching
  • C. Substitute for lost motor functions
  • D. Provide high-tech sensory integration
A

Correct Answer: A

Rationale:

  • Adaptive equipment, like positioning devices, can help inhibit primitive reflexes that interfere with postural control and functional mobility.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A 5-year-old child has minimal hip abduction, increased extensor tone, and difficulty maintaining alignment during sitting. What adaptive equipment would best support their alignment?

  • A. Prone stander
  • B. Supine stander
  • C. Seating system with hip guides
  • D. Posterior walker
A

Correct Answer: C

Rationale:

  • Hip guides provide support for children with limited hip abduction, improving postural alignment and reducing extensor tone during sitting.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The benefits of standing devices include all of the following except:

  • A. Increased lower extremity weight-bearing
  • B. Improved bone mineral density
  • C. Enhanced proprioceptive awareness
  • D. Complete resolution of spasticity
A

Correct Answer: D

Rationale:

  • Standing devices can modulate spasticity and improve weight-bearing and bone health, but they do not completely resolve spasticity, which often requires additional interventions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which of the following features of a seating system is critical for preventing extensor posturing in a child?

  • A. Adjustable footplates for proper ankle dorsiflexion
  • B. A backrest reclined to 120 degrees
  • C. A seat-to-backrest angle of 95-110 degrees
  • D. Removable lateral trunk supports
A

Correct Answer: C

Rationale:

  • A slight ‘dump’ (angle closer to 90 degrees) increases hip flexion and discourages extensor posturing, helping the child maintain better postural alignment.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A family is unable to afford a high-tech powered wheelchair for their child. What funding source is most likely to cover the cost if the equipment is deemed necessary for the child’s education?

  • A. Medicaid waiver
  • B. Private insurance
  • C. IDEA through an IEP or IFSP
  • D. Community philanthropic organizations
A

Correct Answer: C

Rationale:

  • The Individuals with Disabilities Education Act (IDEA) mandates funding for equipment required for educational access and inclusion, provided it’s included in the child’s IEP or IFSP.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which of the following is an example of a thermal burn?

  • A. Contact with faulty electrical wiring
  • B. Prolonged exposure to ultraviolet radiation
  • C. Scalding from hot liquids
  • D. Chemical exposure to acidic solutions
A

Correct Answer: C

Rationale:

  • Scalding from hot liquids is a thermal burn, which occurs due to heat sources like hot liquids, fires, or steam.
  • Other options refer to electrical, radiation, or chemical burns.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A child presents with a red burn that does not blister and heals within a week. What classification best describes this burn?

  • A. Superficial (1st degree)
  • B. Superficial partial-thickness (2nd degree)
  • C. Deep partial-thickness (2nd degree)
  • D. Full-thickness (3rd degree)
A

Correct Answer: A

Rationale:

  • Superficial burns involve only the epidermis, are red without blistering, and heal without scarring within 3-7 days.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which of the following is a key characteristic of deep partial-thickness burns?

  • A. Involves the reticular dermis
  • B. Painful and presents with blisters
  • C. Insensitive to light touch but responds to deep pressure
  • D. Heals without the need for grafting
A

Correct Answer: C

Rationale:

  • Deep partial-thickness burns extend into the reticular dermis, spare some structures, and are typically insensitive to light touch while retaining deep pressure sensation.
  • Healing may require grafting.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

All of the following are goals of splinting and positioning in burn management except:

  • A. Prevent contractures
  • B. Increase circulation to the area
  • C. Maintain joint range of motion
  • D. Protect exposed tendons and nerves
A

Correct Answer: B

Rationale:

  • Splinting and positioning aim to prevent contractures, maintain ROM, and protect vulnerable structures.
  • Increasing circulation is not a primary goal of these interventions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What type of burn would most likely require escharotomy to prevent complications?

A. Superficial burns
B. Superficial partial-thickness burns
C. Deep partial-thickness burns
D. Full-thickness burns

A

Correct Answer: D

Rationale:

  • Full-thickness burns can cause significant swelling and tight eschar, potentially compromising circulation or breathing, requiring escharotomy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the primary benefit of pressure garments in scar management for pediatric burns?

