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Exam Prep > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Upper motor neuron bladder

A

Lack of autonomic response for voiding

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2
Q

Lower motor neuron bladder

A

Lack of ability to empty bladder

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3
Q

Cerebral palsy

A

Umbrella term for neurological brain injury/malformation that occurs before, during or immediately following birth resulting in impaired gross motor, muscle tone, visual impairement, coordination/FMC, balance, posture, reflexes, cognitive processing and oral motor functioning

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4
Q

Spastic CP

A

Lesion of motor cortex resulting in spasticity including hypertonia and hyperreflexia

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5
Q

Key markers of CP

A

Retention of primitive reflexes
Abnormal muscle tone
Hyper-responsive tendon reflexes
Asymmetrical use of extremities
Clonus
Involuntary movement
Poor feeding and tongue control

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6
Q

Dyskinetic CP

A

Lesion of basal ganglia resulting in fluctuations in muscle tone, posturing and involuntary movement including dystonia, athetosis, chorea

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7
Q

Dystonia

A

Excessive repetitive movement and abnormal postures that increase with intention

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8
Q

Athetosis

A

Writhing involuntary movements that are more distal than proximal

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9
Q

Chorea

A

Involuntary movements that are more proximal than distal

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10
Q

Ataxic CP

A

Lesion in cerebellum that results in hypotonia, ataxia movement and lack of stability

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11
Q

Monopleegia

A

One extremity

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12
Q

Hemiplegia

A

UE and LE on same side

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13
Q

Paraplegia

A

LE

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14
Q

Quadriplegia

A

All extremities

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15
Q

Diplegia

A

UE involvement < LE involvement

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16
Q

Common complications with CP

A

Seizures, cognitive deficits, visual impairment, dysphagia

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17
Q

GMFCS Level 1

A

Walks without restrictions, limitations in advanced gross motor skills

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18
Q

GMFCS Level 2

A

Walks without AE, limitations walking outdoors and in community

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19
Q

GMFCS Level 3

A

Walks with AE, limitations walking outdoors and in community

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20
Q

GMFCS Level 4

A

Self-mobility with limitations, transported in w/c or use of power mobility outdoors and in community

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21
Q

GMFCS Level 5

A

Self-mobility severely limited even with AT use

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22
Q

MACS Level 1

A

Handles objects easily and successfully

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23
Q

MACS Level 2

A

Handles most objects with some reduced quality and speed

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24
Q

MACS Level 3

A

Handles objects with difficulty and needs help to modify or prepare activities

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25
Q

MACS Level 4

A

Handles limited section of easily managed objects

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26
Q

MACS Level 5

A

Does not handle objects and has severely limited ability to perform simple actions

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27
Q

CP tx

A
  • Motor planning, control, coordination practice
  • AROM/PROM with stretching, exercise, orthotic
  • AE for participation
  • Seating and positioning education
  • CIMT
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28
Q

Spinal bifida occulta

A

Bony malformation with seperation of vertebral arches with no external malformation, may not be discovered until late childhood

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29
Q

Spina bifida cystica

A

Exposed pouch composed of CSF, meninges and/or spinal cord

  1. Meningocele
  2. Myelomeningocele
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30
Q

Meningocele

A

Contains CSF and meninges but not spinal cord - usually does not present symptoms impacting function if spinal chord is not entrapped, symptoms may include occasionally instability, gait disturbances and bowel/bladder impairment

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31
Q

Myelomeningocele

A

Contains CSF, meninges and spinal cord/nerve roots, most commonly in lumbar region, sensory/motor impairment below the level of the injury, incontinence, ulcers, DVT

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32
Q

Common complications of myelomeningocele

A

Hydrocephalus
Arnold-chiari
Tethered cord

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33
Q

Tonic-clonic seizures

A

Tonic phase: loss of consciousness, stiffening of body, heavy/irregular breathing, drooling, pale skin

Clonic phase: alternating rigidity and rhythmic and relaxation of muscles

Postictal state: period of drowsiness, disorientation or fatigue

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34
Q

Absence seizure

A

Brief lapse or loss of awareness with absence of motor activity that lasts 15 seconds and mimics daydreaming

