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PM&R > Peds > Flashcards

Peds Flashcards

1
Q

TORCHES infections are what?

A

Toxoplasmosis, Other agents (varicella, parvovirus), Rubella, Cytomegalovirus, Herpes/HIV, Syphilis)

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2
Q

What chromosomes are associated with Down’s, Edward’s, Patau, Turner’s, and Klinefelter’s?

A 
21;
18;
13;
45X;
47XXY
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3
Q

When does the greatest change in bone mass occur in boys and girls?

A

Boys: 14-17;

Girls 12-15

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4
Q

When can baby keep head midline? When can they sit and transfer objects? When can they cruise with pincer grasp?

A

4 mos;
7 mos;
10 mos;

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5
Q

When can a kid pile two cubes and use single words? When does hand dominance emerge? When can they go up and down stairs, use two-word phrases, and build eight-cube towers?

A

14 mos;
18 mos;
24 mos (2 yrs)

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6
Q

When can a kid pedal a tricycle, go up stairs with alternating feet, copy a circle? What about going down stairs alternating feet and copying a cross? What about drawing a triangle?

A

3 yrs;
4 yrs;
5 yrs;

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7
Q

What specific anomalies are associated with limb deficiencies?

A

Craniofacial anomalies

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8
Q

What is the most common congenital limb deficiency? When should prosthetic fitting first occur for kids?

A

Terminal transradial;

6-7 months

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9
Q

What is the Krukenberg procedure?

A

Reconstructs the forearm and creates a sensate prehensile surface for children with absent hands by separating the ulna and radius in the forearm

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10
Q

The most common congenital lower limb deficiency is

A

fibular longitudinal deficiency

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11
Q

70-80% of patients with partial proximal femoral focal deficiency (PFFD) also present with

A

associated fibular deficiencies

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12
Q

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

A

Solid ankle cushion heel (SACH); energy-storing feet becoming more popular

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13
Q

Most common cause of pediatric acquired amputation? What about disease-related amputation?

A

Trauma;

tumor

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14
Q

Most common complication of amputation in the immature child? Where most likely to occur?

A

Terminal overgrowth at transected end of long bone; occurs most frequently at humerus, then fibula, then tibia, then femur (HFTF)

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15
Q

When are motorized wheelchairs classically introduced to kids?

A

Age 5-6 years old

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16
Q

Children with congenital limb deficiency do/do not develop phantom sensation or pain

A

DO NOT;

if ACQUIRED, some kids retain some awareness of the amputated part

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17
Q

Nmemonic for club foot deformity?

A 
CAVE:
midfoot CAVUS
forefoot ADDUCTUS
hindfoot VARUS
hindfoot EQUINUS
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18
Q

How to manage clubfoot?

A

Start with Ponseti method of serial casting and manipulation; try to initiate in first month of life;
Can do PT and bracing, and last line of treatment is surgical correction

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19
Q

What is Blount’s disease? In whom is it more common? How to treat?

A

Abnormal fxn of medial portion of prox tibial growth plate with bowing in prox tibia;
AA’s;
osteotomy of prox tibia and fibula

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20
Q

Most common cause of congenital torticollis? Where is head tilted and rotated?

A

SCM fibrosis;

Tilted to ipsilateral side, rotated to contralateral side

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21
Q

Mainstay of treatment of congenital torticollis?

A

Stretching by tilting head to contralateral side and rotating to the ipsilateral side of fibrosis

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22
Q

What is nursemaid’s elbow, and how to manage it?

A

Subluxation of radial head;

Supination, extension of forearm

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23
Q

What is pathology behind medial epicondylar apophysitis?

A

Repetitive traction stress on apophysis of medial epicondylar ossification center of humerus

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24
Q

Most common cause of limping and pain in child’s hips?

A

Transient (toxic) synovitis of hip

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25
Q

Treatment for LCP vs. SCFE?

A

LCP: abduction brace, rest, may need varus osteotomy if need surg;
SCFE: surgical pinning preferred

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26
Q

Most common cause of structural scoliosis?

A

Idiopathic

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27
Q

When is neuromuscular disease most commonly seen?

A

CP, muscular dystrophy, spinal muscular atrophy, spina bifida

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28
Q

When to brace for scoliosis? When is surg needed?

A

20-40 degrees;

Over 40 degrees

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29
Q

How is Scheuermann’s disease diagnosed radiographically?

A

Having 3 or more consecutive vertebrae with greater than 5 degrees anterior wedging

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30
Q

Most common type of spondylolisthesis? Most common in adults? In kids, where is the spondylolisthesis most common? When do you need surgery?

A

Isthmic;
degenerative;
L5-S1, followed by L4-5;
usually over 50% slippage (i.e. grade 3)

31
Q

Most common connective tissue disease in kids?

A

Juvenile idiopathic arthritis

32
Q

Type of JIA most likely to develop chronic iridocyclitis? Acute iridocyclitis?

A

Oligoarticular;

systemic

33
Q

Juvenile dermatomyositis is associated with

A

histologic presence of vasculitis, onset of calcinosis, lack of association with childhood malignancy

34
Q

Jones Criteria to diagnose rheumatic fever?

A 
Major: JONES
Joints (polyarthritis)
Heart (carditis)
Nodules (subcutaneous nodules)
Erythema marginatum
Chorea;
minor include fever, arthralgia, elevated CRP/ESR, prolonged PR interval
35
Q

What is the hallmark of hemophilia?

A

Hemarthrosis

36
Q

Most common cause of pediatric burn injury?