A. Prevents infection
B. Reduces hypertrophic scarring
C. Promotes rapid wound healing
D. Prevents fluid loss

A

Correct Answer: B

Rationale:

  • Pressure garments help reduce hypertrophic scarring by applying consistent pressure, aiding in scar flattening and maturation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A 3-year-old child sustained a burn injury covering both arms and the anterior trunk. Approximately what percentage of total body surface area (TBSA) is affected?

A. 9%
B. 18%
C. 27%
D. 36%

A

Correct Answer: C

Rationale:

  • According to the pediatric Rule of Nines, each arm accounts for 9% (4.5% anterior + 4.5% posterior) and the anterior trunk accounts for 18%, totaling 27% TBSA.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the recommended positioning for a child with a burn to the anterior neck?

A. Neck extension
B. Neck flexion
C. Neutral neck alignment
D. Side bending to the unaffected side

A

Correct Answer: A

Rationale:

  • To prevent contractures, the neck should be positioned in extension, avoiding the typical contracture position of flexion.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

All of the following are conservative scar management techniques for pediatric burns except:

A. Pressure garments
B. Silicone gel sheets
C. Z-plasty surgery
D. Massage therapy

A

Correct Answer: C

Rationale:

  • Z-plasty is a surgical intervention, while the other options are non-invasive scar management techniques.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which of the following is most appropriate for airway clearance in a pediatric patient with burn-related pulmonary complications?

A. Incentive spirometry
B. Positive expiratory pressure (PEP) therapy
C. High-frequency chest wall oscillation (HFCWO)
D. Postural drainage and percussion

A

Correct Answer: D

Rationale:

  • Postural drainage and percussion are effective for mobilizing secretions in pediatric burn patients with pulmonary complications.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Duchenne Muscular Dystrophy (DMD) typically affects which population?

A. Males only
B. Females only
C. Both males and females equally
D. Primarily females with X-linked inheritance

A

Correct Answer: A

Rationale:

  • DMD is an X-linked recessive disorder, meaning it primarily affects males. Females are usually carriers.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which of the following is a hallmark feature of Duchenne Muscular Dystrophy?

A. Increased muscle tone
B. Pseudohypertrophy of the calves
C. Early ambulation milestones
D. Improved endurance with age

A

Correct Answer: B

Rationale:

  • Pseudohypertrophy of the calves, caused by fat and fibrotic tissue replacing muscle, is a classic sign of DMD.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which neuromuscular disorder is characterized by progressive muscle weakness and absent deep tendon reflexes?

A. Spinal Muscular Atrophy (SMA)
B. Charcot-Marie-Tooth Disease (CMT)
C. Duchenne Muscular Dystrophy (DMD)
D. Myasthenia Gravis

A

Correct Answer: A

Rationale:

  • SMA involves progressive muscle weakness and absent or significantly decreased deep tendon reflexes due to degeneration of the anterior horn cells.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

At what age is loss of ambulation typically observed in children with Duchenne Muscular Dystrophy?

A. 5-7 years
B. 8-10 years
C. 10-12 years
D. 13-15 years

A

Correct Answer: C

Rationale:

  • Children with DMD typically lose ambulation between 10-12 years of age if untreated.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

All of the following are contraindicated in physical therapy for children with Duchenne Muscular Dystrophy except:

A. Eccentric exercises
B. Overexertion during therapy
C. High-resistance strength training
D. Submaximal aerobic exercises

A

Correct Answer: D

Rationale:

  • Submaximal aerobic exercises like swimming and cycling are beneficial for overall conditioning and cardiovascular health without causing muscle damage.
38
Q

Which type of Spinal Muscular Atrophy (SMA) is most severe and typically results in loss of motor milestones before 6 months of age?

A. Type 0
B. Type 1
C. Type 2
D. Type 3

A

Correct Answer: B

Rationale:

  • SMA Type 1, also known as Werdnig-Hoffmann disease, is the most severe type and presents with profound muscle weakness and loss of motor milestones early in life.
39
Q

Which of the following is the primary goal of stretching in children with neuromuscular disorders?