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35
Q

Status epilepticus

A

Extended seizure

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36
Q

Akinetic seizure

A

Loss of muscle tone for 30 seconds

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37
Q

Myoclonic seizure

A

Contractions of single muscles or muscle groups

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38
Q

Public health model of service delivery levels

A
  1. Universal (whole population design)
  2. Targeted (selective services)
  3. Intensive
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39
Q

RTI approach to school-based practice

A

Tier 1: school-wide efforts for all children

Tier 2: developing and running programs for at-risk student and consulting with teachers to modify learning demands

Tier 3: individual or group interventions for students

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40
Q

CBT strategies

A
  1. Psychoeducation
  2. Affective education
  3. Cognitive restructuring
  4. Relaxation training
  5. Exposure of fears and contingency mgmt
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41
Q

Affective education

A

Teaching skills to identify and recognize emotions and what impacts emotions

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42
Q

Cognitive restructuring

A

Teaching stills to recognize maladaptive thoughts

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43
Q

Positive behavioral intervention and supports (PBIS) Model

A

Consistent application of procedures for correcting misbehaviors at school

Rules with instructions for behaviors with consistent expectations

Focus is on positive reinforcement and talking through the negative behaviors with the child to teach

Within the 3 tier system

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44
Q

Shifting FM skill

A

Ability to move objects between fingers
- Trying to separate two pieces of paper that are stuck together
- Move fingers closer to the end of your pencil to begin writing

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45
Q

Examples of fingers-to-palm translation skill

A

Grabbing coins out of purse
Crumbling papper

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46
Q

Example of palm-to-fingers translation skill

A

Placing game pieces on a board

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47
Q

Shaping technique for learning

A

Successively approximating or learning intermediate behaviors that are prerequisite of the final behavior with reinforcers applied in small steps

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48
Q

What dx commonly co-occurs with ODD

A

Attention deficit hyperactivity disorder (ADHD)

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49
Q

When does transition planning typically start

A

Age 14 to 16

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50
Q

Social–Cognitive Intervention Model

A

Facilitate learning of behaviors by observing the behavior of others

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51
Q

Ideational praxis

A

Conceptualize, plan, and execute a complex, sequence of motor actions to interact with objects such as toys or climbing equipment

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52
Q

Adaptation

A

Responding to environment challenges as they occur

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53
Q

Mental schemas

A

Organizing experiences into concepts

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54
Q

Operations

A

Cognitive methods used by child to organize schemes and experiences to direct future action

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55
Q

Equilibrium

A

Balance between what child knows and can do vs what environment provides

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56
Q

Assimilation

A

Ability to take new situation and change it to match existing scheme (generalization)

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57
Q

Accomodation

A

Development of new scheme in response to new situation (discrimination)

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58
Q

Bayley Scales of Infant Development

A

What: assess multiple areas of development for baseline including cognitive, language, motor, adaptive behavior and social-emotional behavior (standardized)

Method: age appropriate performaced-based items and parent questionnaire

Population: 1 to 3.5

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59
Q

Hawaii Early Learning Profile

A

What: assess 6 areas of function including cognitive, language, GM, FM, social emotional and self-help (criterion-based)

Method: age appropriate performance-based items administered

Population: birth to 3 with development delay or at risk for development delay

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60
Q

Miller assessment for pre-schoolrs

A

What: assess sensory, motor and cognitive abilities (standardized)

Method: age appropriate performance-based items administered

Population: 2 years 9 months to 5 years 8 months

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61
Q

Pediatric evaluation of disability inventory

A

What: assess capabilities and detects function deficits to determine developmental level across self-care, mobility and social skills (standardized)

Method: observation and interview

Population: 6 months to 7.5 years

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62
Q

Developmental Assessments

A

Bayley Scales of Infant Development
Hawaii Early Learning Profile
Miller assessment for pre-schoolrs

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63
Q

BOT-2

A

What: assess FM and GM (standardized)

Method: long and short form with eight subtests (fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running and ability, upper limb coordination, strength)

Population: 4-21

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64
Q

Peabody developmental motor scales

A

What: assess GM and FM (standardized)

Method: test items to address reflexes, sustained control locomotion, object manipulation, grasping ,visual motor integration

Population: birth to 6 with motor, speech, hearing disorders

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65
Q

Motor assessments

A

BOT-2
Peabody

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66
Q

Berry-VMI

A

What: assesses visual motor integration

Methods: copy 24 geometric shapes (standardized)

