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PM&R > Pediatric PMR > Flashcards

Pediatric PMR Flashcards

1
Q

At what age do you expect supression of the symmetric and asymmetric tonic neck reflex?

A

6-7 months

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2
Q

At what age do you expect supression of the Moro reflex?

A

4-6 months

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3
Q

What chromosomal syndrome presents with webbed neck and coarctation of the aorta?

A

Turner’s (45 X)

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4
Q

What is the most common congenital limb deficiency?

A

Left terminal transradial

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5
Q

What procedure can be preformed on a patient with left terminal transradial deficiency to allow pincer grasp and preservation of sensation?

A

Krukenberg

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6
Q

What is the most common congenital lower limb deficiency?

A

fibular hemimelia (fibula is absent)

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7
Q

What is the Van Ness Rotation?

A

surgery in a child with a short femur which rotates the foot to allow the ankle to act as a new knee

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8
Q

What is another name for a severe equinovarus deformity?

A

club foot

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9
Q

What is the treatment for tibia vara?

A

osteotomy

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10
Q

What is the Gallazzi test?

A

Test for congenital hip dislocation where both knees are flexed up. The knee is lower on the dislocated side.

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11
Q

What is the Barlow test?

A

Test for congenital hip dislocation where both knees are placed in flexion and adduction then a posterior-directed force is applied to dislocate the hip.

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12
Q

What is the Ortolani test?

A

relocation of a displaced hip by abducting and applying anterior/medial force

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13
Q

What is the treatment for congenital hip dislocation?

A

Pavlik harness for 4 months

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14
Q

What are two different ways to reduce a nursemaid’s elbow?

A
  1. hyperpronate the forearm
  2. flex the elbow, supinate, and apply pressure to radial head
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15
Q

What is Little Leaguer elbow?

A

medial condyle traction apophysitis due to overuse

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16
Q

What is Osgood-Schlatter disease?

A

traction apophysitis of the tibial tubercle due to excessive jumping

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17
Q

What presents with sudden-onset hip pain with elevated ESR?

A

transient synovitis

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18
Q

How is the leg positioned in SCFE?

A

external rotation

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19
Q

How do you grade SCFE?

A
  1. 0 - 33%
  2. 34-50%
  3. greater than 50%
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20
Q

Treatment for SCFE?

A

Surgical pinning

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21
Q

What Cobb angles can be braced in idiopathic scoloisis?

A

20 - 40 degrees

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22
Q

What is Scheuermann disease?

A

idiopathic juvenile kyphosis

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23
Q

In Duchenne Muscular Dystrophy, what it the inheritance pattern and gene affected?

A

X-linked recessive, Xp21

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24
Q

What are the first muscles to be affected in Duchenne Muscular Dystrophy?

A

neck flexors

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25
Q

By about what age do patients with Duchenne Muscular Dystrophy lose the ability to ambulate?

A

10 years old

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26
Q

Exposure to what will make myotonia congenita worse?

A

cold weather

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27
Q

What are the three subtypes of juvenile rhematoid arthritis?

A

polyarticular, oligoarticular, systemic

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28
Q

What type of JRA has the worst prognosis if RF positive?

A

polyarticular

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29
Q

In oligoarticular JRA, what referral is mandatory?

A

ophthalmology due to iridocyclitis and uveitis

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30
Q

What marker is positive in enthesitis-related JRA?

A

HLA-B27+

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31
Q

What is the triad seen in systemic JRA (Still’s Disease)?

A

fever, rash, hepatosplenomegaly

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32
Q

How is CP defined?

A

Non-progressive neurologic disese due to a periuterine insult to the brain resulting in motor deficit.

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33
Q

What finding indicates that a CP patient will be able to walk?

A

They can sit independently by age 2

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34
Q

What is the most common form of spina bifida?

A

myelomeningocele

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35
Q

At what age does the greatest change in bone mass occur?

A

Early teens (sooner in girls)

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36
Q

What is the earliest marker of abnormal neurologic maturation?

A

persistent primitive reflexes

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37
Q

What is associated with a congenital femur longitudinal deficiency?

A

fibular deficiency

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38
Q

What is the most common prosthetic foot prescribed for the child amputee?

A

SACH

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39
Q

What is the most common complication after amputation in the immature child?

A

terminal overgrowth of transected bone (humerus most common)

40
Q

Traditionally, at what age can an child be given a motorized WC?

A

5 years old

41
Q

Initial treatment for club foot?

A

serial casting

42
Q

What is Blount’s disease?

A

proximal medial tibia growth plate dysfunction causing tibia vara

43
Q

What is the most common cause of congenital torticollis?

A

fibrosis of the SCM

44
Q

When do you consider surgical intervention for congenital torticollis?

A

no improvement by 18 months

45
Q

Most common cause of hip pain in children?

A

transient synovitis of the hip

46
Q

What is the cause of Legg-Calve-Perthes disease?