A. Improve muscle strength
B. Prevent contractures
C. Increase endurance
D. Improve nerve conduction velocity

A

Correct Answer: B

Rationale:

  • Stretching is aimed at maintaining joint mobility and preventing contractures in children with progressive neuromuscular disorders.
40
Q

Which neuromuscular disorder is associated with foot deformities, including high arches and curled toes?

A. Myasthenia Gravis
B. Spinal Muscular Atrophy (SMA)
C. Charcot-Marie-Tooth Disease (CMT)
D. Duchenne Muscular Dystrophy (DMD)

A

Correct Answer: C

Rationale:

  • CMT is characterized by peripheral nerve involvement, leading to foot deformities such as pes cavus (high arches) and hammer toes (curled toes).
41
Q

Which drug therapy is currently available for treating Spinal Muscular Atrophy (SMA)?

A. Baclofen
B. Spinraza
C. Prednisone
D. Botox

A

Correct Answer: B

Rationale:

  • Spinraza (nusinersen) is a drug used to treat SMA by improving the survival motor neuron (SMN) protein levels.
42
Q

A child with Duchenne Muscular Dystrophy demonstrates difficulty transitioning from sitting to standing and uses their hands to push off their thighs. This is known as:

A. Waddling gait
B. Gower’s sign
C. Steppage gait
D. Trendelenburg sign

A

Correct Answer: B

Rationale:

  • Gower’s sign is a classic feature of DMD, where children use their hands to push off their thighs due to proximal muscle weakness.
43
Q

What is the primary cause of respiratory distress syndrome (RDS) in neonates?

A. Infection of the lungs
B. Deficient pulmonary surfactant
C. Immature cilia in the airways
D. Structural abnormalities of the thorax

A

Correct Answer: B

Rationale:

  • RDS is caused by a deficiency in pulmonary surfactant, leading to airless alveoli, inelastic lungs, and difficulty breathing.
44
Q

Which of the following is a characteristic sign of bronchopulmonary dysplasia (BPD)?

A. Increased pulmonary compliance
B. Persistent respiratory symptoms after 1 month
C. Rapid resolution of respiratory symptoms
D. Overproduction of surfactant

A

Correct Answer: B

Rationale:

  • BPD is a chronic respiratory disorder characterized by persistent symptoms, scarring of lung tissue, and dependence on supplemental oxygen beyond 1 month.
45
Q

In cystic fibrosis, which of the following contributes to airway obstruction?

A. Excess surfactant
B. Thick, viscous secretions
C. Increased bronchial diameter
D. Hypermobile cilia

A

Correct Answer: B

Rationale:

  • Cystic fibrosis leads to the retention of thick, poorly hydrated mucus in the airways, causing obstruction and frequent infections.
46
Q

Which physical therapy intervention is most appropriate for airway clearance in a child with cystic fibrosis?

A. Incentive spirometry
B. Rib cage mobilization
C. Postural drainage and percussion
D. Respiratory muscle strengthening

A

Correct Answer: C

Rationale:

  • Postural drainage and percussion are effective techniques for mobilizing mucus in the lungs, a key goal in managing cystic fibrosis.
47
Q

Which of the following is a contraindication for high-frequency chest wall oscillation (HFCWO) in pediatric patients?

A. Recent skin grafts
B. Poor posture during use
C. Lack of parental supervision
D. Reduced pulmonary compliance

A

Correct Answer: A

Rationale:

  • Recent skin grafts or open wounds are contraindications for HFCWO due to the potential for disrupting healing.
48
Q

A child presents with asthma and experiences severe dyspnea and cyanosis. What is the immediate priority?

A. Perform postural drainage
B. Administer bronchodilator medication
C. Encourage deep breathing exercises
D. Begin incentive spirometry

A

Correct Answer: B

Rationale:

  • Administering bronchodilators is the immediate priority in severe asthma attacks to relieve bronchospasm and improve breathing.
49
Q

Which exercise is most appropriate for improving cardiovascular endurance in children with pulmonary conditions?

A. High-resistance strength training
B. Swimming
C. Sprinting
D. Static stretching

A

Correct Answer: B

Rationale:

  • Swimming is a low-impact aerobic exercise that enhances cardiovascular endurance and promotes controlled breathing, making it ideal for pulmonary conditions.
50
Q

What is the most common initial symptom of respiratory distress syndrome (RDS) in neonates?
A. Bradycardia
B. Cyanosis
C. Grunting on expiration
D. Persistent coughing

A

Correct Answer: C
Rationale: Grunting on expiration is a key initial symptom of RDS, helping to maintain positive airway pressure in neonates with insufficient surfactant.

