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Pediatrics > Pts with Developmental Disabilities - Jensen > Flashcards

Pts with Developmental Disabilities - Jensen Flashcards

1
Q

Statistically which gender has higher prevlance than the other in regards to DD (developmental disabilities)?

A

Males - twice the prevalance as females

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2
Q

True or False. DD population has a higher incidence of learning related vision anomalies than the general population?

A

True

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3
Q

True or False. Children insured by medical had a two fold higher prevalance

A

False. Insured under medicaid

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4
Q

Down syndrome, will display what chromosomes being attached?

A

14, 21, 22

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5
Q

What is the incidence for Down syndrome (DS)?

A

1:700 live birth

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6
Q

What are the chances of having another child after a DS child is born?

A

1 in 100

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7
Q

What part of the skull or brain is flatter than normal in DS pts?

A

Occiptal lobe

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8
Q

How does a flat nasal bridge impact a DS child?

A

Glasses are hard to fit

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9
Q

What is a common oculomotor dysfunction in DS pts?

A

Nystagmus

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10
Q

True or False. Memory is decreased over the years in DS?

A

True

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11
Q

What are common ocular issues DS will present with?

A

Keratoconus
Broad Epicanthal folds
Oblique palpebral fissures
Blepharitis - severe and young due to this the mechanical rub will cause keratoconus

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12
Q

What are brushfields spots?

A

White spots on the cornea - common in DW pt

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13
Q

True or False. Cataracts will show at 40YO in normal beings but in DS when do they play out?

A

20 to 30yrs of age

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14
Q

True or False. Cardiac anomalies are less likely compared to pulmonary anomalies in DS pts.

A

False. Cardiac issues are the most comon

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15
Q

What will you find the most common, hyperopia or Myopia in DS?

A

Hyperopia

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16
Q

What is cerebral palsy (CP)?

A

Childhood disease that causes rigid or spastic muscle in the limbs - disease caused by lack of oxygen to the child and a lesion in the immature brain

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17
Q

What is the hallmark sign of CP?

A

Abnormal muscle tone

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18
Q

To what age will CP show hypotonicity, then display hypertonicity

A

6 to 9 months

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19
Q

What is the most common type of CP?

A

Spastic - 70 to 80%

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20
Q

What is the sub type for CP when the legs are effected than arms

A

Diplegia

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21
Q

Hypotonicity is called what type of CP?

A

Ataxic - cerebellum has a lesion

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22
Q

True or False. CP is an aquired risk

A

True

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23
Q

What will increase the risk of CP by 5 times?

A

Premature birth

Note: Birth weight will be changed 20 times

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24
Q

What is the mean of CP individuals living up to?

A

age 50

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25
Q

True or False. CP individuals have above avg intelligence level.

A

True

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26
Q

What is the most common systemic charcteristics

A

Delayed motor development

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27
Q

What is the common refractive error in CP?

A

Hyperopia

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28
Q

What is the common stype of strabismus in CP?

A

They are equal

Exo = Eso

29
Q

What is the most common type of oculomotor dysfunction in CP pts?

A

Pursuits and Saccades are impacted

30
Q

What are common things to remember when examining CP pts?

A

Positioning, No sudden movement, No loud, unexpected noises, speak smoothly and softly. SMILE

31
Q

What sub type of CP display’s slow writhing movements along with involuntary movements that interfere with normal motor function; gaze anomalies, drooling, abnormal gait(basal ganglia damage)

A

Athetoid

32
Q

What is fragile X syndrome?

A

Most commonly inherited form ID caused by repeated nucleotide (FMR - 1 gene is unstable)

33
Q

Which gender is impacted the most with FX?

A

Males

34
Q

What is the hallmark for FX?

A

Macroodisasm (enlarged testes)

35
Q

What is a common systemic charcteristics?

A

Scoliosis

36
Q

What is the common IQ for FX pt?

A

22 to 65

37
Q

FX pt will question you many times but what is the biggest difference between them and autistic individual?

A 
FX = expect and answer
Autism = don't need an answer
38
Q

What is the most common ocular charactertics in FX pt?

