A high-risk infant is any infant/newborn w/ high probability of developing sensory, motor, cognitive, language or social deficit (including behavioral problems) sometime in childhood.
Normal ❌ lbs LBW ❌ lbs VLBW ❌ lbs ELBW ❌ lbs
Post-Term ❌ weeks Full-Term ❌ weeks Pre-Term ❌ weeks Extremely Pre-Term ❌ weeks
When positioning a pre-term infant, which of the following is the most correct?
Encourage flexion throughout body and adduction of extremities
Encourage flexion throughout body
Encourage adduction of extremities
Encourage extension throughout body and abduction of extremities
Encourage extension throughout body
Encourage abduction of extremities
Why is proper positioning of the pre-term neonate important?
Helps w/ self-regulation
Minimizes positional deformities
Helps minimize motor stress signs
Helps the neonate escape physiologic flexion
Keeps the infant from rolling off the table
Reduces intensity of lanugo
What do you need to do for a neonate with an Apgar score of 10?
Nothing!
Immediate Resuscitation!!
Less intense resuscitation may be needed
What do you need to do for a neonate with an Apgar score of 1?
What condition would you suspect if a neonate had the following symptoms?
Bluish tint to lips/gums/nail beds, increased respiration rates, increased effort of breathing (grunts, flaring of nostrils, retraction of abdomen and soft tissue between ribs)
Hyaline membrane disease
Meconium aspiration
IVH-intraventricular hemorrhage
Necrotizing enterocolitis (NEC)
Periventricular leukomalacia
❌ :: Inadequate Surfactant ❌ :: Bowel movement, Anoxic Event ❌ :: Mini-Stroke ❌ :: Intestines Start to Die ❌ :: Increased pressure in Ventricles
IVH – Intraventricular Hemorrhage Grade 1 0 2 3 4 5( 1, 0, 2, 3, 4, 5 ) :: Not Bad Grade 4 5 3 2 1 0( 4, 5, 3, 2, 1, 0 ) :: Worst
Which is the correct list of pre-term infant characteristics?
Delayed primitive reflexes, Global hypotonia, Low Birth Weight, Sensory overstimulation
Delayed primitive reflexes, Global hypertonia, Low Birth Weight, Sensory overstimulation
Delayed primitive reflexes, Global hypertonia, Low Birth Weight
Delayed primitive reflexes, Global hypotonia, Low Birth Weight
Global hypotonia, Low Birth Weight, Sensory overstimulation
Global hypertonia, Low Birth Weight, Sensory overstimulation
Delayed primitive reflexes, Low Birth Weight, Sensory overstimulation
Delayed primitive reflexes, Low Birth Weight, Lanugo
Low Birth Weight, Sensory overstimulation, Lanugo
Low Birth Weight
The single most important warning sign of child abuse is ___.
multiple injuries incurred at one time or at frequent intervals
a low SES of the family
the father's education level
a multi-generational familial history of child abuse
Parenting Styles: ❌ :: Children are constantly told what they cannot do (but not what they can do). Often grow-up to rebel against authority figures ❌ :: Children never hear any rules. If someone tries to implement a rule, the child becomes upset and throws a temper tantrum.
Which combination is likely to result in a child that tends to be submissive, dependent, neat. Knows consequences of breaking rules. Knows parents love them so tries to follow rules. “Nice kids to have around”. Tends to be compliant in therapy.
Box 1: High level of restriction Plus Warmth
Box 2: High level of restriction + Hostility
Box 3: Balance of limits/permission + Warmth
Box 4: Balance of limits/permission + Hostility
Which combination is likely to result in a child that is socially withdrawn, fear-ridden, shy, quarrelsome, self-aggressive emotionally. Some are very compliant to avoid trouble. Others may be quarrelsome around other adults because their rules don't govern their behavior.
Box 1: High level of restriction + Warmth
Which combination is likely to result in a child that is socially outgoing, active, creative, independent. Knows what they are capable of but also aware of own limits. Tends to be leaders. Secure in own abilities.