51
Q

Which of the following is a major complication of bronchopulmonary dysplasia (BPD)?
A. Pulmonary hypertension
B. Increased mucociliary clearance
C. Hyperinflation of the lungs
D. Overproduction of alveoli

A

Correct Answer: A
Rationale: Pulmonary hypertension is a serious complication of BPD, resulting from chronic hypoxemia and vascular changes in the lungs.

52
Q

Which positioning technique is recommended to improve breathing patterns in a child with asthma?
A. Supine with pillows under the knees
B. Sitting upright with rib cage expansion exercises
C. Prone on elbows with neck flexion
D. Side-lying with knees drawn to the chest

A

Correct Answer: B
Rationale: Sitting upright encourages rib cage expansion, promotes diaphragmatic breathing, and reduces reliance on accessory muscles in asthma management.

53
Q

What is the primary characteristic of spastic cerebral palsy?

  • A. Involuntary and uncontrolled movements
  • B. Resistance to passive movement increasing with velocity
  • C. Low muscle tone and hypermobility
  • D. Disorder of balance and coordinated movements
A

Correct Answer: B

Rationale:

  • Spastic cerebral palsy is characterized by increased resistance to passive movement that worsens with increased velocity, resulting from damage to the motor cortex.
54
Q

Which of the following motor types of cerebral palsy is associated with damage to the cerebellum?
A. Spastic
B. Dyskinetic
C. Ataxic
D. Hypotonic

A

Correct Answer: C
Rationale: Ataxic cerebral palsy, associated with cerebellar damage, involves poor balance, wide-based gait, tremors, and difficulties with coordinated movements.

55
Q

A child with diplegic cerebral palsy is most likely to present with:
A. Unilateral motor impairments affecting one side of the body
B. Motor impairments primarily affecting the lower extremities
C. Severe cognitive and speech impairments
D. Profound motor impairments in all four extremities

A

Correct Answer: B
Rationale: Diplegic cerebral palsy primarily affects the lower extremities, with lesser involvement of the upper extremities. It is commonly seen in premature infants.

56
Q

What Gross Motor Function Classification System (GMFCS) level is associated with community ambulation without assistive devices?
A. Level I
B. Level II
C. Level III
D. Level IV

A

Correct Answer: A
Rationale: GMFCS Level I indicates that the individual can walk in the community without assistive devices, though they may have some limitations in advanced motor skills.

57
Q

All of the following are common musculoskeletal complications in children with cerebral palsy except:
A. Hip subluxation
B. Scoliosis
C. Leg length discrepancy
D. Hypermobile joints

A

Correct Answer: D
Rationale: Hypermobile joints are not typical in cerebral palsy. Instead, musculoskeletal complications often include hip subluxation, scoliosis, and leg length discrepancy.

58
Q

A child with cerebral palsy demonstrates scissoring of the legs during gait. Which muscle group is most likely spastic?
A. Hip abductors
B. Hip adductors
C. Hamstrings
D. Quadriceps

A

Correct Answer: B
Rationale: Spasticity in the hip adductors leads to scissoring gait, characterized by crossing of the legs during ambulation.

59
Q

Which of the following interventions is most effective for improving gait mechanics in children with cerebral palsy?
A. Static stretching
B. Partial body weight-supported treadmill training (PBWSTT)
C. Passive range of motion exercises
D. Strengthening with high-resistance exercises

A

Correct Answer: B
Rationale: PBWSTT is effective in promoting reciprocal stepping patterns, improving gait mechanics, and activating central pattern generators in children with cerebral palsy.

60
Q

What is the primary goal of selective dorsal rhizotomy (SDR) in children with cerebral palsy?
A. Improve muscle strength
B. Reduce spasticity
C. Correct hip dysplasia
D. Address sensory deficits

A

Correct Answer: B
Rationale: SDR involves cutting sensory nerve rootlets to reduce spasticity in children with cerebral palsy, improving functional mobility and comfort.