A 
Refractive Error(17%), sometimes high
Nystagmus
Strabismus
Esotropia > Exotropia
Ptosis
Deficits in visual processing
39
Q

What is Autism?

A

A group of developmental disabilities characterized by atypical development in:
Socialization, Communication and Behavior

40
Q

What are three common multisystem disorders with documented abnormalities in Autism?

A
  1. Immune system
  2. Gastrointestinal System
  3. Metabolism
41
Q

At what age can be Autism be diagnosed?

A

prior to 3 years f age

42
Q

What is Asperger’s syndrome?

A

High level function of autism

-retain ability to communicate

43
Q

What is Rett syndrome

A

Mutation on the X chromosome.

-Motor and language function loss

44
Q

What is on the autism spectrum stat conducted by CDC?

A

1 to 68

45
Q

What is the most common gender to manifest autism?

A

Males - 5 times the amount

Note: When females have autism, they have more issues

46
Q

True or False. Asperger’s syndrome usually have above average intelligence?

A

True

47
Q

What is the most common facts about asperger’s syndrome?

A

Difficulty with eye contact, Odd repttive movements, unusual sensory responses, don’t do small talk

48
Q

True or False. Identical twins, likely to be on the spectrum of autism?

A

True

49
Q

What are three common associated disorders linked to Autism?

A

Fragile X, Down Syndrome and Tuberous Sclerosis

50
Q

What are characteristics of Autism?

A

Hypersensitive or hyposentive to touch, taste, smell or sounds.

51
Q

True or False. Sensory processing skills are diminished in autistic individuals

A

True

Note: Toe walking will occur. They need to be in contact with the ground at all times

52
Q

What is the most common Visual Characrteristics of austism?

A

Poor fixation - won’t make eye contacts

53
Q

What structures are impacted in Fetal Alcohol Syndrome (FAS)?

A

Brain cells are interrupted by alcohol exposure.

Note: We don’t know if it could be the drugs that is taken at the same time impacted

54
Q

True or False. FAS is more common in Europe

A

True

55
Q

What are physical chacactertics of FAS?

A

Flat maxilla, Microcephaly, thin upper lip

56
Q

What are the systemic characterisitcs of FAS?

A

Growth retardation, CNS disorders and Learning disabilities

57
Q

What are Visual Charactertics of FAS?

A 
High myopia and astigmatism
Oculomotor anomalies
Strabismus
Cataracts
Optic Nerve hypoplasia
58
Q

What is the characteristic of Sensory Processing Disorder (SPD)?

A

Inability of the individual to organize sensory information he/she receives from their environment

59
Q

What are good methods for exam techniques for special populations?

A

Snellen letters, Cardiff cards, Teller acuity cards, LEA paddles and fix and follow.

60
Q

What is the standard for recognition acuity?

A

Lea symbols

61
Q

What is the VA criteria for Forced choice prefrential looking?

A

1 mth = 20/800
6 mth= 20/100
1 year = 20/50
3 year = 20/20

Note: VA’s should be similiar to each eye and significance is 2 line difference

62
Q

What enterance tests should you make?

A

Pursuits, Saccades, EOM’s, NSUCO/SCCO (norms start at 5 YO), color vision (Ishihara, HRR), Visual Fields (do kinetic fields if they can’t count), NPC (interesting target), CT (use thumb as an occluder for young small pts)

Note: make sure you make noise to get their attention at all times

63
Q

You can’t get a binocularity test, what should you conduct?

A

10PD vertical prism test to get a response

64
Q

What is the ratio for Hirschberg?

A

1mm = 22PD

65
Q

At what age should you see expected norms for NPC?

A

6 months

66
Q

What is a good test for finding refractive error?

A

Bruckner reflex

Note: You only do this to find high refractive error
Inferior crescents - Myopia
Superior crescents - hyperopia

67
Q

What is the modification correction factor for mohindra retinoscopy?

A

-1.25 if over two years and -0.75 if under two years

68
Q

What is an excellent way to find the posterior seg of special population?

A

OCT

Pediatrics (6 decks)

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