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Written Prep > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

______ = neonatal Ax w/ 5 aspects

A

APGAR

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2
Q

5 aspects of APGAR?

A
  1. appearance
  2. pulse
  3. grimace
  4. activity
  5. respiration
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3
Q

Scoring of the APGAR?

A

0 (non exisent) to 2 (normal and strong)

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4
Q

APGAR: core of __ - ___ indicates being born in significant distress; __ - ___ = mild distress

A

0-3;4-6

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5
Q

5 goals of of pediatric physio?

A
  1. participation
  2. motor abilities
  3. functional mobility
  4. health
  5. prevention
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6
Q

_______ _____ _____ ______ = head turned to one side w/ extension of ipsilateral and flexion of contralateral arm (fencers pose_

A

asymmetrical tonic neck reflex (ATNR)

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7
Q

ATNR = __ - __ months

A

0-4

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8
Q

_____ reflex = when feeling like they are falling the child will open their arms then bring them back to their chest

A

moro

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9
Q

_______ reflex = grasp when pressure is put on palm of hand, will relax if you stroke back of hand

A

grasping

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10
Q

grasping reflex = __ - __ months

A

0-4

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11
Q

_____ reflex = body weight shift and the baby will make stepping motions

A

stepping

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12
Q

Babinski = normal in infants until __ - __ months, extension of big toe and fanning of the rest w/ stimulation of sole of foot

A

12-24

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13
Q

Stepping reflex = in first __ months

A

2

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14
Q

_______ ______ ______ = will flex UE and extend LE w/ neck flexion; when neck extended UE will extend and LE are flexed

A

symmetrical tonic reflex

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15
Q

______ ______ reflex = stimulate pressure to base of toe and get toe flexion

A

plantar grasp

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16
Q

Symmetrical tonic neck reflex = ___ months

A

3 months

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17
Q

Plantar grasp reflex = present at __ weeks to __- __ months

A

28; 9-10

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18
Q

____ reflex = stroke side of cheek, baby will open mouth and turn towards side of stimulation

A

rooting

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19
Q

Rooting reflex = up to __ months

A

3

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20
Q

______ reactions = no matter their position, head will orient to upright position

A

righting

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21
Q

______ reactions = related to trunk stability

A

equilibrium

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22
Q

______ reactions = extending arms w/ sudden displacement as not to fall

A

protective

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23
Q

Developmental milestones: birth to 3 months

A
  1. able to turn head side to side
  2. brief head righting
  3. random kicks in supine
  4. maintain head midline
  5. hand fisted w/ reflex grasp
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24
Q

Developmental milestones: 4 - 5 months

A
  1. able to prop w/ extended elbows
  2. head control
  3. rolls
  4. supported sitting
  5. WB in stating when supported
  6. grasp / hold small toys (3-5 months)
  7. release toys (3-5 months)
  8. increased frequency of reaching (3-5 months)
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25
Q

Developmental milestones: 5 months

A

head control in sitting

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26
Q

Developmental milestones: 6 months

A
  1. sitting independently
  2. uses hands for play
  3. stands w/ support
  4. radial palmar grasp (6-8 months)
  5. rake to grasp (6-8 months)
  6. reaching path is straight (6-8 months)
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27
Q

Developmental milestones: 7 months

A
  1. anticipate and orient hand for reach and grasp

2. commando crawling

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28
Q

Developmental milestones: 8-9 months

A
  1. 4 pt kneel
  2. moves from sit to prone
  3. pivots in sitting
  4. may pull to stand
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29
Q

Developmental milestones: 9-11 months

A
  1. points and pokes w/ index finger

2. uses PINCHER grip **

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30
Q

Developmental milestones: 10 - 11 months

A
  1. can move out of prone or supine
  2. sitting bum scoot
  3. transfer from stand –> sit w/out falling
  4. picks up objects from floor w/out support
  5. stands hands free for a few seconds
  6. ++ mobility (crawls up stairs, cruising, walking w/ hands held, can start walking independently)
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31
Q

Developmental milestones: 12 - 18 months

A
  1. walks independently
  2. transitions to stand at mid floor
  3. squats
  4. picks up toys w/out support
  5. walks up stairs w/ hand held or rail
  6. initiates ball kick / throws ball
  7. walks backwards / sideways a few steps
  8. opens books
  9. handedness usually established
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32
Q

Developmental milestones: 2-2.5 years

A
  1. propels or steers push toys
  2. walks on tip toes
  3. jumps
  4. stands on one foot
  5. kick ball
  6. throw and catch
  7. ascend and descend stairs independently
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33
Q

Developmental milestones: 3-5 years

A
  1. climb stairs independently
  2. run faster and more controlled
  3. walk in straight line
  4. throw under and over head
  5. somersaults
  6. gallop and skip
  7. dress and eat independently
  8. use mature tripod grasp (4.5 years)
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34
Q

Down syndrome = alteration of chromosome __

A

21

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35
Q

Name minimum 5 S/S of down syndrome

A

Any of …

  1. identifiable facial features
  2. hypotonia
  3. dec strength and ligament laxity
  4. short arms and legs
  5. heart defects
  6. AA instability
  7. scoliosis
  8. pronated feet
  9. hip dislocation
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36
Q

