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DPT 772 - Pediatrics II > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

Which genetic mutation is responsible for Duchenne Muscular Dystrophy (DMD)?

A) Mutation in SMN1 gene
B) Deletion in Xp-21 region
C) Myotonic DMPK mutation
D) Chromosome 19 abnormality

A

B) Deletion in Xp-21 region

DMD is caused by a deletion or mutation in the Xp-21 region, affecting dystrophin production.

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2
Q

What is the typical age of diagnosis for DMD?

A) Birth
B) 2–5 years
C) 10–12 years
D) After 15 years

A
  • B) 2–5 years
  • DMD is commonly diagnosed between ages 2–5 when symptoms such as weakness and delayed milestones appear.
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3
Q

Which physical therapy intervention is contraindicated for patients with DMD?

A) Submaximal exercises
B) Cycling
C) High-resistance eccentric exercises
D) Stretching

A

C) High-resistance eccentric exercises

These are contraindicated as they can lead to muscle damage in DMD patients.

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4
Q

What is the most common cause of death in patients with DMD?

A) Liver failure
B) Cardiac or respiratory complications
C) Renal failure
D) Neurological decline

A

B) Cardiac or respiratory complications - Most patients with DMD die due to cardiopulmonary issues by their 20s or 30s.

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5
Q

What is the purpose of night splints for patients with DMD?

A) Prevent scoliosis progression
B) Maintain ankle range of motion
C) Strengthen lower limb muscles
D) Promote balance and coordination

A

B) Maintain ankle range of motion - Night splints help maintain range by providing a prolonged stretch to ankle structures.

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6
Q

What structure is primarily affected in Spinal Muscular Atrophy (SMA)?

A) Peripheral nerves
B) Anterior horn cells
C) Neuromuscular junction
D) Dystrophin gene

A

B) Anterior horn cells

SMA is a neurogenic disorder affecting the anterior horn cells and leading to muscle weakness.

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7
Q

Which SMA type is characterized by onset before 6 months and rapid progression?

A) Type 0
B) Type 1
C) Type 2
D) Type 4

A

B) Type 1

SMA Type 1, or Werdnig-Hoffmann disease, presents before 6 months and often leads to respiratory failure.

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8
Q

Which drug therapy for SMA is administered as a single-dose IV?

A) Spinraza
B) Zolgensma
C) Evrysdi
D) Corticosteroids

A

B) Zolgensma

Zolgensma is a gene replacement therapy for SMA, administered as a single-dose IV infusion.

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9
Q

What is the hallmark clinical symptom of SMA?

A) Increased deep tendon reflexes
B) Muscle atrophy and weakness
C) Sensory deficits
D) Hypertonicity

A

B) Muscle atrophy and weakness

SMA is primarily characterized by progressive muscle weakness due to motor neuron degeneration.

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10
Q

Which physical therapy intervention is most appropriate for a child with SMA who is a sitter?

A) Independent walking exercises
B) Standing programs and bracing
C) Treadmill training
D) Submaximal strength training

A

B) Standing programs and bracing

  • Sitters benefit from bracing and standing programs to maintain function and prevent contractures.
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11
Q

What is the primary cause of Respiratory Distress Syndrome (RDS) in neonates?

A) Infection
B) Surfactant deficiency
C) Premature lung fibrosis
D) Genetic abnormalities

A

B) Surfactant deficiency - RDS in neonates is caused by insufficient surfactant, leading to alveolar collapse.

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12
Q

Which of the following is a contraindication for chest physiotherapy in children?

A) Subcutaneous emphysema
B) High-frequency chest oscillation
C) Positive expiratory pressure
D) Diaphragmatic breathing exercises

A

A) Subcutaneous emphysema -

  • This condition is a relative contraindication for chest physiotherapy techniques.
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13
Q

Which symptom is most associated with severe asthma exacerbation in children?

A) Cyanosis
B) Mild wheezing
C) Slight shortness of breath
D) Sneezing

A

A) Cyanosis

  • Severe asthma can result in cyanosis due to inadequate oxygenation.
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14
Q

What is a characteristic symptom of cystic fibrosis?

A) Dry cough
B) Failure to thrive
C) Elevated muscle tone
D) Bradycardia

A

B) Failure to thrive

  • CF often causes poor growth and weight gain due to malabsorption and respiratory complications.
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15
Q

Which intervention is recommended for mild to moderate cystic fibrosis?

A) High-intensity resistance training
B) Intermittent aerobic activities
C) Submaximal eccentric exercises
D) Passive stretching

A

B) Intermittent aerobic activities - Activities like cycling, walking, and swimming improve respiratory and cardiovascular function.

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16
Q

Which motor classification is most common in children with cerebral palsy?