Population: 2-100

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67
Q

DTVP-2

A

What: assess visual perceptual skills and visual motor integration

Methods: eight subtests (eye-hand coordination, copying, spatial relations, visual-motor speed, position in space, figure ground, visual closure, form consistency)

Age: 4-10

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68
Q

MVPT-4

A

What: assess visual motor without motor components

Method: 5 subtests (spatial relations, visual discrimination, figure ground, visual closure, visual memory

Population: 4 - 95

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69
Q

MFVPT-vertical

A

What: assess individuals with spatial deficits due to hemispatial neglect or abnormal visual saccades

Method: 36 items placed vertically are used to assess spatial relationship, visual discrimination, figure ground, visual closure and visual memory without motor components

Population: 4 - 95

70
Q

Visual perception assessments

A

MFVPT
Berry-VMI
DVTP
MVPT

71
Q

Childhood Autism Rating Scale

A

What: determine severity of ASD as mild, moderate, severe and distinguished children with ASD from children with development delays

Method: observational tool to rate behaviors

Population: children 2+ with ASD

72
Q

Copying inventory and early copying inventory

A

What: assess coping habits, skills and behaviors including effectiveness, style, strengths and vulnerability to develop intervention for coping skills

Method: questionnaire or caregiver questionnaire

Early: 4 - 36 months
Coping: 15 years +

73
Q

Revises Knox Preschool Play Scale

A

What: observations of play skills to differentiate developmental play abilities, strengths, weakness, interests

Method: two 30 min observations completed in natural indoor and outdoor environment with peers and observations are organized according to 6 month intervals up to age 3 across four dimensions (space mgmt, material mgmt, symbolic and participation)

Population: 0 - 6

*useful when standardized assessment might not be possible

74
Q

Test of playfulness

A

What: assess child’s playfulness

Method: observation of four aspects of play including intrinsic motivation, internal control, suspension from reality and framing. The extent, intensity and skillfulness of play are rated (more of each = more play)

Population: 15 months to 10 years

75
Q

Transdisiplinary play-based assessment

A

What: assesses child development, learning style, interaction patterns and behaviors to determine need for services

Method: non-standardized play assessment using observation across 6 stages

Population: 0 - 6

76
Q

School function assessment

A

What: assess functional performance to promote participation in school environment (does not measure academic performance)

Method: criterion-referenced questionnaire that addresses level of participation, type of support required and performance on school-related tasks

Population: K - 6th grade (5 - 12)

77
Q

Bradydysrhythmia

A

Abnormally slow HR (<60 bpm)
Atrioventricular block most common
May require pacemaker

78
Q

Tachydysrhythmia

A

Abnormally fast HR (>200-300)
Can lead to CHF
May result in irritability, poor eating habits, pallor skin

79
Q

Respiratory distress syndrome

A

Deficiency of surfactant (supports breathing upon birth), can result in chronic lung conditions due to compromised O2 absorption

80
Q

Bronchopulmonary dysplasia

A

Due to prolong use of mechanical ventilation to treat acute respiratory problems leading to thickening of airway and greater risk for future infection/problems

81
Q

Asthma

A

Airway constriction in lower respiratory tract, difficulty breathing, wheezing

82
Q

Asthma intervention

A

Reduction to irritant education
Pacing
Stress mgmt
Structured peer-groups
Breathing exercises

83
Q

Cystic fibrosis

A

Degenerative condition resulting in malfunctioning mucus-producing glands that block small intestine and pancreas

Can result in chronic pulmonary disease that causes chronic cough, wheezing and lower respiratory tract infection

84
Q

Intervention for CF

A

Education on progression
Energy conservation
Strategies for efficient breathing

85
Q

Signs of hemophilia

A

Excessive bleeding
Excessive bruising
Spontaneous bleeding
Nosebleeds

86
Q

Osteogenesis imperfecta

A

Brittle bones disease, minor trauma results in fractures, frequnetly develop progressive deformities

87
Q

What strategies are important for osteogenesis imperfecta

A

Caregiver ed on handling and positioning
Include activity with weight bearing

88
Q

Marfan syndrome

A

Excessive growth at the epiphyseal plates resulting in lax and hypermobile joints and abnormal connective tissue which provides support for the body and organs

89
Q

Arthrogryposis multiplex congenita

A

Incomplete contracture of joints at birth associated with reduction of anterior horn cells, patients present with increased stiffness and incomplete fibrous ankylosis

90
Q

Focus of intervention with Arthrogryposis multiplex congenita

A

Increase and maintain ROM
Stretching/strengthening program
Use of adaptive equipment for ADL/IADL

91
Q

Congenital clubfoot

A

Forefoot adduction and supination, heel varus, equinus of the ankle, and medial deviation of the foot.

