Pediatric conditions and treatment

Question 1

Periventricular leukomalacia can result in what disability?

Answer 1

CP

Question 2

What grades of periventricular hemorrhage can lead to CP?

Answer 2

grades 2-4

- graded from 1-4

Question 3

T/F: CP is always d/t issues during birth.

Answer 3

false, can be prenatal, perinatal, or postnatal

Question 4

T/F: Infant jumpers/walkers would be an appropriate intervention for premature infant children.

Answer 4

false, they encourage extensor tone which we’re trying to limit

Question 5

What does athetoid CP look like?

Answer 5

decreased tone, floppy, foot stability in proximal joints, ataxia/incoordination in upright

Question 6

What are the gross motor classifications for kids with CP?

Answer 6

I-V

I = walks without restrictions
II = walks without device, limitations walking in community
III = walks with AD, still limited in community
IV = self mobility with limitations; power mobility in community
V = self mobility severely limited, even with assistive technology

Question 7

Why is a posterior walker used over an anterior walker for kids with CP?

Answer 7

promotes better posture and decreases extensor tone in arms from arm posture used to support oneself

Question 8

You’re working with a patient who has an intrathecal baclofen pump. What are some symptoms that would indicate overdose?

Answer 8

drowsiness
dizziness
respiratory depression
seizures
hypotonia
loss of consciousness

Question 9

What are the different types of spina bifida and their severities?

Answer 9

occulta = no spinal cord involvment

cystica = visable/open lesion

• myelomeningocele = CSF and herniated cord tissue in cyst
• meningocele = only CSF in cyst, no cord

Question 10

Why do defects in neural tube occur, resulting in spina bifida?

Answer 10

decreased folic acid, infection, exposure to alcohol/valproic acid, hot tub soaks

Question 11

What other issues are common to occur with spina bifida? (think brain, MS)

Answer 11

hydrocephalus (lots of these kids have shunts to relieve pressure)

talipes equinovarus (club foot)

Question 12

High level lumbar patients with spina bifida might need what to ambulate?

Answer 12

RGO

Question 13

You’re educating a patient with spina bifida’s family on how to watch for shunt malfunction. What symptoms should you tell them to look out for?

Answer 13

headache, bulging fontanelles, decreased muscle tone, seizure/vomiting, increased irritability, redness along shunt tract

Question 14

What’s the difference between Erb’s paralysis and Klumpke’s paralysis?

Answer 14

Both come from traction or compression injury to unilateral brachial plexus during birth or cervical rib abnormality

• Klumpke’s is lower: C8-T1 (finger flexors, wrist flexors/extensors)
• Erb’s involved C5-6 (upper arm paralysis down to long extensors in wrist/thumb)

Question 15

What’s the prognosis of a traction injury?

Answer 15

they resolve spontaneously

Question 16

Waiter’s tip posture is commonly seen in what injury?

Answer 16

Erb’s palsy

Question 17

What does PT intervention look like for babies with brachial plexus injuries?

Answer 17

partial immobilization of limb on abdomen

• gentle ROM after to prevent contracture
• gentle constraint of unaffected arm via positioning

Question 18

What are the optimal feeding techniques for patients with downs?

Answer 18

short, frequent feeding sessions to improve energy conservation

Question 19

T/F: Traction is an appropriate modality for kids with downs.

Answer 19

FALSE b/c they’re so lax

Question 20

Why does heterotopic ossification occur?

Answer 20

prolonged immobility combined with increased tone around joint

Question 21

T/F: Weakness in DMD begins from proximal to distal.

Answer 21

true

Question 22

What does a positive Gower’s sign indicate?

Answer 22

weak quads and glutes - using UEs to walk up legs

Question 23

What are common contractures that form with DJD?

Answer 23

PF contracture
lumbar lordosis
TFL contracture
kyphoscoliosis

Question 24

What should you tell the family about encouraging/not encouraging physical activity for their child newly diagnosed with DMD?

Answer 24

you WANT to encourage physical activity through recreational exercise and functional activities
- helps maintain strength/CV function

Question 25

T/F: Night splints are often given immediately to patients with DMD as contractures usually develop early.

Answer 25

true, especially in PFs and TFL

Question 26

T/F: Patients with DMD are losing muscle so need progressive resisted exercise to gain more muscle.

Answer 26

no they cannot exercise at maximal levels, overwork injury occurs and that torn muscle fiber is now gone forever

Question 27

T/F: Estim used in kids with DMD has been shown to improve contractility.

Answer 27

true

Question 28

What meds help to prolong life in DMD d/t improvements in pulmonary dysfunction?

Answer 28

steroids

Question 29

What positioning equipment can be effective in reducing effects of the tonic labrynthine reflex?

Answer 29

side lyers

- they also put hands in visual field which is good

Question 30

For what years is an EIP in place? (early intervention program) What about IEP? (individual education plan)

Answer 30

birth to 3 = EIP

3-21 = IEP