Pediatric Conditions Flashcards
Down syndrome
Trisomy 21
- heart & GI defects
- immune disorders (autoimmune, some cancers, infectious diseases i.e pneumonia)
- sleep apnea
- obesity
- spinal problems (antlantoaxial instability = at risk for SCI from overextension of the neck)
- leukemia
- dementia
- endocrine problems
- dental problems
- seizures
- ear infections, hearing/vision problems
Conditions associated with prematurity
- Necrotizing enterocolitis (NEC)
- bronchopulmonary dysphasia (BPD)
- intraventricular hemorrhage (IVH)
Myelomeningocele spica bifida
Most severe
- motor/sensory deficits of LEs (stance, locomotion issues, bowel/bladder dysfunction
- LE weakness/paralysis)
- UE impairments: motor weakness, impaired hand/finger dexterity, motor speed & planning, bimanual coordination (affects eye-hand coordination interfering with ADLs such as buttoning a shirt
- spatial relations, body image, hand dominance development
- perception, cognitive development issues
Type 2 Arnold-Chairi malformation: abnormal brain development involving cerebellum
ASD
- Communication, social, repetitive behavior
- perseveration, inflexible routines
- lack of safety
- SI, food preferences
- decreased environmental awareness
- difficulty with transitions
- no eye contact
- no reciprocal interaction
ADHD
Inattention, impulsive, hyperactive
Acquired brain injury
LOC & post traumatic amnesia
- impaired self care & writing
- decreased postural control
- vision & sensory
- delayed info processing
- aphasia
- ataxia
Spastic CP
Stiff, tight muscles, + Babinski sign, pyramidal, UMN disease
- Hemiplegia
- diplegia
- quadriplegia
Dyskinetic CP
Extrapyramidal, LMN, involuntary movements (chorea/jerky, choreoathetosis = both jerky & slow writhing movements)
- athetoid: writhing
- dystopia: distorted, repetitive posture
Ataxic CP
Shaky & balance issues, cerebellum dysfunction
- ataxic: jerky, uncoordinated, difficulty timing, unbalanced trunk/limb posture, may/may not have hypotonia
Mixed CP
Pyramidal & extrapyramidal, multiple movement patterns
Conditions associated with CP
- ID: attention, memory, decisions, problem solving, language, processing speed
- visual: strabismus, nystagmus, retinopathy, homoymous hemianopsia, hyperopia, cortical vision impairment, retinopathy
- hearing, language, speech: articulation, reading, expressive/receptive language
- seizures
- feeding & growth: hypotonia, weak suck, coordinated swallow, tonic bite, hyperactive gag, tongue thirst, constipation, gastroesophageal reflex, saliva control
- osteopenia: weak/brittle bones, fractures
- pain, sleep issues, bladder control, behavior
CP interventions
Constraint induced movement therapy, NDT, physical exercise, adaptive seating, serial casting, AE, AT
WC adaptations for CP
Solid seat/back, trunk support, tray, tilt seat 10-15 deg tilt, cushions, inserts, power controls
Orthotics for CP
AFO, resting hand splint
Marfans
Delayed walking, scoliosis, coxa Vera, stooped shoulders, skull assymetries
Achondroplasia
Dwarfism (grow 4ft or less)
- short limbs
- lumbar lordosis, coxa vara, cubits varus
- back/leg pain
Osteogenesis imperfecta
Brittle bones
- fetal: most severe
- infantile: childhood fx
- juvenile: least severe
Congenital clubhand
Partial/full absence of radius, ulnar shaft bowing, underdeveloped UE nerves/muscles
- hand remains functional
Congenital clubfoot
Unilateral or bilateral food medial deviation
Polydactly
Extra fingers/toes
Megadactyly
Overly large digits
Microdactyly
Overly small digits
Syndactyly
No web space
Clinodactyly
Abnormal bent finger- often in Down syndrome
Amelia
Absent limb or distal segments
- phocomelia: prox segment missing
- paraxial deficiencies: medial/lateral side of limb missing
- transverse hemimelia: amputated across central area
Anencephaly
No development above brain stem, don’t survive infancy
Encephalocele
Protrusion in occipital brain
- cog impairment
- hydrocephalus
- motor impairment
- seizures
Phenylketonuria
ASD tendencies, severe ID, behavior issues
Galactosemia
LD, perception problems, tremors, choreoathetosis, ataxia
Lesch-Nathan syndrome
Infant appears normal then regresses
- spasticity
- self injurious behavior: nail biting, face rubbing
- ID
Cytomegalovirus
universal precautions
- low birth weight, hearing loss
- microcephaly, neuro deficits
- spleen/liver damage
Prader Willi syndrome
Hypotonia, food seeking behaviors
- mod ID
- poor thermoregulation
Klinefelter’s syndrome
Extra X chromosome, boys
- emotional/behavior problems
- can’t father children
William’s syndrome
Characteristic affinity for music, social skills, writing
- ID
- Visual spatial, motor difficulties
- cerebral, heart issues
Chi du chat syndrome