A) Dyskinetic
B) Ataxic
C) Spastic
D) Hypotonic

A

C) Spastic - Approximately 75% of children with CP exhibit spasticity as the primary motor type.

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17
Q

What is a characteristic gait deviation in children with diplegic CP?

A) Toe walking bilaterally
B) Wide-based, unsteady gait
C) Scissoring gait
D) Increased trunk sway

A

C) Scissoring gait - Children with diplegic CP often present with a scissoring pattern due to spasticity in the adductors.

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18
Q

What is the primary etiology of cerebral palsy?

A) Genetic mutation
B) Hypoxic brain injury
C) Trauma after 2 years of age
D) Chronic inflammation

A

B) Hypoxic brain injury - CP results from non-progressive disturbances in the fetal or infant brain, often due to hypoxia.

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19
Q

Which GMFCS level describes children with CP who require assistive devices for ambulation?

A) Level I
B) Level II
C) Level III
D) Level IV

A

C) Level III - GMFCS Level III children use assistive devices for ambulation but have limited independence.

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20
Q

Which physical therapy intervention is evidence-based for improving gait in children with CP?

A) Passive stretching only
B) Constraint-induced movement therapy
C) Treadmill training
D) Electrical stimulation alone

A

C) Treadmill training

  • Evidence supports treadmill training to improve reciprocal stepping and gait patterns in CP.
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21
Q

What is the clinical significance of pseudohypertrophy in DMD?

A) Indicates muscle strength is improving
B) Reflects replacement of muscle by fat and fibrous tissue
C) Is a normal finding in growing children
D) Suggests cardiac complications

A

B) Reflects replacement of muscle by fat and fibrous tissue

  • Pseudohypertrophy in DMD is due to fat and fibrosis replacing muscle tissue.
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22
Q

Which test is commonly used to assess lower extremity function in children with DMD?

A) Brooke Scale
B) 6-Minute Walk Test
C) Modified Ashworth Scale
D) Timed Up and Go

A

B) 6-Minute Walk Test

  • This test evaluates endurance and lower extremity functional capacity in DMD patients.
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23
Q

Which intervention is recommended for children with SMA to prevent contractures?

A) High-resistance exercises
B) Passive stretching
C) Weightlifting
D) Hyperextension exercises

A

B) Passive stretching - Passive stretching helps prevent joint contractures in SMA patients.

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24
Q

What is the primary aim of Spinraza in treating SMA?

A) Replacing the SMN1 gene
B) Increasing functional SMN protein production
C) Reducing fibrosis
D) Enhancing muscle regeneration

A

B) Increasing functional SMN protein production

  • Spinraza
    works by promoting full-length SMN protein production.
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25
Q

What is a common pulmonary complication in children with cystic fibrosis?

A) Hemoptysis
B) Retention of thick mucus in airways
C) Atelectasis
D) Pleural effusion

A

B) Retention of thick mucus in airways

  • This is a hallmark complication of cystic fibrosis, leading to infections and airway obstruction.
26
Q

Which breathing pattern is typical of a child with respiratory distress syndrome?

A) Slow, shallow breathing
B) Nasal flaring and grunting
C) Irregular apnea episodes
D) Periodic hyperventilation

A

B) Nasal flaring and grunting - These are key symptoms of respiratory distress syndrome in neonates.

27
Q

What is a characteristic posture of the upper extremity in children with hemiplegic CP?

A) Shoulder protraction, elbow flexion, forearm pronation
B) Shoulder retraction, elbow extension, forearm supination
C) Neutral shoulder and wrist, elbow flexion
D) Shoulder adduction, elbow extension, wrist ulnar deviation

A

A) Shoulder protraction, elbow flexion, forearm pronation

  • This posture is typical of hemiplegic CP in the upper extremity.
28
Q

Which gait pattern is most commonly observed in children with spastic diplegic CP?

A) Wide-based gait with trunk sway
B) Scissoring gait with crouched posture
C) Foot drop with circumduction
D) Toe-walking with wide base of support

A

B) Scissoring gait with crouched posture

  • This gait is typical of spastic diplegic CP, characterized by adductor spasticity and crouched stance.
29
Q

What is a common medical complication associated with quadriplegic CP?

A) Respiratory infections
B) Increased bone density
C) Hyperreflexia
D) Enhanced gross motor skills

A

A) Respiratory infections

  • Quadriplegic CP often leads to respiratory complications due to reduced mobility and weak respiratory muscles.
30
Q

Which standardized test is used to measure gross motor function in children with CP?

A) PEDI-CAT
B) Gross Motor Function Measure (GMFM)
C) Functional Mobility Scale
D) Modified Ashworth Scale

A

B) Gross Motor Function Measure (GMFM) - The GMFM is a validated tool for assessing gross motor function in children with CP.