_______-_______ syndrome = related to disturbance in hypothalamus, genetic deletion of chromosome 15 usually

A

prader-willi

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37
Q

Name 5 S/S of prader-willi syndrome in infants

A
  1. hypotonia
  2. delayed motor and learning development
  3. little spontaneous movement
  4. resp difficulties
  5. oral motor or feeding difficulties
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38
Q

3 Rx for Prader-Willi syndrome in infants?

A
  1. gross motor development
  2. compensatory postures
  3. nutritionist
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39
Q

5 S/S of Prader-Willi syndrome in older kiddos?

A
  1. hypotonia
  2. intellectual impairment
  3. short stature
  4. hyperphagia
  5. extreme obesity/behaviour problems
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40
Q

5 Rx for Prader-Willi syndrome in older children?

A
  1. weight management
  2. inc activity level
  3. orthotics
  4. improve postural control
  5. behaviourist
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41
Q

Neonatal respiratory distress syndrome = < ___ weeks gestation due to lack of ______

A

37; surfactant

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42
Q

4 S/S of neonatal resp distress syndrome ?

A
  1. tachypnea
  2. in drawing
  3. cyanosis
  4. occurs soon after birth
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43
Q

Rx for neonatal resp distress syndrome ?

A

corticosteroids

44
Q

Sudden infant death syndrome = death of infant under __ year w/ unexplained cause, peaks at __ - __ months and usually occurs at night

A

1;3-4

45
Q

Is SIDS more common in male or female infants ?

A

males

46
Q

Risk factor for SIDS = _____ sleeping; may also be caused by ______

A

prone; infection

47
Q

5 S/S of FAS?

A
  1. facial changes
  2. brain damage
  3. hypersensitivity
  4. poor concentration
  5. poor feeders / eaters
48
Q

_______ _______ ________ = rare NON progressive neuromuscular syndrome of unknown etiology; S/S can include joint contractors, muscle weakness, poor muscle development and fibrosis

A

arthrogryposis multiplex congenital (AMC)

49
Q

The fibrosis seen in AMC can lead to what other 3 issues?

A
  1. scoliosis
  2. heart defects
  3. resp problems
50
Q

_____ ______ # = affects the growth plate in children

A

salter harris

51
Q

Salter Harris # = immobilization usually between __ - __ weeks

A

3-6

52
Q

_______ = developmental delay in social / language / motor and/or cognitive development, more common in M > F

A

autism

53
Q

Average age of onset of autism = __ years

A

4

54
Q

Name 5 S/S of autism

A

Any of …

  1. stereotyped and repetitive play skills
  2. avoids eye contact
  3. dislikes change in routine
  4. strong sensory preferences
  5. dyspraxia
  6. gait = waddling, abnormal weight distribution
  7. cerebellar involvement
55
Q

3 outcome measures to use in autism ?

A
  1. M-ABC
  2. Bayley-3
  3. PDMS -2
56
Q

_____ disease = localized disorder of bone remodelling (excessive resorption followed by increase in bone formation) –> structurally disorganized mosaic of bone, weaker, larger, less compact, more vascular, more susceptible to #

A

paget’s

57
Q

Pagets disease normally involves multiple bones, especially _____ skeleton

A

axial

58
Q

__ - __ % of pts with Pagets disease are asymptomatic

A

70-90!!!

59
Q

5 S/S of Pagets disease?

A
  1. bone pain
  2. secondary OA
  3. bony deformity
  4. excessive warmth
  5. neurologic complications
60
Q

Name 5 points to touch on for education for pts w/ Paget’s disease

A
  1. proper posture
  2. body mechanics
  3. avoidance of trauma
  4. precautions against falling
  5. hazards of immobility
61
Q

________= pituitary gland produces excess growth hormone during adulthood, = increased bone size

A

acromegaly

62
Q

In children excess growth hormone leads to ______ rather than acromegaly

A

gigantism

63
Q

S/S of acromegaly? (2)

A
  1. enlarged hands and feet

2. gradual changes in shape of face (protruding jaw and brow, enlarged nose, thickened lips, etc)

64
Q

Name 3 complication of acromegaly

A

Any of …

  1. HTN
  2. cardiomyopathy
  3. OA
  4. precancerous growth on lining of colon
  5. sleep apnea
  6. carpal tunnel
  7. hypopituitarism
  8. uterine fibroids
  9. SC compression
  10. vision loss
65
Q

_____ = short stature (4 foot 10” or shorter)

A

dwarfism

66
Q

What are the two types of dwarfism?

A
  1. proportionate

2. disproportionate

67
Q

Dwarfism: may need ____ _____ if related to deficiency, or insertion of _____ to drain excess fluid and relieve pressure on brain

A

growth hormone; shunt

68
Q

_____-______ syndrome = pain and swelling at insertion of patellar tenon to tibial tubercle

A

Osgood-Schlatter

69
Q

Osgood-schlatter = self limited, caused by minor degree of _______ of tibial tubercle, associated with patella _____

A

separation; alta

70
Q

Osgood-schlatters = usually in kids __ -___; more common in boys or girls?