A

Scald burns

37
Q

Of all the burn-related contractures in kids, which is most commonly involved?

A

Axilla

38
Q

Reasons to hospitalize kids with burns?

A

Over 5% full thickness injury, over 10% total BSA in kids or elderly, or over 20% in general;
inhalation injuries, electrical burns, trauma; HEENT, hands, feet, genitalia

39
Q

Most common type of tumor in kids? Most common type of malignant bone tumors in kids?

A

ALL;

osteosarcoma, followed by Ewing’s sarcoma

40
Q

Leading cause of TBI in kids?

A

Transportation-related

41
Q

Hypopituitarism presents with

A

growth failure and delayed or arrested puberty;

see GH, LH, and FSH most deficient

42
Q

Which has better prognosis classically, TBI or anoxic brain injury?

A

Traumatic

43
Q

CP is a disorder primarily of ________ and _____, but is also associated with

A

movement control; posture;

cognitive and sensory associated problems resulting from non-progressive lesion to immature brain

44
Q

When do majority of CP cases occur? Some risk factors?

A

Prenatal;

prenatal ICH, placental complications, gestational toxins, gestational teratogenic agents

45
Q

What is most common antecedent of CP?

A

Prematurity

46
Q

Most common type of CP?

A

Spastic diplegia

47
Q

Which type of CP has highest incidence of significant disability? Which has high incidence of sensorineural deafness?

A

Tetraplegic;

dyskinetic

48
Q

What is common cause of spastic diplegia, and what can be seen on MRI?

A

History of IVH;

can see peri-ventricular leukomalacia

49
Q

For ataxic CP, what is this classically associated with?

A

Sensorineural hearing loss, hyperbilirubinemia, neonatal jaundice

50
Q

GMFCS descriptors

A

Level 1: Walking without restrictions

2: Walking without assistive devices;
3: Walks with assistive mobility devices;
4: Self-mobility with limitations;
5: Self-mobility severely limited even with use of assistive devices

51
Q

Prognosis for ambulation in kid with CP is good if

A

independent sitting occurs by age 2

52
Q

Predictors of successful and unsuccessful employment include

A

IQ level, ambulation level, speech, and degree of hand function

53
Q

What are positions for asymmetric vs symmetric tonic neck reflex? When are they suppressed?

A

For asym, turn neck to side and see extension on that side with flexion on occiput side;
for symm, neck flexion and neck extension lead to arms flexing and extended, respectively, while legs do the opposite;
6-7 months

54
Q

Which geographic regions have highest incidence of myelodysplasia? Lowest?

A

British Isles, Ireland, Wales, Scotland;

Japan

55
Q

For spina bifida, when does defect of neural tube closure typically occur?

A

Day 26

56
Q

What is myelomeningocele classically associated with?

A

Arnold-Chiari malformation type 2 with hydrocephalus

57
Q

Most frequent single cause of death in spina bifida?

A

Central respiratory dysfunction (stridor, central apnea, aspiration)

58
Q

Proteus UTI’s associated with

A

calcinosis

59
Q

Presence of ________ or _______ reflex associated with greater chance of bowel continence

A

bulbocavernosus;

anocavernosus

60
Q

In spina bifida, what is the relationship of intellectual function with level of spinal cord dysfunction?

A

Inversely proportion, ie higher the lesion, lower the score

61
Q

In spina bifida, among verbal, math, written, or visual perceptual skills, what is usually greatest?

A

Verbal

62
Q

For spina bifida, when to achieve independent self-cath?

A

Age 5-6 years; boys learn easier than girls due to anatomic differences

63
Q

What are kids with spina bifida at increased risk for reaction wise?

A

Anaphylaxis (latex allergy)

64
Q

For spina bifida thoracic lesions, what is ambulation ability?

A

Assistive devices for passive standing: parapodium, swivel walker, HKAFOs with spinal extensions, walker or Lofstrand crutches

65
Q

For spina bifida lower thoracic and lumbar lesions, how to ambulate?

A

RGO;

can use AFO if L3 spared

66
Q

Functional community ambulation in spina bifida by level?

A

Thoracic: 0 to 33%;
High lumbar: 31% can achieve some degree;
Low lumbar: 38% get there under age 15, 95% if age 15-31;
Sacral: All can achieve

67
Q

Employment rate among those with spina bifida?

A

25-50%

68
Q

Why does Gower’s sign happen?

A

Proximal (pelvic girdle) muscle weakness; can’t rise from sitting position on floor

69
Q

Muscle biopsy findings for Duchenne?

A

Degenerating fibers often observed in clusters, with necrotic fibers surrounded by macrophages and lymphocytes

70
Q

In DMD, where is earliest weakness seen? At ankle, knee, and hip, what muscle groups are stronger?

A 
Neck flexors;
pelvic girdle weakness precedes shoulder weakness;
Ankle DF weaker than PF;
Ankle evertors weaker than inverters;
knee extensors weaker than flexors;
hip extensors weaker than flexors;
hip abductors weaker than adductors
71
Q

Emery-Dreifuss muscular dystrophy inheritance, protein involved, and contractures of what?

A

X-linked recessive;
emerin;
elbow flexors

72
Q

Central core myopathy with high incidence of

A

malignant hyperthermia

73
Q

Another name for SMA type III, and what is characteristic prognosis-wise?

A

Kukelberg-Welander syndrome;

good long-term survival, depending on respiratory function

74
Q

Number one cause of mortality in childhood neuromuscular diseases?

A

Pulm complications

PM&R (12 decks)

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