61
Q

Which classification of cerebral palsy is associated with uncontrolled and involuntary movements?
A. Ataxic
B. Dyskinetic
C. Spastic
D. Hypotonic

A

Correct Answer: B
Rationale: Dyskinetic cerebral palsy is characterized by uncontrolled, involuntary movements due to damage to the basal ganglia.

62
Q

Which of the following is a typical posture for a child with hemiplegic cerebral palsy?
A. Shoulder flexion, elbow flexion, wrist extension, and pronated forearm
B. Shoulder retraction, elbow flexion, wrist flexion, and ulnar deviation
C. Shoulder abduction, elbow extension, wrist supination, and finger extension
D. Neutral alignment of the shoulder, elbow, and wrist with mild spasticity

A

Correct Answer: B
Rationale: Children with hemiplegic cerebral palsy often exhibit shoulder retraction, elbow flexion, wrist flexion, and ulnar deviation due to spasticity.

63
Q

Which of the following congenital heart defects is characterized by a left-to-right shunt?
A. Tetralogy of Fallot
B. Ventricular septal defect (VSD)
C. Transposition of the great arteries
D. Coarctation of the aorta

A

Correct Answer: B
Rationale: VSD involves a left-to-right shunt due to higher pressure in the left ventricle, causing blood to flow abnormally into the right ventricle.

64
Q

What is the primary physiological abnormality in Tetralogy of Fallot?
A. Aortic stenosis
B. Pulmonary stenosis
C. Left ventricular hypertrophy
D. Patent ductus arteriosus

A

Correct Answer: B
Rationale: Pulmonary stenosis is one of the four defining features of Tetralogy of Fallot, along with VSD, overriding aorta, and right ventricular hypertrophy.

65
Q

A child presents with cyanosis, dyspnea, and ‘tet spells.’ Which congenital heart defect is most likely?
A. Atrial septal defect (ASD)
B. Tetralogy of Fallot
C. Coarctation of the aorta
D. Transposition of the great arteries

A

Correct Answer: B
Rationale: ‘Tet spells,’ characterized by cyanosis and difficulty breathing, are classic in Tetralogy of Fallot due to reduced pulmonary blood flow.

66
Q

Which congenital heart defect is commonly associated with a machine-like murmur?
A. Patent ductus arteriosus (PDA)
B. Atrial septal defect (ASD)
C. Ventricular septal defect (VSD)
D. Coarctation of the aorta

A

Correct Answer: A
Rationale: PDA produces a continuous, machine-like murmur due to abnormal blood flow between the aorta and pulmonary artery.

67
Q

What is the primary goal of administering prostaglandins in neonates with certain congenital heart defects?
A. Reduce pulmonary artery pressure
B. Close the ductus arteriosus
C. Maintain patency of the ductus arteriosus
D. Enhance myocardial contractility

A

Correct Answer: C
Rationale: Prostaglandins are administered to maintain ductus arteriosus patency in defects requiring mixed blood flow, such as transposition of the great arteries.

68
Q

Coarctation of the aorta typically presents with:
A. Cyanosis and poor feeding
B. Strong upper extremity pulses and weak lower extremity pulses
C. Machine-like murmur
D. Right-to-left shunting

A

Correct Answer: B
Rationale: Coarctation of the aorta causes strong pulses and hypertension in the upper extremities and weak pulses in the lower extremities due to narrowing of the aorta.

69
Q

Which of the following interventions is most critical during a hypercyanotic ‘Tet spell’?
A. Administer oxygen and place the child in a knee-chest position
B. Encourage the child to lie flat and rest
C. Administer diuretics and reduce fluid overload
D. Perform chest compressions to improve circulation

A

Correct Answer: A
Rationale: During a ‘Tet spell,’ the knee-chest position and supplemental oxygen improve oxygenation by increasing systemic vascular resistance and decreasing right-to-left shunting.

70
Q

Which of the following is a hallmark symptom of congestive heart failure (CHF) in children?
A. Widened pulse pressure
B. Poor weight gain and tachypnea
C. Bradycardia and cyanosis
D. Decreased heart sounds

A

Correct Answer: B
Rationale: Poor weight gain, tachypnea, and feeding difficulties are hallmark symptoms of CHF in children due to impaired cardiac output.

