Spina Bifida

Question 1

In utero exposure to what 2 anticonvulsants can result in spina bifida

Answer 1

Valproic acid and carbamazepine

Question 2

Most common type of spina bifida

Answer 2

Myelomeningocele

Question 3

What nerve roots somatically innervate the bladder through the pudendal plexus?

Answer 3

S2-S5

Question 4

At what level of spina bifida can children sit normally?

Answer 4

If L4-5 is spared

Question 5

Most common level of spina bifida occulta

Answer 5

L5-S1

Question 6

Which level of spina bifida leads to complete leg paralysis

Answer 6

T6-T12

Question 7

What nerve roots parasympathetically innervate the bladder?

Answer 7

S2-S4

Question 8

How is level of spina bifida lesion related to IQ?

Answer 8

The higher the lesion, the lower the IQ

Question 9

Which level of spina bifida leads to pes cavus foot

Answer 9

S1-S2 or S3-S4

Question 10

What procedure do children with hydrocephalus need?

Answer 10

Ventriculoperitoneal shunting

Question 11

What weeks do you test for AFP?

Answer 11

13-15 weeks

Question 12

What physical exam finding is used to prognosticate bowel continence in spina bifida?

Answer 12

Bulbocavernous or anocavernous reflex

Question 13

Which level of spina bifida leads to hip and knee flexion contractures

Answer 13

T6-T12

Question 14

Treatment of bilateral hip dislocation without restriction of joint mobility in spina bifida

Answer 14

Leave alone

Question 15

Downward displacement of medulla and brainstem through the foramen magnum

Answer 15

Arnold-chiari malformation

Question 16

Which level of spina bifida leads to equinus foot

Answer 16

T6-T12 or L1-L3

Question 17

What nerve roots sympathetically innervate the bladder?

Answer 17

T10-L2

Question 18

What weeks do you do an amniocentesis?

Answer 18

16-18 weeks

Question 19

Which level of spina bifida leads to calcaneovarus foot with ankles dorsiflexed

Answer 19

L4-L5

Question 20

Which level of spina bifida leads to knee extension contractures

Answer 20

L4-L5

Question 21

Below what spinal level of spina bifida can children ambulate without device

Answer 21

At or below S1

Question 22

When do children with spina bifida begin rolling? And what is normal?

Answer 22

Normal = rolling by 7 months

Spina bifida = 18 months

Question 23

2 main types of spina bifida

Answer 23

Occulta and cystica

Question 24

Which type of spina bifida may be associated with Arnold-chiari malformation

Answer 24

Myelomeningocele

Question 25

What 4 countries has the highest incidence of spina bifida

Answer 25

England, Scotland, Wales, Ireland

Question 26

Which level of spina bifida leads to knee flexion contractures

Answer 26

L1-L3

Question 27

What weeks do you do a fetal US

Answer 27

16-24 weeks

Question 28

Which type of spina bifida has a cystic sac that contains the spinal cord?

Answer 28

Myelomeningocele

Question 29

Which country has the lowest rate of spina bifida

Answer 29

Japan

Question 30

Most common cause of death in spina bifida

Answer 30

Central respiratory dysfunction

Question 31

What calcinosis is common with UTI of what bacteria in spina bifida patients?

Answer 31

Proteus

Question 32

What fails to fuse in spina bifida occulta

Answer 32

Posterior elements of vertebrae

Question 33

What 2 things can you measure in maternal serum and amniotic fluid to test for NTD?

Answer 33

Alpha-fetoprotein and acetylocholinesterase

Question 34

What is spina bifida aperta

Answer 34

Any NTD where deformity is open to environment

Question 35

At what age can you start intermittent catheterization for spina bifida?

Answer 35

5-6 yo

Question 36

Why do spina bifida patients have precocious puberty

Answer 36

Premature activation of hypothalamus pituitary gonadal axis from increased pressure on hypothalamus