92
Q

Congenital club hand

A

Partial/full loss of radius and bowing of the ulnar shaft, underdevelopment of the upper extremity nerves and musculature

93
Q

Dysplasia of the hip

A

Dislocation of head of femur from acetabulum resulting in hip laxity that can lead to long term disability if not diagnosed early but with splinting/casting there are good outcomes

94
Q

Barlow test

A

Used to assess dysplasia of hip - determines if head of femur is dislocated from acetabulum when in adduction with posterior force

95
Q

Without tx for dysplasia of hip what will result

A

Trendelenburg’s sign - hip drops to the opposite side of dislocation and trunk shifts toward dislocated when the child stands on one foot

96
Q

Polydactyly

A

Additional fingers or toes

97
Q

Syndactyly

A

Webbing occurs beween fingers and toes

98
Q

Megadactyly

A

Overly large digits - difficulty with FMC

99
Q

Microdactyly

A

Overly small digits

100
Q

Amelia

A

Absence of limb or segment of limb

101
Q

General presentation of JRA

A

Joint inflammation
Joint stiffness
Joint contracture
Change in growth patterns

102
Q

Three types of JRA

A
  1. Pauciarticular: four or fewer joints
  2. Polyarticular: five or more joints
  3. System “stills disease: polyarticular with organ involvement (fever, rash, anorexia, elevated WBC, spleen/liver enlargement)
103
Q

Intervention for JRA

A

Splinting as needed
AROM/PROM
Monitor joint functionality
Monitor joit defority
Energy conservation
Adaptive equipment

104
Q

Types of fractures

A

Complete
Comminuted
Compound
Epiphyseal
Greenstick
Intrauterine

105
Q

Lordosis

A

Anteroposterior curvature in lumbar region
Hollow back
Anterior pelvic tilt

106
Q

Lordosis tx

A

Stretching hip flexors
Strengthening abdominals
Postural training
Back brace

107
Q

Kyphosis

A

Posterior convexity
Round back in thoracic region
Posterior pelvic tilt
Lateral flexion

108
Q

Kyphosis tx

A

Postural training
Strengthening
Milwaukee brace
Anterior spinal release

109
Q

Scoliosis

A

Lateral curvature of the spine

110
Q

Types of scoliosis

A
  1. functional: due to bad posture, contracure. leg discrepancy or pain, spine is still flexible
  2. Congenital: structure due to abnormal spinal structure
111
Q

Severity of scoliosis based on degrees

A

Cure 20 degrees or less: mild
Curve more than 40 degrees: permanent deformity
Curve 65-80 degrees: reduced cardiopulmonary fx

112
Q

Scoliosis tx

A

Boston brace
Thoracolumbosacral orthotic
Abdominal muscle strengthening
ADP adaptations

113
Q

Muscular dystrophy category classified by

A

Progressive degeneration and weakness of muscle groups that can lead to death

114
Q

Limb girdle muscular dystrophy

A

Affects proximal muscles of pelvis and shoulder girdle with slow progression

115
Q

Facioscapulohumeral muscular dystrophy

A

Affects face, upper arms, scapular region with limited ability to raise arms and decrease mobility in facial muscles

116
Q

Duchenne’s muscular dystrophy (DMD)

A

Most common form of muscular dystrophy with symptoms developing between ages 2-6 and fast progression of muscle weakness

117
Q

How is DMD diagnosed

A

Gower’s sign - when asked to get up from sitting on floor child moves hands on legs and crawls up to thighs to assume standing

118
Q

Prognosis of DMD

A

Age expectancy in 20s due to respiratory/cardiovascular complications
Wheelchair by age 9