A

10-15; boys

71
Q

5 Rx for osgood schlatters?

A
  1. ice
  2. rest
  3. decrease activity
  4. avoid squatting and jumping
  5. brace / cast in severe cases
72
Q

Osgood-schlatters: generally resolves in __ weeks if following precautions; most cases within __ months

A

6;3

73
Q

_______ ________ = lesion of subchondral bone and articular surface

A

osteochondritis dessicans

74
Q

Common sites for osteochondritis dessicans?

A
  1. distal femur MOST common
  2. lateral surface of medial femoral condyle
  3. femoral capitate epiphytes
  4. talus
75
Q

Osteochondritis dessicans = due to ischemic ______, cause ______

A

necrosis; unknown !

76
Q

S/S of osteochondritis dessicans?

A
  1. pain
  2. swelling around knee
  3. antalgic gait
  4. locking (if fragment separates)
77
Q

Osteochondritis dessicans is often asymptomatic (T/F)

A

TRUE

78
Q

4 Rx for osteochondritis dessicans?

A

Mostly SELF LIMITING!

  1. immobilization
  2. gradual activity w/ quads strengthening
  3. Sx if separation and intra-articular fragment
79
Q

______ ____ ______ = walking milestones normal but up on toes; child others appears completely normal

A

idiopathic toe walking

80
Q

3 S/S of idiopathic toe walking?

A
  1. childs walks and runs on toes
  2. variable degree of tightness in PF’s
  3. always SYMMETRICAL!
81
Q

4 Rx for idiopathic toe walking?

A
  1. AFO’S
  2. PT (ROM and strength)
  3. serial casting
  4. botox
82
Q

_______= rotational deformity of the C spine with secondary tilting of head

A

torticollis

83
Q

Torticollis = _____ head tilt w/ ______ rotation

A

lateral; contralateral

84
Q

______ ______ torticollis = unilaterale shortening or fibrosis of SCM at birth or shortly after

A

congenital muscular

85
Q

Torticollis = increased risk w/ prolonged time on _____

A

back

86
Q

Associated conditions w/ torticollis?

A
  1. plagiocephaly
  2. facial asymmetry
  3. hip dysplasia
  4. MSK abnormalities (metatarsus adducts, etc)
  5. brachial plexus injury
  6. TMJ dysfunction
  7. developmental delay
87
Q

3 typical presentations of congenital muscular torticollis?

A
  1. SCM “tumor” (palpable mass in SCM; not a neoplasm but scar tissue)
  2. muscular torticollis (without palpable tumour but thickening and / or shortening of SCM)
  3. postural torticollis (where clinical features present without tumour or muscle tightness)
88
Q

Other causes of torticollis may include ocular torticollis where the ____ ____ mm is weak and bb head tilts to correct double vision; OR space occupying lesion (______ _____ tumour)

A

superior oblique; post fossa

89
Q

5 aspects of Ax of congenital muscular torticollis?

A
  1. Hx
  2. observation
  3. ROM
  4. strength + tone
  5. development
90
Q

Should see lateral head righting reflex > __ months in bbs

A

4

91
Q

5 Rx for congenital muscular torticollis?

A
  1. stretching
  2. strengthening
  3. positioning
  4. environmental adaptations
  5. parental education
92
Q

_______ = the misshaping and flattening of an infants head through sustained external directional force

A

plagiocephaly

93
Q

4 main components of a paediatric examination ?

A
  1. Hx
  2. systems review
  3. intervention
  4. re-examination
94
Q

6 aspects of Hx component of paediatric exam?

A
  1. prenatal
  2. birth
  3. general health
  4. milestones
  5. procedures / interventions
  6. goals
95
Q

4 outcome measures to assess paediatric intervention?

A
  1. FMS
  2. GMFCS
  3. GMFM
  4. COPM
96
Q

____ = ages 4-18 w. CP; rates walking ability at 5, 50, and 500m; questions not observation; used to figure out what devices you will need

A

FMS (functional mobility scale)

97
Q

Scoring of the FMS?

A

N - 6

You want a high score

98
Q

_______ = 5 levels for kids w/ CP, based on self initiated movement, good for communication b/w families and health care professionals and goal planning

A

GMFCS (gross motor functional classification system)

99
Q

______ = standardized test for gross motor function for children w/ CP, all items that a 5 year old (normal development) would do, can measure over time to see change and set realistic goals

A

GMFM (gross motor functional measure)

100
Q

Scoring of the GMFCS?

A

5 levels, 1 = high function, 5 = very limited

101
Q

_____ = identifies goals in self care, productivity and leisure ; family centred!

A

COPM

102
Q

4 aspects of measuring tone in peds?

A
  1. mm palpation
  2. PROM
  3. quantifying tone
  4. primitive reflexes
103
Q

When measuring tone using modified Tardieu, assses ROM at ___ (high velocity) and ___ (end ROM and slow sleep)

A

R1; R2

104
Q

Scoring of the modified Tardieu?

A

0-5, want lower score

105
Q

What is the modified Ashworth scale used for? What is the scoring?

A

Tone Ax; 5 point scale, 0-4

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