71
Q

Which congenital heart defect results in systemic and pulmonary circulations operating as parallel circuits?
A. Atrial septal defect (ASD)
B. Transposition of the great arteries (TGA)
C. Coarctation of the aorta
D. Patent ductus arteriosus (PDA)

A

Correct Answer: B
Rationale: In TGA, the systemic and pulmonary circulations are parallel, requiring mixing of blood through defects like ASD or PDA for survival.

72
Q

Which diagnostic tool is commonly used to confirm congenital heart defects in neonates?
A. MRI
B. Echocardiogram
C. Chest X-ray
D. Pulmonary function test

A

Correct Answer: B
Rationale: Echocardiography is the gold standard for diagnosing congenital heart defects due to its ability to visualize cardiac structures and blood flow.

73
Q

What is the primary cause of traumatic brain injury (TBI) in children under 2 years of age?
A. Motor vehicle accidents
B. Shaken baby syndrome
C. Sports injuries
D. Falls from height

A

Correct Answer: B
Rationale: Shaken baby syndrome is the leading cause of TBI in children under 2, characterized by repetitive acceleration-deceleration forces causing brain injury.

74
Q

Which Glasgow Coma Scale (GCS) score range is indicative of a moderate TBI?
A. 13-15
B. 9-12
C. 6-8
D. 3-5

A

Correct Answer: B
Rationale: A GCS score of 9-12 indicates moderate TBI, with potential for confusion, lethargy, or altered consciousness.

75
Q

What is the hallmark feature of diffuse axonal injury (DAI)?
A. Focal bleeding in the brain
B. Widespread tearing of axons
C. Localized swelling in one hemisphere
D. Direct skull fracture over the site of impact

A

Correct Answer: B
Rationale: Diffuse axonal injury involves widespread tearing or shearing of axons due to rotational forces, leading to disrupted neural communication.

76
Q

Which of the following is a common secondary injury mechanism in TBI?
A. Initial impact causing brain deformation
B. Axonal shearing from acceleration forces
C. Increased intracranial pressure (ICP)
D. Fracture of the skull

A

Correct Answer: C
Rationale: Secondary injuries such as increased ICP, hypoxia, or ischemia worsen the primary damage sustained during the initial trauma.

77
Q

Which Rancho Los Amigos Level of Cognitive Functioning is associated with a confused-agitated state?
A. Level III
B. Level IV
C. Level V
D. Level VI

A

Correct Answer: B
Rationale: Level IV is characterized by confused-agitated behavior, with restlessness, inappropriate responses, and difficulty with attention.

78
Q

What is the primary goal of positioning in children with acute TBI?
A. Increase blood pressure
B. Maintain intracranial pressure (ICP) below 20 mmHg
C. Promote early ambulation
D. Reduce range of motion deficits

A

Correct Answer: B
Rationale: Proper positioning helps maintain ICP below 20 mmHg, reducing the risk of secondary brain injury.

79
Q

A child with a TBI presents with decorticate posturing. This indicates damage to:
A. The brainstem
B. The cerebellum
C. The cerebral hemispheres above the brainstem
D. The basal ganglia

A

Correct Answer: C
Rationale: Decorticate posturing results from damage to the cerebral hemispheres above the brainstem, leading to flexion in the upper extremities and extension in the lower extremities.

80
Q

Which of the following is a typical symptom of post-concussion syndrome in children?
A. Persistent vomiting
B. Retrograde amnesia
C. Dizziness and difficulty concentrating
D. Elevated intracranial pressure

A

Correct Answer: C
Rationale: Post-concussion syndrome involves symptoms such as dizziness, difficulty concentrating, and fatigue, which may persist for weeks or months after the injury.

81
Q

All of the following are recommended cognitive rest strategies after a mild TBI except:
A. Avoiding screen time
B. Limiting schoolwork
C. Participating in physical sports
D. Taking frequent rest breaks

A

Correct Answer: C
Rationale: Physical sports should be avoided during recovery from a mild TBI, as they increase the risk of re-injury. The other options support cognitive rest.