31
Q

Which PT intervention is most beneficial for improving strength in children with CP after a selective dorsal rhizotomy?

A) Passive stretching
B) Submaximal resistance training
C) Aquatic therapy
D) Constraint-induced movement therapy

A

B) Submaximal resistance training

  • Strength training is crucial post-selective dorsal rhizotomy to enhance functional mobility.
32
Q

What is a common postural deviation in children with spastic CP?

A) Posterior pelvic tilt
B) Anterior pelvic tilt with lumbar lordosis
C) Neutral pelvic alignment
D) Kyphotic spine

A

B) Anterior pelvic tilt with lumbar lordosis - This posture is common due to spasticity in the hip flexors and lumbar extensors.

33
Q

Which gross motor milestone is typically delayed in children with CP?

A) Sitting without support
B) Reaching for objects
C) Smiling
D) Recognizing faces

A

A) Sitting without support - Children with CP often show delayed gross motor milestones like unsupported sitting.

34
Q

What is the purpose of selective dorsal rhizotomy (SDR) in children with CP?

A) Strengthening weak muscles
B) Reducing spasticity by severing sensory nerve rootlets
C) Increasing joint range of motion
D) Improving respiratory function

A

B) Reducing spasticity by severing sensory nerve rootlets - SDR is a surgical intervention to manage spasticity in CP.

35
Q

Which classification system is used to describe the functional abilities of children with CP?

A) Hammersmith Scale
B) Gross Motor Function Classification System (GMFCS)
C) Modified Ashworth Scale
D) Functional Independence Measure

A

B) Gross Motor Function Classification System (GMFCS) - This system classifies functional abilities in children with CP across five levels.

36
Q

Which pulmonary condition is associated with premature infants?

A) Chronic bronchitis
B) Respiratory distress syndrome (RDS)
C) Cystic fibrosis
D) Tuberculosis

A

B) Respiratory distress syndrome (RDS) - Premature infants often develop RDS due to insufficient surfactant production.

37
Q

What is the primary goal of high-frequency chest wall oscillation (HFCWO) in cystic fibrosis management?

A) Strengthen respiratory muscles
B) Mobilize thick airway secretions
C) Reduce inflammation in the airways
D) Improve oxygen saturation levels

A

B) Mobilize thick airway secretions - HFCWO helps clear mucus from the airways in cystic fibrosis patients.

38
Q

Which symptom distinguishes severe asthma exacerbation from mild asthma?

A) Wheezing
B) Nasal congestion
C) Cyanosis and inability to speak
D) Mild chest tightness

A

C) Cyanosis and inability to speak

  • These symptoms indicate severe respiratory distress during an asthma attack.
39
Q

Which drug therapy is commonly used to manage spasticity in children with CP?

A) Spinraza
B) Baclofen
C) Zolgensma
D) Corticosteroids

A

B) Baclofen

  • Baclofen is used to reduce spasticity in children with CP by acting on the central nervous system.
40
Q

What is the purpose of treadmill training for children with CP?

A) To increase joint flexibility
B) To activate central pattern generators for stepping
C) To reduce spasticity
D) To improve hand function

A

B) To activate central pattern generators for stepping - Treadmill training promotes reciprocal stepping patterns in children with CP.

41
Q

Which activity is recommended to maintain function in children with DMD?

A) High-intensity resistance training
B) Cycling or swimming
C) Eccentric strengthening exercises
D) Sprinting drills

A

B) Cycling or swimming - These are low-impact activities that help maintain cardiovascular fitness and overall function.

42
Q

What is the role of corticosteroids in managing DMD?

A) Cures the disease
B) Slows muscle degeneration
C) Enhances muscle growth
D) Improves cardiac function

A

B) Slows muscle degeneration - Corticosteroids reduce inflammation and slow muscle degeneration in DMD.

43
Q

What is a key benefit of Zolgensma for SMA patients?

A) Reduces joint contractures
B) Replaces the missing SMN1 gene
C) Enhances muscle protein synthesis
D) Prevents scoliosis

A

B) Replaces the missing SMN1 gene - Zolgensma is a gene therapy that introduces a functional SMN1 gene.

44
Q

Which physical therapy intervention is suitable for SMA patients classified as walkers?

A) Standing programs
B) Aquatic therapy and balance training
C) Total body vibration therapy
D) Passive stretching

A

B) Aquatic therapy and balance training - These activities help maintain mobility and prevent fatigue in walkers with SMA.

45
Q

What is a typical clinical sign of atelectasis in pediatric patients?

A) Increased respiratory rate
B) Cyanosis
C) Decreased breath sounds in the affected area
D) Productive cough

A

C) Decreased breath sounds in the affected area - Atelectasis leads to reduced airflow and breath sounds over collapsed lung tissue.

