MIDTERMS: Pedia Reviewer Flashcards
Most common type of CP?
Spastic Hemiplegia
Consists of rapid, irregular, unpredictable contractions of individual muscles or small muscle groups
a. Athetosis
b. Chorea
c. Dystonia
d. Ballismus
b. Chorea
Severe perinatal Asphyxia may result in injury of the following, except:
a. Medulla oblongata
b. Cerebral cortex
c. Basal ganglia
d. Hippocampus
a. Medulla oblongata
Consists of slow, smooth, writhing movements that involve distal muscles
a. Athetosis
b. Dystonia
c. Spasticity
d. Chorea
a. Athetosis
Inability to use both hands in midline or to reach out with the affected limb
Spastic hemiplegia
In choreoathetotic CP, athetosis is most apparent during reaching:
a. True
b. False
a. True
Kernicterus can cause:
a. Spastic quadriplegia
b. Athetoid CP
c. Spastic diplegia
d. Dystonic CP
b. Athetoid CP
In dyskinetic CP, which of the following is NOT true?
a. Flexion with shoulder protraction in the prone position
b. Involuntary movements are typically present
c. Movements are more noticeable during voluntary actions
d. The movements can fluctuate between stiffness and lack of control
a. Flexion with shoulder protraction in the prone position
Clonus and extensor plantar responses are absent in:
a. Spastic CP
b. Athetoid CP
c. Dystonic CP
d. Ataxic CP
c. Dystonic CP
Lower limbs are more affected than the upper limbs:
a. Spastic diplegia
b. Spastic quadriplegia
c. Ataxic CP
d. Dystonic CP
a. Spastic diplegia
Congenital infection could result in:
a. Spastic diplegia
b. Athetoid CP
c. Spastic quadriplegia
d. Ataxic CP
c. Spastic quadriplegia
Poor head control
a. Spastic Quadriplegia
b. Spastic Hemiplegia
c. Athetoid CP
d. Ataxic CP
a. Spastic Quadriplegia
Most commonly associated with periventricular leukomalacia:
a. Spastic quadriplegia
b. Ataxic CP
c. Spastic diplegia
d. Athetoid CP
c. Spastic diplegia
Language skills are typically delayed
a. Ataxic CP
b. Spastic CP
c. Athetoid CP
d. Spastic Hemiplegia
a. Ataxic CP
In a patient with spastic hemiplegia, which of the following is NOT true?
a. Abducted arm
b. Poor head control
c. Asymmetry in muscle tone
d. Affected side has more flexion
a. Abducted arm
A 10-month-old (corrected age) infant born at 23 weeks gestational age suffered grade III intraventricular hemorrhage prenatally and was on a ventilator for 2 months after birth. During a physical therapy evaluation, increased resistance to passive movement is noticed in all extremities, but most markedly in the lower extremities. The infant will probably be diagnosed with:
a. Spastic Hemiplegia
b. Spastic Quadriplegia
c. Spastic Diplegia CP
d. Athetoid CP
c. Spastic Diplegia CP
It describes a hernia of the meningeal membranes with little or no dysgenesis of the underlying nervous systems
a. Meningocele
b. Myelomeningocele
c. Hydrocephalus
d. Encephalocele
Meningocele
A therapist completes an examination on a young girl with spastic CP. The therapist determines that the girl has involvement in all four extremities as well as the head, neck, and trunk. What type of CP classification best describes the girl’s condition?
a. Spastic Diplegia
b. Spastic Hemiplegia
c. Spastic Tetraplegia
d. Ataxic CP
c. Spastic Tetraplegia
A 1-year-old child is being evaluated by an Early Intervention Team. The child demonstrates fluctuating muscle tone and has difficulty with stability. Righting and equilibrium reactions are delayed. The type of CP exhibited by this child is most likely:
a. Spastic Diplegia
b. Ataxic CP
c. Athetoid CP
d. Spastic Hemiplegia
c. Athetoid CP
A 12 yr old child with severe spastic quadriplegia CP can be expected to exhibit all of the following EXCEPT:
A. Increased muscle tone
B. Abnormal righting and equilibrium reactions
C. Impaired voluntary control
D. Decreased reflex activity
B. Abnormal righting and equilibrium reactions
A CP child with periventricular leukomalacia involving medial fibers of the corticospinal tract manifests as:
a. Spastic Hemiplegia
b. Spastic Quadriplegia
c. Spastic Diplegia
d. Athetoid CP
c. Spastic Diplegia
Which has sensorineural hearing loss?
a. Spastic Quadriplegia
b. Athetoid CP
c. Ataxic CP
d. Spastic Hemiplegia
b. Athetoid CP
What is the IQ of a mild mental retardate?
a. 85-100
b. 70-84
c. 55-69
d. Below 55
c. 55-69
The following characteristics are used to formally define mental retardation EXCEPT:
A. Significant limitations in intellectual functioning
B. Significant limitations in adaptive behavior
C. Onset before the age of 18
D. Premature birth
D. Premature birth
Tipping the wheelchair backwards to keep a child with increased trunk and lower extremity extensor tone from slipping forward is not advisable because it exaggerates the:
A. Symmetrical tonic neck reflex
B. Tonic labyrinthine reflex
C. Moro reflex
D. Labyrinthine posturing
D. Labyrinthine posturing
A 2-week old baby is suspected to have a dislocatable (L) hip. The most appropriate special test to confirm this is:
A. Barlow maneuver
B. Ortolani test
C. Galleazzi sign
D. Trendelenburg test
C. Galleazzi sign
Which of the following would NOT be recommended when treating a child?
A. Using games as therapy activities
B. Scheduling therapy in a consistent, structured environment
C. Various therapists should be involved at each visit so that the child feels secure with a variety of social contacts
D. Encouraging the child to make choices during treatment
C. Various therapists should be involved at each visit so that the child feels secure with a variety of social contacts
A child is being evaluated for physical therapy. The child is able to hop on one foot several times, throw a ball overhand, and dress self. The most likely developmental age of the child would be:
A. 3 years
B. 4 years
C. 5 years
D. 6 years
C. 5 years
A therapist performs a developmental assessment on a 3-month-old child. Which reflex is stimulated by the head suddenly dropping into extension?
A. Moro reflex
B. Startle reflex
C. Palmar grasp reflex
D. Landau reflex
A. Moro reflex
The therapist holds an infant in ventral suspension. The patient exhibited extension of the neck, trunk, and hips. The reflex is described as the:
A. Asymmetrical tonic neck reflex (ATNR)
B. Symmetrical tonic neck reflex (STNR)
C. Landau reflex
D. Moro reflex
C. Landau reflex
The following are considered normal in a toddler’s gait, EXCEPT:
A. Flat feet
B. Increased knee flexion during stance phase
C. Toe walking
D. Wide base of support
C. Toe walking
An infant is able to control his head in supported sitting. The correct age of this infant is:
A. 2 months
B. 3 months
C. 4 months
D. 5 months
C. 4 months
If a therapist elects to examine a 5-month infant’s palmar grasp reflex, which of the following stimuli is the most appropriate?
A. Light touch on the palm
B. Quick stretch to the fingers
C. Maintained pressure to the palm of the hand
D. Gentle traction of the wrist
C. Maintained pressure to the palm of the hand
This reflex is NOT present at birth:
A. Suckling reflex
B. Moro reflex
C. Rooting reflex
D. Protective extension
D. Protective extension
A developmental examination is completed on an 8-month-old infant. Findings from the examination include: the patient brings hand to mouth, requires assistance for ring sitting, presents with slight head lag, and does not reach across midline for objects. This child appears:
A. Developmentally delayed
B. Developmentally normal
C. Developmentally advanced
D. Developmentally disorganized
A. Developmentally delayed
The following are symptoms of the presence of ATNR in school-going children EXCEPT:
A. Difficulty crossing midline
B. Poor handwriting
C. Travel sickness
D. Difficulty sitting still
C. Travel sickness
An appropriate fine motor behavior that should be established by 9 months of age would be the ability to:
A. Transfer objects from one hand to another
B. Pick up small objects with a pincer grasp
C. Build a tower of 2 blocks
D. Scribble spontaneously
A. Transfer objects from one hand to another
If a therapist elects to examine a 5-month infant’s palmar grasp reflex, which of the following stimuli is the most appropriate?
A. Light touch on the palm
B. Quick stretch to the fingers
C. Maintained pressure to the palm of the hand
D. Gentle traction of the wrist
C. Maintained pressure to the palm of the hand
This reflex is not present at birth:
A. Suckling reflex
B. Moro reflex
C. Rooting reflex
D. Protective extension
D. Protective extension
A developmental examination is completed on an 8-month-old infant. Findings from the examination include: the patient brings hand to mouth, requires assistance for ring sitting, presents with slight head lag, and does not reach across midline for objects. This child appears:
A. Developmentally delayed
B. Developmentally normal
C. Developmentally advanced
D. Developmentally disorganized
A. Developmentally delayed
An appropriate fine motor behavior that should be established by 9 months of age would be the ability to:
A. Transfer objects from one hand to another
B. Pick up small objects with a pincer grasp
C. Build a tower of 2 blocks
D. Scribble spontaneously
A. Transfer objects from one hand to another
Stage of social play wherein the child plays near other children but still does not engage in play with them:
A. Cooperative play
B. Parallel play
C. Solitary play
D. Associative play
B. Parallel play
Which of the following anti-spastic medications reduces the release of calcium from the sarcoplasmic reticulum in the intrafusal and extrafusal muscle fibers?
A. Baclofen
B. Dantrolene
C. Diazepam
D. Tizanidine
B. Dantrolene
Which is not considered a normal finding during an examination of a newborn infant?
A. Dramatic skin color changes with change of state
B. Head molding
C. Presence of primitive reflexes
D. Jaundice in the first 24 hours
A. Dramatic skin color changes with change of state
Match the milestone: “Gives connected account of experiences”
48 months
Match the milestone: “Three word sentences are usual”
36 months
Match the milestone: “Refers to self by name, uses ‘me’ and ‘mine’”
24 months
Match the milestone: “Shouts for attention”
10 months
Match the milestone: “Responsive vocalization”
4 months
Match the milestone: “Copies circles”
3 years
Match the milestone: “Skips alternating feet”
5 years
Match the milestone: “Shows mastery of grammar”
6 years
Match the milestone: “Walks down the stairs”
2 years
Match the milestone: “Gives name, address, age”
5 years
Match the milestone: “Circular reaction (action motivates repetition)”
4 months
Match the milestone: “Can retrieve object from view”
10 months
Match the milestone: “Preoperational period – able to evoke an object or event not present”
24 months
Match the milestone: “Capable of insight (solving a problem by mental combinations)”
18 months
Match the milestone: “Differentiates available behavior patterns for new ends”
14 months
Match the milestone: “Removes garment”
14 months
Match the milestone: “Starts to show ‘no’ behavior”
10 months
10 months
7 months
Match the milestone: “Starts 2-word phrases”
24 months
Match the milestone: “Creeps on all fours”
10 months
Match the milestone: “Hands mostly open”
4 months
Match the milestone: “Hands fisted”
1 month
Match the milestone: “Recognizes bottle”
4 months
Match the milestone: “Blows bubbles”
4 months
Match the milestone: “Maintains sitting”
7 months
Absolute indication for immediate further evaluation follows when:
a. No pointing gestures by 7 months
b. No babbling by 18 months
c. No single words by 16 months
d. No 3-word spontaneous phrases by 24 months)
a. No pointing gestures by 7 months
In children with autism, following a person’s gaze develops by:
(10 months / 18 months / 12 months / 14 months)
12 months
Outcome measure that was noted to be very helpful in patients with Neurofibromatosis 1:
(BOT-2 / GMFM-88 / AIMS / PDMS-2)
GMFM-88
Walks using a handheld mobility device:
(GMFCS Level II / GMFCS Level V / GMFCS Level IV / GMFCS Level III)
GMFCS Level II
In children with autism, symbolic play is:
(Delayed at 14 months / Absent at 14 months / Absent at 18 months / Delayed at 18 months)
Absent at 18 months
Bilateral CNS lesion:
(Spastic triplegia / Spastic quadriplegia / Spastic monoplegia / Spastic hemiplegia)
Spastic quadriplegia
Which of the following reflexes is NOT integrated at the mid-brain level?
(Positive supporting reaction / Optical righting reflex / Neck righting reaction / Amphibian reaction)
Amphibian reaction
At 6 months, a normal child can:
(Walk if assisted / Roll over, may sit up / Pull self up / Say MAMA)
Roll over, may sit up
Level of spina bifida of an infant noted with calcaneovarus:
(S1 / L2 / L4 / T12)
L4
Which of the following classes of CP is most commonly caused by damage to the basal ganglia with hyperbilirubinemia or severe anoxia?
(Spastic / Rigid / Ataxic / Athetoid)
(Spastic / Rigid / Ataxic / Athetoid)
Patients with similar characteristics to mild autism but without significant impairments in cognition and language:
(Adrenoleukodystrophy / Asperger’s Syndrome / Pelizaeus-Merzbacher Disease / Rett Syndrome)
Asperger’s Syndrome
You are examining a girl of 9 months of age. Persistence of this reflex or response is abnormal:
(Plantar grasp / Head righting / Protective extension / Positive supporting)
Plantar grasp
A physical therapist is working with a child who has CP with spastic diplegia. All of the following could be used to improve the child’s ability to ambulate except:
A. Strength of the quadriceps
B. Balance training
C. Gait training
D. Stretching exercises
A. Strength of the quadriceps
In planning rehabilitation for the patient with CP, we should select the method and materials necessary to establish:
A. Independence in ADLs
B. Functional mobility
C. Comprehensive assessment
D. All of these
D. All of these
A physical therapy strategy to help a child with developmental delay to accurately learn how to reach would be:
A. Have the child reach for blocks
B. Place toys out of reach
C. Encourage reaching while sitting
D. Use a feeding chair
A. Have the child reach for blocks
A method of exercise by which normal and pathological reflexes are utilized as movement forces
Temple Fay
Based on the ontogenic plan or the normal developmental sequence of the human being, employs an orderly progression of techniques
Phelps
Bracing is not used, as it is felt that the neuromuscular training must be accomplished according to natural patterns
Schwarts
The principle of therapy which is most successful is that of restricting all but two movements of an extremity in the performance of a functional activity
Deaver
A pediatric physical therapist is working with a four-year-old who has myelodysplasia at the L5 level. At this level, the most appropriate orthosis to recommend for ambulation would be a:
A) Knee-ankle-foot orthosis
B) Hip-knee-ankle-foot orthosis
C) Ankle-foot orthosis
D) Foot orthosis
B) Hip-knee-ankle-foot orthosis
A physical therapist is working with a child who has cerebral palsy (CP) with spastic diplegia. All of the following could be used to improve the child’s ability to ambulate except:
A) Bilateral lower extremity activities such as “bunny hopping”
B) Strengthening exercises
C) Gait training
D) Balance activities
D) Balance activities
. Treatment for a child diagnosed with CP must be individualized to each child’s needs. In planning a treatment program that will remain effective over time, all of the following guidelines should be incorporated except:
A) Play should be integrated into therapy
B) Therapy should focus on functional activities
C) Direct movement responses should be prioritized
D) Play should not be integrated into therapy as it distracts from direct movement response
C) Direct movement responses should be prioritized
A physical therapist’s plan of care for a 7-year-old child with spastic diplegia includes all of the following except:
A) Pivot prone posture (prone extension)
B) Standing frame use
C) Gait training
D) Stretching exercises
D) Stretching exercises
A 2-week-old infant born at 27 weeks gestation with hyaline membrane disease is referred for a physical therapy consult. Nursing reports that the child “desaturates to 84% with handling” and has optimal secretions at present. The physical therapist should:
A) Perform manual techniques for secretion clearance, 2 to 4 hours daily, to maintain airway patency
B) Limit handling to reduce desaturation
C) Begin full oral feedings
D) Discontinue physical therapy until the infant is stable
B) Limit handling to reduce desaturation
An important adjunct to physical therapy management of a child with moderate spastic hemiplegia would be the use of:
A) A tone inhibiting ankle-foot orthosis (AFO)
B) A knee immobilizer
C) A pelvic stabilizing belt
D) A wheelchair
A) A tone inhibiting ankle-foot orthosis (AFO)
Which of the following developmental milestones will occur last?
A) Balancing 10 seconds on each foot
B) Walking backward
C) Walking upstairs with alternating feet
D) Walking up and down the stairs with alternating feet
D) Walking up and down the stairs with alternating feet
Upon evaluation of a one-year-old child, you note that the child exhibits fluctuating muscle tone and has difficulty with stability. Righting and equilibrium reactions are delayed. Most likely, the child has:
A) Spastic diplegia
B) Spastic quadriplegia
C) Athetoid cerebral palsy
D) Spastic hemiplegia
C) Athetoid cerebral palsy
A 6-year-old boy has a diagnosis of Duchenne Muscular Dystrophy and is still ambulatory. The MOST appropriate activity to include in his plan of care would be:
A) Wheelchair sports
B) Circuit training using resistance training and conditioning exercises
C) Progressive resistance strength training
D) Recreational physical activities such as swimming
B) Circuit training using resistance training and conditioning exercises
You are working with a 2-year-old child with Down syndrome who frequently uses a W-sitting position. The main reason to discourage W-sitting in this young child is that it may:
A) Increase abnormally high tone
B) Delay the development of normal sitting
C) Cause femoral torsion and knee strain
D) Decrease abnormal low to
B) Delay the development of normal sitting
Gait Due to a symmetrical distal neuropathy of the toxic, metabolic, or familial type, as in alcoholic neuropathy or Charcot-Marie-Tooth progressive peroneal atrophy
Bilateral Foot Drop or Steppage Gait
Gait Seen in muscular dystrophy and polymyositis, these patients find it difficult to get up onto or down from the examining table or difficult to stand up from a sitting or reclining position
Lordotic Waddling Gait
Gait Resembles a double foot drop. Seen in patients with tabes dorsalis, patients lift the knees high and slap the feet down
Dorsal Column or Sensory Ataxic Gait
Gait The back is lordotic, and when patients walk, they do not put any weight on the painful leg and take stiff, slow, short strides, with no heel strike. The trunk tilts slightly to the side opposite the pain
Radicular Pain or Antalgic Gait
Gait This type of gait is seen in Duchenne’s muscular dystrophy, spastic diplegia, and autistic or other retarded children -
Toe-Walking Gait
All of the following would be appropriate goals when treating a patient diagnosed with Down syndrome, except:
A) Minimizing gross motor delay
B) Encouraging social interaction
C) Promoting functional independence
D) Focusing solely on physical skills
D) Focusing solely on physical skills
A patient comes to the therapist because she has noted a pronounced tuft of hair on the center of her spinal column in the lumbar area. The therapist notes no loss in motor or sensory function. This patient most likely has what form of spina bifida?
A) Spina Bifida Oculta
B) Meningomyelocele
C) Myelomeningocele
D) Spina Bifida Cystica
A) Spina Bifida Oculta
During the evaluation of an infant, the therapist observes that with passive flexion of the head, the infant flexes the arms and actively extends the legs. Which of the following reflexes is being observed?
A) Protective extension
B) Asymmetrical tonic neck reflex (ATNR)
C) Symmetrical tonic neck reflex (STNR)
D) Flexor withdrawal
C) Symmetrical tonic neck reflex (STNR)
A patient asks the therapist whether she should be concerned that her 4-month-old infant cannot roll from his back to his stomach. The most appropriate response to the parents is:
A) “This is probably nothing to be concerned about because, although it varies, infants can usually perform this task by 5 months of age.”
B) “You should consult a pediatrician as this may indicate a delay.”
C) “Most infants can roll over by 4 months, so it is concerning.”
A) “This is probably nothing to be concerned about because, although it varies, infants can usually perform this task by 5 months of age.”
A 5-year-old boy with spastic hemiplegia shows signs of increased muscle tone in his left upper extremity. Which of the following would be the most effective intervention to facilitate motor control in the affected limb?
A) Strengthening exercises for the right upper extremity
B) Use of constraint-induced movement therapy (CIMT)
C) Gait training
D) Balance activities
B) Use of constraint-induced movement therapy (CIMT)
. In treating a child with autism spectrum disorder, which of the following is an important consideration?
A) The child will thrive in a busy environment.
B) The child may have difficulty understanding verbal instructions.
C) The child will likely have no difficulties with social interactions.
D) The child should only engage in physical activities that require minimal structure.
B) The child may have difficulty understanding verbal instructions.