82
Q

What imaging modality is most sensitive for detecting diffuse axonal injury (DAI)?
A. CT scan
B. MRI
C. X-ray
D. Ultrasound

A

Correct Answer: B
Rationale: MRI is more sensitive than CT scans for detecting diffuse axonal injury, as it provides better visualization of soft tissue changes.

83
Q

Which spinal cord injury (SCI) level is most commonly associated with the need for ventilatory support?
A. C1-C3
B. C4-C5
C. T1-T6
D. T7-T12

A

Correct Answer: A
Rationale: Injuries at C1-C3 affect the phrenic nerve, which controls the diaphragm, often requiring ventilatory support.

84
Q

Central cord syndrome is characterized by:
A. Complete loss of motor and sensory function below the level of the lesion
B. Greater motor impairment in the upper extremities than the lower extremities
C. Ipsilateral loss of motor function and contralateral loss of pain and temperature sensation
D. Preservation of proprioception and vibration sense

A

Correct Answer: B
Rationale: Central cord syndrome typically presents with greater motor impairment in the upper extremities due to damage to the central part of the spinal cord.

85
Q

What is the most common cause of spinal cord injury in children?
A. Birth trauma
B. Sports-related injuries
C. Motor vehicle accidents
D. Falls from height

A

Correct Answer: C
Rationale: Motor vehicle accidents are the leading cause of spinal cord injuries in children, particularly in older age groups.

86
Q

A child with a complete T6 SCI would likely retain which of the following functional abilities?
A. Voluntary control of the bladder
B. Full upper extremity function
C. Partial lower extremity movement
D. Independent diaphragm function

A

Correct Answer: B
Rationale: A T6 injury spares upper extremity function but results in loss of voluntary bladder control and lower extremity paralysis.

87
Q

Which spinal cord syndrome is characterized by ipsilateral loss of motor function and contralateral loss of pain and temperature sensation?
A. Central cord syndrome
B. Brown-Séquard syndrome
C. Anterior cord syndrome
D. Posterior cord syndrome

A

Correct Answer: B
Rationale: Brown-Séquard syndrome results from hemisection of the spinal cord, causing ipsilateral motor loss and contralateral pain and temperature loss.

88
Q

What is a hallmark sign of autonomic dysreflexia in individuals with SCI above T6?
A. Severe hypertension and bradycardia
B. Hypotension and tachycardia
C. Profuse sweating below the level of injury
D. Loss of deep tendon reflexes

A

Correct Answer: A
Rationale: Autonomic dysreflexia is characterized by severe hypertension, bradycardia, and sweating above the level of injury, often triggered by a noxious stimulus.

89
Q

Which of the following interventions is most appropriate for a child with autonomic dysreflexia?
A. Place the child in a supine position and administer IV fluids
B. Sit the child upright and identify the noxious stimulus
C. Perform passive range of motion exercises
D. Administer a corticosteroid injection

A

Correct Answer: B
Rationale: Sitting the child upright reduces blood pressure, and identifying and resolving the noxious stimulus (e.g., bladder distension) addresses the underlying cause.

90
Q

Which tool is commonly used to classify the severity of a spinal cord injury?
A. Glasgow Coma Scale (GCS)
B. ASIA Impairment Scale (AIS)
C. Rancho Los Amigos Scale
D. Modified Ashworth Scale

A

Correct Answer: B
Rationale: The ASIA Impairment Scale is used to classify the severity of SCI, assessing motor and sensory function as well as completeness of the injury.

91
Q

In spinal cord injuries, preservation of sensation in the perianal region (S4-S5) is indicative of:
A. Complete SCI
B. Incomplete SCI
C. Autonomic dysreflexia
D. Central cord syndrome

A

Correct Answer: B
Rationale: Preservation of sensation in S4-S5 indicates an incomplete SCI, as it reflects partial preservation of function below the level of injury.

92
Q

Which of the following is a key focus of physical therapy for children with spinal cord injuries?
A. Preventing contractures and promoting mobility
B. Performing daily manual muscle testing
C. Administering medications to manage spasticity
D. Assessing blood pressure during exercise

A

Correct Answer: A
Rationale: Physical therapy focuses on preventing contractures, maintaining range of motion, and promoting functional mobility to maximize independence.

DPT 772 - Pediatrics II (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions