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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
By about what age do patients with Duchenne Muscular Dystrophy lose the ability to ambulate?
10 years old
26
Exposure to what will make myotonia congenita worse?
cold weather
27
What are the three subtypes of juvenile rhematoid arthritis?
polyarticular, oligoarticular, systemic
28
What type of JRA has the worst prognosis if RF positive?
polyarticular
29
In oligoarticular JRA, what referral is mandatory?
ophthalmology due to iridocyclitis and uveitis
30
What marker is positive in enthesitis-related JRA?
HLA-B27+
31
What is the triad seen in systemic JRA (Still's Disease)?
fever, rash, hepatosplenomegaly
32
How is CP defined?
Non-progressive neurologic disese due to a periuterine insult to the brain resulting in motor deficit.
33
What finding indicates that a CP patient will be able to walk?
They can sit independently by age 2
34
What is the most common form of spina bifida?
myelomeningocele
35
At what age does the greatest change in bone mass occur?
Early teens (sooner in girls)
36
What is the earliest marker of abnormal neurologic maturation?
persistent primitive reflexes
37
What is associated with a congenital femur longitudinal deficiency?
fibular deficiency
38
What is the most common prosthetic foot prescribed for the child amputee?
SACH
39
What is the most common complication after amputation in the immature child?
terminal overgrowth of transected bone (humerus most common)
40
Traditionally, at what age can an child be given a motorized WC?
5 years old
41
Initial treatment for club foot?
serial casting
42
What is Blount's disease?
proximal medial tibia growth plate dysfunction causing tibia vara
43
What is the most common cause of congenital torticollis?
fibrosis of the SCM
44
When do you consider surgical intervention for congenital torticollis?
no improvement by 18 months
45
Most common cause of hip pain in children?
transient synovitis of the hip
46
What is the cause of Legg-Calve-Perthes disease?
rapid growth in relation to blood supply
47
What system should be assessed in a child with a congential vertebral anomaly?
renal
48
How is Scheuermann's disease defined?
three or more consecutive vertebrae with \> 5 degrees anterior wedging
49
What is an isthmic spondylolisthesis?
slippage due to fracture of the pars (L5 most common)
50
What is dysplastic spondylolisthesis?
slippage due to congenital malformation of the facet joints at LS junction
51
What are 3 indications for surgical fusion of spondylolisthesis?
1. slippage greater than 50% 2. instability 3. progressive neurological deficits
52
What is the main factor determing outcome in children with Lupus?
Nephritis
53
What are two clinic features associated with juvenile dermatomyositis?
vasculitis and calcinosis
54
most common cause of septic arthritis in a newborn?
staph aureus
55
most common cause of septic arthritis in a child 2 months to 2 years old?
H. influenzae
56
most common cause of septic arthritis an a child older than 2?
staph auerus
57
What is the hallmark complication of hemophilia?
hemarthrosis
58
besides giving factor replacement, what three measures can be taken to treat hemarthrosis?
cold, pressure, and immobilize for 48hrs
59
Rule of 9s in Children
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
most common area for burn-related contracture in children
axilla
61
most common malignant CNS tumor in children?
Medulloblastoma (Embryonal)
62
most common type of malignant bone tumor in children?
osteosarcoma
63
What is the leading cause of death in children older than one?
TBI
64
Is the presence of a skulll fracture a good indication of severity of TBI in children?
No
65
What is the mechanism of injury in a lower trunk brachial plexopathy (Klumpke's)?
violent upward pull of the shoulder
66
What is the cause of diabetes insipidus?
deficiency of ADH
67
In general, what cause of TBI (traumatic or anoxic) has a better prognosis in children?
traumatic
68
69
What are three major **prenatal** risk factor categories for CP?
vascular, toxins, infection
70
What is prematurity the most common antecedent of CP?
prematurity is associated with fragile brain vasculature
71
What type of CP is associated with a high incidence of deafness?
dyskinetic
72
slow writhing involuntary movements
Athetosis
73
slow rhythmic movement with tone changes
dystonia
74
abrupt jerky movements
chorea
75
what metabolic abnormality is associated with sensorineural hearing loss in CP?
hyperbilirubinemia
76
What GMFCS level walks with assistive devices?
3
77
What is the range for the GMFCS scale?
1 (no restrictions) to 5 (severly limited mobility)
78
Persistence of primitive reflexes up to what age is a poor prognostic sign?
18 months
79
What is the incidence of mental retardation in CP? seizures in CP?
50% for each
80
Which CP related movement disorder is most associated with sensory neural impairment?
athetosis
81
What is a good indication of intellectual potential in a patient with CP?
Speaking in 3 word sentances by age 3.
82
Where is the highest incidence of spina bifida?
British Isles
83
What is a myelocele?
cystic cavity in front of the anterior wall of the spinal cord
84
What malformation is associated with myelomeningocele?
Arnold-Chiari Type II
85
What findings are associated with sacral level spina bifida?
cavus foot, bowel and bladder dysfunction
86
Lesions above what level preserve the spinal reflex arc?
L2
87
At what age can a boy learn to self-cath?
5 years old
88
What should you suspect in a spina bifida patient with rapidly progressing scoliosis?
tethered cord
89
What spinal cord level needs to be spared for a child with spina bifida to be able to walk with an AFO
L3
90
What is the cause of toe walking in DMD?
fibrotic dorsiflexors are overpowered by plantar flexors
91
What does the muscle biopsy look like in DMD?
clusters of necrotic fibers surrounded by macrophages and lymphocytes
92
Of the five main antagonistic pairs of muscles in the lower extremity, what are the weaker ones (3 hip, 1 knee, 2 ankle)?
hip abductors, hip extensors, knee extensors, ankle dorsiflexors, ankle evertors
93
In DMD, FVC below what threshold is a contraindication to surgical spinal arthrodesis?
40%
94
What is the clinical hallmark of Emery-Dreifuss muscular dystrophy?
elbow flexor contractures presenting in adolesence
95
Which type of CMT is axonal?
Type II

PM&R (78 decks)

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