119
Q

Congenital muscular dystrophy

A

Onset in utero with brain involvement impacting neuro-muscular functioning with symptoms including hypotonia, generalized muscle weakness and contractures

120
Q

Categories of congenital muscular dystrophy

A

CMD I: no sever intellectual impairment

CMD II: muscle and brain abnormalities

CMD II and IV: muscle brain and eye abnormalities

121
Q

Condition mgmt. spina bifida 5-6 years old

A

Begin pressure checks
Communicate with caregivers about body changes
Keep track of AD
Self-catheterization at school
Carry doctor contact info in case of emergency

122
Q

Condition mgmt. spina bifida 10-14 years old

A

Recognize when feeling bas is due to condition
Name docs
Know medications
Direct others how to help with AD
Self-catheterization in community
Takes responsibility for health

123
Q

Condition mgmt. spina bifida 15-18 years old

A

Take meds independently
Know how to contact docs and therapists
perform regular skin checks
Maintain equipment
Manage weight

124
Q

Erb-Duchenne palsy

A

Injury to brachial plexus (C5 and C6) due to extreme shoulder flexion which is common with breech deliveries resulting in unilateral weakness and wasting of small muscles of hands and shoulder and difficulties with sensory discrimination of UE

125
Q

Characteristic posture of Erb-Duchenne

A

Waiter’s tip position - shoulder adduction and internal rotation, elbow extension, forearm pronation and wrist flexion

126
Q

Klumpke’s palsy

A

Compression to brachial plexus (C8 and T1) resulting in paralysis of hand and wrist muscles and claw deformity

127
Q

OT intervention with brachial plexus injury

A

Observation of ADL
Fabrication of sling that fits proximally around humerus to ensure alignment of shoulder joint
PROM/AROM
Resistive and WB exercises
Tactile stimulation using texture, vibration, massage
Bilateral based activities
Edema mgmt

128
Q

Is mental imagery a CBT approach

A

Yes

129
Q

Zones of regulation

A

Curriculum to teach children about regulating emotions and sensory needs and using strategies reach optimal regulation across four zones

130
Q

Four zones of regulation

A

Red: high arousal, intense emotions, anger
Yellow: less arousal but still more heightened state, stress, anxious, nervous
Green: optimal state, ready to work, calm, focused and attentive
Blue: sadness illness, boredom, fatigue

131
Q

3 types of learning disabilities

A

Dyslexia
Dysgraphia
Dyscalculia

132
Q

Atlantoaxial instability

A

Common complication with down syndrome of excessive movement at the junction between the atlas (C1) and axis (C2) a which can lead to dislocation of atlantoaxial joint and permanent spinal cords damage, children should not hyper-flex neck or perform front rolls

133
Q

Prader willi syndrome

A

Moderate intellectual disability, food seeking behaviors, hypotonia, poor thermal regulation, underdeveloped sex organs, long faces with slanted eyes

134
Q

Williams syndrome

A

Intellectual disabilities, cerebral and cardiovascular abnormalities, interest in muscle, social interaction and writing, difficulties with visual, spatial and motor skills

135
Q

Fragile-X syndrome

A

Intellectual disability, cranial-facial deformities, prominent jaw/forehead, flat feet, hypermobile joints

136
Q

PKU

A

Inborn error in processing amino acids resulting in severe intellectual and behavioral difficulties if specific diet of limited protein is not followed (can resolve around age 10 if followed correctly)

137
Q

Galactosemia

A

Inborn error due to inability to convert milk sugar to glucose which can result in spleen and liver dysfunction with symptoms of jaundice, vomiting, lethargy, cataracts, tremors, choreoathetosis, ataxia and infection and if left untreated death. Treatment involves no milk diet.