Microcephaly, ID, hypotonia, failure to thrive, heart issues, respiratory & feeding
Turner’s syndrome
Visual perception, heart, congenital edema of extremities, no ID
Neurofibromatosis
Mild ID, LD
- speech, skeletal issues
Fragile X
ID, hyper mobile joints, anxiety, delayed talking, hyperactive, seizures
Pervasive developmental delay
Impaired ideation, limited play
Tourette’s syndrome
Loss of muscle coordination, involuntary purposeless movement
- ticks, coprolalia, incoherent grunts
Trisomy 13
Palau’s syndrome
- microcephaly, neural tube deficits, most don’t survive
ODD
At least 6 m of 4+ criteria
- loses temper, angry, resentful
- argues with adults, does not follow rules
- spiteful, vindictive
- blames others for mistakes
- deliberately annoys people, is easily annoyed
- touchy
Conduct disorder
- aggressive towards people/animals
- vandalism, theft, lying
- violates rules, norms, rights of others
- disruptive, uncooperative, sometimes combative
- affects job, social, school
Learning disability
- dyspraxia, dyslexia, dysgraphia, dyscalculia
- attention, concentration, thinking, memory
- speech, communication
- auditory
- sensory/perceptual deficits
Developmental coordination disorder/dyspraxia
Clumsy (FM, GM), social skills, delayed motor development, affects ADLs, school
Duchenne’s MD
Most common, progressive muscle weakness
- low tone, + Gower’s sign, waddling gait, frequent falls, weak voluntary muscles (heart, diaphragm), trouble getting up/runnning, Trendelenburg sign, LD, behavior/speech issues
Becker’s MD
Slow progression, less severe than Duchennes
- motor issues with hips, thighs, pelvis, shoulders
- enlarged calves
- cardiac involvement
Facioscapularhumeral MD
Affects face, scapula, upper arms
- stooped shoulders (can’t raise arms up)
- mask like face
- weak abs, sometimes hips
- NO CARDIAC/RESPIRATORY INVOLVEMENT
Limb girdle MD
Slow progression within first 30 y of life
- prox muscles of pelvis & shoulder
Congenital MD
Hypotonia, decreased muscle mass, no deep tendon reflexes, contracture, general muscle weakness
- Comorbid: torticollis, clubfoot, diaphragm/heart/spine issues
- type 1: no severe intellectual function difficulty
- type 2: muscle brain issues
- type 3: muscle, brain, eye issues
Congenital syphilis
Infant must be isolated
- early stage: hepatitis, failure to thrive, neuro issues
- if infected: osteochondritis in joints, bone issues, dental issues, vision, auditory
Toxoplasmosis
ID, hydrocephalus, CP, seizures, GI issues, liver, cardiac, choreoretinitus
Rubella
ID, hearing loss, liver/spleen, seizures, heart issues, microcephaly
- most won’t survive
Congenital herpes
Skin lesions 1-10 days after delivery, internal organ lesions, CNS damage, poor feeding/vomiting, fever, lethargy
Encephalitis
Brain inflammation due to bacteria or viral
- brain damage (mild to severe)
Meningitis
Tissues over brain & SC infected
- neuro motor
- visual & auditory
- LD
- seizures
Arthrogyposis multiplex congenital
Spine issues, torticollis, congenital heart, contractures, weak, stiff/spindly extremities, paralysis, fibrous ankylosis (incomplete contracture) of joints
- UE resting position = shoulders IR, elbows ext, wrists flexed
- LE resting position = flexed, IR hips, clubfoot
Rett syndrome
Only girls, lose motor ability previously learned (walking), regress
- slow growth
- eventual muscle weakness, rigid, spastic
- loss of communication, unusual eye movements, breathing issues, abnormal behaviors, cognitive issues, seizures, scoliosis, sleep issues, abnormal hand movements
ID
- heart disease, anemia, diabetes, obesity, seizures, ambulating issues, vision, speech
Mild: IQ 55-70 (learn at 3-7th grade level)
Mod: IQ 40-55 (learn at 2nd grade level)
severe: IQ 25-40: support for routine, supervision for no routine, aspiration
Profound: IQ under 25: assistance with all tasks, behavioral, orthopedic, neuromuscular issues
Juvenile RA
Arthritis in 1+ joints for 6+ weeks, systemic
- pauclarticular: less than 5 joints
- polyarticular: more than 5 joints
- systemic (Stills disease): polyarticular with organ involvement (high fever, high WBC, rash, anorexia, liver/spleen enlarged)
AIDS
Speech, language, motor deficits, ataxia, spasticity, tremors, seizures, chronic respiratory illness
Developmental dysplasia of the hip
Bilateral, dx via Barlow test (checks for clicking), early tx needed or Trendelenburg sign, hip laxity
Which childhood conditions result in learning disabilities?
Galactosemia, meningitis, klinefleter’s, neurofibromatosis, duchenne’s MD
Conditions with low tone (hypotonia)
Down syndrome, marfans, spina bifida, chi du chat, fragile X, MD, prader willi
Conditions with high tone (hypertonia)
Juvenile RA, AIDS, arthrogyposis multiplex congenital, lesch nyhan syndrome
