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Peds patho
Scorebuilders 2010
| Question | Answer |
|---|---|
| Why does the femoral head degenerate in Legg-Calve-Perthes disease? | Disturbance in the blood supply (avascular necrosis) to the femoral head |
| Which pediatric disease is not considered self limiting?A) Congenital torticollisB) Legg-Calve-Perthes DiseaseC) Osgood-Schlatter Disease | Congenital torticollis |
| What are the four distinct stages of Legg-Calve-Perthes Disease? | )Condensation 2) Fragmentation 3) Re-ossification 4)Remodeling |
| Causative factors of Legg-Calve-Perthes Disease. | Trauma,genetic predisposition,synovitis,vascular abnormalities, infection |
| Characteristics of Legg-Calve-Perthes Disease include all of the following except:1) Pain 2)Increased ROM 3)Antalgic gait 4) Positive trendelenberg | Increaed ROM |
| What is the primary focus of treating Legg-Calve-Perthes Disease? | Relieve pain, maintain the femoral head in the proper position, improve ROM |
| What can PT do for Legg-Calve-Perthes patients? | Stretching, splinting, crutch training, aquatic therapy, traction, exercise |
| Is orthotic devices and surgical intervention indicated in Legg-Calve-Perthes disease? | YES depending on classification and severity of the condition |
| What is another name for Osgood-Schlatter disease and what is it? | Traction apophysis; repetitive traction on the tibial tuberosity apophysis |
| What is the cause of swelling in Osgood-Schlatter disease? | The repeated tension to the patella tendon over the tibial tuberosity causes a small avulsion of the tuberosity which causes swelling |
| What are the characteristics of Osgood-Schlatter disease? | Point tenderness over the patella tendon insertion on the tibial tubercle, antalgic gait, pain with increasing activity |
| What activities would place strain on the patella tendon that you should avoid in someone with Osgood-Schlatters disease? | Squatting, running or jumping |
| What should conservative treatment focus on with Osgood-Schlatter disease? | Education, icing, flexibility exercises and eliminating activities that place strain on the patella tendon (squatting, running, jumping) |
| What type of tissue does osteogenesis imperfect affect and at what time does it affect it? | Connective tissue disorder that affects the formation of collagen during bone development |
| How many classifications are there of osteogenesis imperfect? | 4 classifciations that vary in levels of severity |
| Osteogenesis imerfecta is a genetically inheritated disease; which types are considered autosomal dominant traits and which traits are considered autosomal recessive traits? | Autosomal dominant:Type I and IV Autosomal recessive traits: Types II, III |
| What are the characteristics of osteogenesis imperfecta? | Pathological fractures, osteoporosis, hypermobile joints, bowing of the long bones, weakness, scoliosis,impaired respiratory function |
| What are the essential areas of treatments in osteogenesis imperfecta? | Use of orthotics, active and symmetrical movements, positioning, functional mobility and fracture management |
| When does treatment of osteogenesis imperfecta start and how does it start? | Begins at birth with caregiver education and proper handling and facilitation of movement |
| What are the 4 classifications of scoliosis? | Infantile, juvenile, adolescent, or adult |
| What neuromuscular and musculoskeletal conditions is scoliosis associated with? | CP, MD, leg length discrepancy |
| Is the cause of scoliosis always known? | No, some have unknown etiology or could have altered development of the spine in utero |
| What are the characteristics of a structural curve in scoliosis? | Cannot be corrected with active or passive movements |
| Is the rotation of the vertebrae towards the convex or concave side in a structural curve and which side is the rib hump? | Rotation toward convex side, rib hump on convex side |
| Where should you look for asymmetries for in a structural curve scoliosis? | Shoulders, scapulae, pelvis and skinfolds |
| How does a non-structural scoliosis curve correct with active ROM? | Lateral bending towards the apex of the curve- |
| What is the cause of the non-structural scoliosis curve and will it progress and does it involve rotation of the vertebrae? | Cause: leg length discrepancy, Non-progressive, minimal rotation |
| What is the treatment for scoliosis curves that are less than 25 degrees? | Monitoring |
| What is the treatment for scoliosis curves that are between 25 and 40 degrees? | Orthotic management, PT intervention for posture, flexibility, respiratory function and body mechanics |
| What is the treatment for curves over 40 degrees? | Surgical intervention to improve spinal stability |
| What does clubfoot or talipes equinovarus look like? | Adduction of forefoot, various positioning of the hindfoot, equinus at the ankle, severe cases can include deformity of the lower leg |
| What are the causative factors of talipes equiniovarus? | Theories include familial tendency, positioning in utero or defect in ovum |
| What neuromuscular conditions does club foot accompany? | Spina bifida, arthrogryposis- club foot may result from the lack of movement in utero to reposition |
| When does treatment start for talipes equinovarus and what does it consist of? | Soon after birth, includes splinting and serial casting; goal is to restore proper positioning of the foot and ankle |
| What does the treatment consist of if conservative treatment failed in club foot? | Surgical intervention and subsequent casting |
| What is the most common chronic rheumatic disease in children? | Juvenile rheumatoid arthritis (JRA): inflammation of joints and connective tissue |
| What is the causative factor associated with JRA? | Exact etiology unknown, causative factors include external source such as a virus, infection, or trauma that may trigger an autoimmune response producing JRA in a child with a genetic predisposition |
| What type of JRA accounts for 10% to 20% of children with JRA? | Systemic JRA |
| If your patient presented with an acute onset of symptoms, high fever, and rash; what type of JRA would you suspect? | Systemic JRA |
| What organs are involved with systemic JRA? | Enlargement of the spleen and liver, inflammation of lungs and heart |
| What type of JRA accounts for 30-40% of children with JRA? | Polyarticular juvenile rheumatoid arthritis |
| What type of JRA has a high female incidence? | Polyarticular juvenile rheumatoid arthritis |
| How many joints does polyarticular juvenile RA effect? | arthritis in more than five joints with symmetrical joint involvement, RF + majority |
| What type of JRA accounts for 40-60% of children with JRA? | Oligoarticular (Pauciarticular) JRA. |
| How many joints does Oligoarticular JRA effect? | less than five joints with asymmetrial joint involvment |
| What are the general characteristics of Oligoarticular JRA? | inflammation, malaise, pain with palpation and movement, stiffness, iritis, fever and rash |
| What pharmacological management |
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