46
Q

What is the primary goal of postural drainage in respiratory therapy?

A) Reduce airway inflammation
B) Prevent atelectasis
C) Mobilize secretions
D) Increase lung compliance

A

C) Mobilize secretions - Postural drainage uses gravity to aid the clearance of secretions from specific lung segments.

47
Q

Which type of CP is most often associated with a wide-based unsteady gait?

A) Spastic CP
B) Ataxic CP
C) Dyskinetic CP
D) Hypotonic CP

A

B) Ataxic CP

  • This type of CP involves balance and coordination deficits, resulting in a wide-based unsteady gait.
48
Q

What is the typical gait pattern seen in children with hemiplegic CP?

A) Scissoring gait
B) Wide-based ataxic gait
C) Circumduction on the affected side
D) Bilateral toe walking

A

C) Circumduction on the affected side

  • Hemiplegic CP often presents with circumduction of the affected limb during swing phase.
49
Q

Which orthopedic complication is common in children with CP?

A) Leg lengthening
B) Hip dysplasia
C) Increased bone density
D) Knee varus deformity

A

B) Hip dysplasia - Spasticity and abnormal movement patterns in CP can lead to hip subluxation or dysplasia.

50
Q

What is the primary purpose of neuromuscular blocks (e.g., Botox) in CP management?

A) Reduce joint contractures
B) Strengthen muscles
C) Increase aerobic endurance
D) Decrease spasticity

A

D) Decrease spasticity - Neuromuscular blocks like Botox reduce spasticity by inhibiting neuromuscular transmission.

51
Q

Which test is used to predict independent walking in infants at risk for CP?

A) HINE
B) GMFM
C) PEDI-CAT
D) Modified Ashworth Scale

A

A) HINE - The Hammersmith Infant Neurological Examination (HINE) is predictive of independent walking in infants at risk for CP.

52
Q

What is a key benefit of aquatic therapy for children with CP?

A) Increases bone density
B) Reduces spasticity and enhances movement
C) Improves speech development
D) Prevents respiratory infections

A

B) Reduces spasticity and enhances movement - Aquatic therapy provides buoyancy and resistance, facilitating functional movement.

53
Q

What type of respiratory support is often required for children with severe quadriplegic CP?

A) Oxygen supplementation only
B) Mechanical ventilation
C) Incentive spirometry
D) Postural drainage

A

B) Mechanical ventilation - Severe cases may require ventilatory support due to weakened respiratory muscles.

54
Q

What is the purpose of hip abduction bracing in children with CP?

A) Increase weight-bearing capacity
B) Prevent hip subluxation
C) Enhance gait speed
D) Promote trunk stability

A

B) Prevent hip subluxation - Abduction bracing maintains proper hip alignment and reduces the risk of subluxation.

55
Q

Which GMFCS level includes children with CP who can ambulate independently but with some limitations?

A) Level I
B) Level II
C) Level III
D) Level IV

A

B) Level II - GMFCS Level II describes children with limitations in walking long distances or on uneven terrain.

56
Q

Which respiratory condition is associated with scarring of lung tissue and thickened arterial walls?

A) Bronchopulmonary dysplasia
B) Atelectasis
C) Cystic fibrosis
D) Primary ciliary dyskinesia

A

A) Bronchopulmonary dysplasia - BPD is a chronic respiratory disorder characterized by these changes.

57
Q

Which gait deviation is common in children with spastic diplegia?

A) Jump gait
B) Circumduction gait
C) Wide-based ataxic gait
D) Foot drop with contralateral vaulting

A

A) Jump gait - Spastic diplegia often results in excessive knee flexion during stance and a ‘jump’ during terminal stance.

58
Q

What is a typical functional mobility goal for children with CP undergoing PT?

A) Achieve independent ADLs
B) Eliminate spasticity entirely
C) Prevent all orthopedic surgeries
D) Maximize respiratory function

A

A) Achieve independent ADLs - Physical therapy focuses on enhancing functional independence in daily activities.

59
Q

Which type of assistive device is most commonly used by children with GMFCS Level III?

A) Power wheelchair
B) Posterior walker
C) Crutches
D) Manual wheelchair

A

B) Posterior walker - Children with GMFCS Level III typically use a posterior walker for ambulation.

60
Q

What is the primary goal of stretching interventions in children with CP?

A) Eliminate spasticity
B) Improve respiratory function
C) Prevent contractures and maintain range of motion
D) Increase strength

A

C) Prevent contractures and maintain range of motion - Stretching helps manage spasticity and prevent secondary complications like contractures.

DPT 772 - Pediatrics II (17 decks)

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