Which combination is likely to result in a child that is aggressive, non-compliant, delinquent in behaviors. Not used to having any limits on behavior, no restrictions. Anything goes. Will push to edge of tolerance.
Which type of CP is described with the following notes: Wide movements Therapy Goal: Provide midline control Put motorized WC controller close to patient’s midline Lots of reflexes kick-in
Athetoid
Ataxic
Spastic Diplegia
Spastic Hemiplegia
Spastic Quadraplegia
Which type of CP is described with the following notes: i. Little movements ii. Patients might fall through the cracks iii. Hypotonic iv. Wide base of support v. Little tremor/wobble
Which type of CP is described with the following notes: i. Causes (PVH) ii. Legs are more involved, but slight UE involvement may occur iii. PT involved at a young age iv. Probably OT, too, to address one of the hands v. Lots of pre-term babies
Which type of CP is described with the following notes: Pediatric patients need an MRI early for quick diagnosis Pre-term babies may appear to have this, but don’t really Caused by Brain tumors or Metabolic issues
Which type of CP is described with the following notes: High-tone throughout extremities Extension Use one side more than the other
Which type of CP is characterized as Increased mm tone that's velocity dependent (lesion in motor cortex or corticospinal pathway)
Spastic
Flaccid
Which type of CP is characterized as extreme fluctuations of mm tone from low to high. (damage to BG)
Which type of CP is characterized as dec mm tone w/ mild flux towards norm tone. (damage to cerebellum)
Which type of CP is characterized as severely dec tone. (diffuse injury in brain)
Lesion in Motor Cortex or Corticospinal Pathway :: ❌ CP Damage to Basal Ganglia :: ❌ CP Damage to Cerebellum :: ❌ CP Diffuse Brain Injury :: ❌ CP
Which of the following describe Erb's Palsy?
Lesion at C5-C6
Waiter's Tip Position
Lesion at C7-T1
Claw Hand
Which of the following describe Klumpke's Palsy?
Waiter's Tip
Select the symptoms of Clubfoot
Forefoot AD-Duction
Varus Hindfoot/Calcaneus
Rigid PF Position
Forefoot AB-Duction
Valgus Hindfoot/Calcaneus
Rigid DF Position
Which of the following most accurately describes the proper treatment for Clubfoot?
Serial Casting followed by an AFO (all-day -> only at night)
Wearing an AFO (all-day -> only at night)
Amputation
AFO all-day, every day
Which joints are involved in clubfoot?
talocalcaneal
talonavicular
calcaneocuboid
tarsometatarsal
tibiotalar
❌ Test :: Determines if a hip is dislocatable ❌ Test :: Manually reduces a dislocated hip
Congenital Muscular Torticollis causes a >15% 10% 5% 25% 20%( 15%, 10%, 5%, 25%, 20% ) difference between sides when measuring neck rotation neck flexion neck extension( neck rotation, neck flexion, neck extension ) and neck lateral flexion neck flexion neck extension( neck lateral flexion, neck flexion, neck extension ).
For a sex-linked genetic disorder, where the female is a carrier and the father is normal, what is the probability that a child will have the disorder (i.e. be affected)?
0%
25%
50%
75%
For a sex-linked genetic disorder, where the female is a carrier and the father is normal, what is the probability that a child will be a carrier?
For a sex-linked genetic disorder, where the female is a carrier and the father is normal, what is the probability that a child will be normal (i.e. not affected or carrier).
Which of the following are the TORCH-S infections?
Toxoplasmosis
Influenza
Varicella
Rubella
Cytomegalovirus
Herpes
Syphillis
HIV
Pertussis
Ricketts
Which of the following describe Ultrasound?
Can screen for Down Syndrome
Can confirm diagnosis of Spina Bifida
Standard procedure in all pregnancies
Performed at 9-11 wks gestation
Only used if there is an abnormal alpha-fetoprotein level
Performed at 14-18 wks gestation, results take an additional 2-3 wks
May cause spontaneous abortion
May test mom by mistake and provide false negative
Can be used for karyotyping and enzyme analysis to look for chromosomal or genetic disorders
Which of the following describe Chorionic Villi Sampling?
Which of the following describe Amniocentesis?