A

rapid growth in relation to blood supply

47
Q

What system should be assessed in a child with a congential vertebral anomaly?

A

renal

48
Q

How is Scheuermann’s disease defined?

A

three or more consecutive vertebrae with > 5 degrees anterior wedging

49
Q

What is an isthmic spondylolisthesis?

A

slippage due to fracture of the pars (L5 most common)

50
Q

What is dysplastic spondylolisthesis?

A

slippage due to congenital malformation of the facet joints at LS junction

51
Q

What are 3 indications for surgical fusion of spondylolisthesis?

A
  1. slippage greater than 50%
  2. instability
  3. progressive neurological deficits
52
Q

What is the main factor determing outcome in children with Lupus?

A

Nephritis

53
Q

What are two clinic features associated with juvenile dermatomyositis?

A

vasculitis and calcinosis

54
Q

most common cause of septic arthritis in a newborn?

A

staph aureus

55
Q

most common cause of septic arthritis in a child 2 months to 2 years old?

A

H. influenzae

56
Q

most common cause of septic arthritis an a child older than 2?

A

staph auerus

57
Q

What is the hallmark complication of hemophilia?

A

hemarthrosis

58
Q

besides giving factor replacement, what three measures can be taken to treat hemarthrosis?

A

cold, pressure, and immobilize for 48hrs

59
Q

Rule of 9s in Children

A

For a child less than one, the head is 18 and legs are 4.5. For each subsequent year, 1% is returned to the legs until the age of 9.

60
Q

most common area for burn-related contracture in children

A

axilla

61
Q

most common malignant CNS tumor in children?

A

Medulloblastoma (Embryonal)

62
Q

most common type of malignant bone tumor in children?

A

osteosarcoma

63
Q

What is the leading cause of death in children older than one?

A

TBI

64
Q

Is the presence of a skulll fracture a good indication of severity of TBI in children?

A

No

65
Q

What is the mechanism of injury in a lower trunk brachial plexopathy (Klumpke’s)?

A

violent upward pull of the shoulder

66
Q

What is the cause of diabetes insipidus?

A

deficiency of ADH

67
Q

In general, what cause of TBI (traumatic or anoxic) has a better prognosis in children?

A

traumatic

68
Q
A
69
Q

What are three major prenatal risk factor categories for CP?

A

vascular, toxins, infection

70
Q

What is prematurity the most common antecedent of CP?

A

prematurity is associated with fragile brain vasculature

71
Q

What type of CP is associated with a high incidence of deafness?

A

dyskinetic

72
Q

slow writhing involuntary movements

A

Athetosis

73
Q

slow rhythmic movement with tone changes

A

dystonia

74
Q

abrupt jerky movements

A

chorea

75
Q

what metabolic abnormality is associated with sensorineural hearing loss in CP?

A

hyperbilirubinemia

76
Q

What GMFCS level walks with assistive devices?

A

3

77
Q

What is the range for the GMFCS scale?

A

1 (no restrictions) to 5 (severly limited mobility)

78
Q

Persistence of primitive reflexes up to what age is a poor prognostic sign?

A

18 months

79
Q

What is the incidence of mental retardation in CP? seizures in CP?

A

50% for each

80
Q

Which CP related movement disorder is most associated with sensory neural impairment?

A

athetosis

81
Q

What is a good indication of intellectual potential in a patient with CP?

A

Speaking in 3 word sentances by age 3.

82
Q

Where is the highest incidence of spina bifida?

A

British Isles

83
Q

What is a myelocele?

A

cystic cavity in front of the anterior wall of the spinal cord

84
Q

What malformation is associated with myelomeningocele?

A

Arnold-Chiari Type II

85
Q

What findings are associated with sacral level spina bifida?

A

cavus foot, bowel and bladder dysfunction

86
Q

Lesions above what level preserve the spinal reflex arc?

A

L2

87
Q

At what age can a boy learn to self-cath?

A

5 years old

88
Q

What should you suspect in a spina bifida patient with rapidly progressing scoliosis?

A

tethered cord

89
Q

What spinal cord level needs to be spared for a child with spina bifida to be able to walk with an AFO

A

L3

90
Q

What is the cause of toe walking in DMD?

A

fibrotic dorsiflexors are overpowered by plantar flexors

91
Q

What does the muscle biopsy look like in DMD?

A

clusters of necrotic fibers surrounded by macrophages and lymphocytes

92
Q

Of the five main antagonistic pairs of muscles in the lower extremity, what are the weaker ones (3 hip, 1 knee, 2 ankle)?

A

hip abductors, hip extensors, knee extensors, ankle dorsiflexors, ankle evertors

93
Q

In DMD, FVC below what threshold is a contraindication to surgical spinal arthrodesis?

A

40%

94
Q

What is the clinical hallmark of Emery-Dreifuss muscular dystrophy?

A

elbow flexor contractures presenting in adolesence

95
Q

Which type of CMT is axonal?

A

Type II

PM&R (21 decks)

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