138
Q

Lesch-Nyhan syndrome

A

Inborn error due to inability to metabolize purines, infant often appear normal for firs year and then regress and present with intellectual disability , neuro-motor degeneration, spastic, nail-biting and face-rubbing compulsions, treatment involved self-injurious behavior

139
Q

Developmental coordination disorder

A

Condition of motor incoordination, symptoms first present as delayed achievement of motor millstones and self-care skills and progress to difficulty with FM/GM skills as well as social skills and academics due to underlying motor coordination impairment

140
Q

Implications for OT with developmental coordination disorder

A

Focus on performance across contexts
Use modification/accommodations for written language including keyboarding
Provide support in PE
Practice safe motor skills
Develop self concept and self esteem

141
Q

Common approach for developmental coordination disorder

A

CO-OP (cognitive orientation to daily occupational performance

142
Q

CO-OP

A

Client-centered and cooperative problem-solving approach used to coach child through self-discovery to determine solutions for problems that involve motor performance, child helps to formulate and select goals and work on way to generalize across contexts

143
Q

Anticipated outcomes of CO-OP

A

Acquisition, generalization and transfer of skill
Improved self-efficacy and independent strategy development

144
Q

Typical grasp progression

A

Primitive - transitional - mature

145
Q

Primitive grip

A

Whole hand with pronated forearm used to hold pencil with writing movement coming from shoulder

146
Q

Transitional grip

A

Flexed fingers with radial side down and pronated forearm that transitions to supinated forearm position

147
Q

Mature grip

A

Pencil stabilized by distal phalanges of thumb, middle, index with writs slightly extended and forearm supinated resting on table

148
Q

Functional grips for handwriting

A

Dynamic tripod
Lateral tripod
Dynamic quadrupod
Lateral quadrupod

149
Q

Word legibility formula

A

Total # legible words / total number of words written

150
Q

Neurodevelopmental approach to HW

A

For children who have poor postural control, abnormal tone and poor proximal stability focuses on completed preparation activities for posture/stability and UE function

151
Q

Acquisitional approach to HW

A

HW should be taught directly through brief daily lessons and individualized to the child

152
Q

Three phases of HW using acquisitional approach

A
  1. Cognitive phase: child understands demand of HW and develops cog strategies for required motor output
  2. Associate phase: child practices and starts to self-monitor, use of proprioceptive feedback and visual cues
  3. Autonomic phase : child performs HW with minimal conscious effort
153
Q

Sensorimotor approach to HW

A

Multi-sensory input provided to enhance snsory system for HW including use of alternative media experiences and multiple writing tools, surfaces and positioning

154
Q

Biomechanical approach to HW

A

Focused on ergonomic factors that impact production of writing including sitting posture, paper position, pencil grasp and paper modifications

155
Q

Psychosocial approach to HW

A

Focused on improving self-control, copying skills and social behaviors

156
Q

Miller Function and participation scales age group

A

2 years 6 months to 7 years 11 months

157
Q

BOT-2 age group

A

4-21 years

158
Q

SFA age group

A

K - 6th grade (5 - 12)

159
Q

Sensory integration and praxis test age group

A

4 years through 8 years, 11 months

160
Q

Standardized tests for sensory integration assessment

A

BOT
SFA
MFUN
SPIT

161
Q

Caregiver questionnaires for sensory integration assessment

A

SP
SPM
Touch inventory for elementary-school-aged children

162
Q

Common assessments for students with behavioral disorders

A

SFA
Social skills rating system

163
Q

Intervention strategies for studnets with behavioral disorders

A
  • Take place in context
  • Goal-directive
  • Motivational and meaningful
  • Enjoyable
  • Just right challenge
  • Rational intervetnion
164
Q

What is rational intervention

A

Therapists uses least amount of control necessary to support child based decisions with understanding that safety and respect are priorities and that each interaction is an opportunity for learning

165
Q

Color zones used in rational intervention to classify behavior and determine whether intervention is needed

A

Green: behaviors appropriate and acceptable

Yellow: behaviors are slightly problematic and require additional observation, child may benefit from enviro adjustments, cues or facilitation

Red: behaviors require immediate intervention because child or others are being put at risk by negative behavior (verbal or physical)

166
Q

RI response options

A

Matching
Facilitation
Monitoring
Gentle correction
Moderate correction
Strong correction

167
Q

Matching

A

OT match response to child behavior

168
Q

Facilitation

A

Observe child and improve environmental supports

169
Q

Monitoring

A

Observe child and let child know OT is present to encourage and prompt with guiding questions to help child problem solve

170
Q

Gentle correction

A

Altering environment, reminding child of expectations, modeling appropriate behavior, redirecting to different location/activity

171
Q

Moderate correction

A

Giving child a break by redircting

Exam Prep (19 decks)

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