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PM&R Pediatric Boards > CP from Textbook > Flashcards

CP from Textbook Flashcards

1
Q

AACPDM hip guidance GMFCS II, x-ray

A

Age 2, 6, and 10

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2
Q

Degree of scoli for CP fusion

A

40 skeletal immature

50 skeletal mature

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3
Q

Are arms or legs closer to ventricles (medial)

A

legs, hence PVL causing diplegia

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4
Q

3 criteria of CP

A
  1. Neuromotor control problem
  2. Static brain lesion
  3. injury before birth or first year
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5
Q

Movement pattern on 25% of CP

A

dyskinetic, ataxic, hypotonic

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6
Q

If you haven’t walked by this age, you prob won’t walk

A

4

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7
Q

AACPDM Hip guidance GMFCS IV and V, x-ray

A

Age 2 to 12 twice a year, then yearly to 16

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8
Q

Definition of CP

A

Group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to no progressive disturbances that occurred in the developing fetal or infant brain

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9
Q

Epidemiology of CP

A

Increasing due to more premies surviving, more term with CP, and longer survival. There are more kids with severe CP now.

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10
Q

Extra risks for low Bone Mineral density

A
  • increasing severity of neurological findings
  • Increased feeding difficulty
  • anticonvulstants
  • low weight
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11
Q

Risk factors for CP

A
  • placental abruption
  • birth asphyxia
  • neonatal medical problems
  • prematurity
  • Infection
  • Inflammation
  • coagulopathy
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12
Q

What is the greatest risk factor for CP

A

prematurity

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13
Q

What are TORCH infections

A

TO– Toxoplasmosis
R–Rubella
C–Cytomegalovirus
H–Herpes

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14
Q

Movement type of 75% of CP

A

Spastic (and a touch of dystonic)

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15
Q

Cause found for most CP

A

No

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16
Q

What is tonic labyrinthine tonic neck reflex

A

Basically “crunches”. lay back and body will extend. Flex neck, legs will flex

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17
Q

other MRI CP findings

A

Neuronal migration disorders:

  • Lissencephaly
  • polymicrogyria
  • schizencephaly
  • holoprosencephaly
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18
Q

What is an indicator of hemiplegic CP

A

Hand preference before 18 months

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19
Q

What trimester does PVL happen

A

2nd

20
Q

GMFCS I

A

Run and stairs no help or hands

21
Q

Percentage quadriplegic v diplegia v hemiplegic

A

Quadriplegic 20%
Hemiplegic 40%
Diplegic 40%
(ish)

22
Q

What GMFCS are most quadriplegics

A

25% I-III

75% IV-V

23
Q

What GMFCS are most hemiplegics

A

I-III (99%)

24
Q

V

A

No means of independent mobility

25
Q

Schizencephaly is…

A

Abnormal Schiz (clefts) (division) (cleavage) (split) parts of one or both sides (open or closed lip)

26
Q

What defines dystonia

A

involuntary sustained or intermittent muscle contractions causing twisting and repetitive movements and abnormal postures

27
Q

Most common CP MRI

A

white matter near lateral ventricles

28
Q

What is polymicrogyria

A

Too many folds (gyria)

29
Q

When was the big MetaAnalysis on SEMLS published

A

2012, 31 studies, not all good studies

30
Q

Does bracing work for CP Scoli

A

No (probably) –
Miller J Pedi Ortho 1996 21 kids, 5 years, 23 hours a day, no difference from 22 kids no bracing. No difference in curve, shape, or progression

31
Q

Incidence of scoliosis in CP

A

20% overall, 70% in quadriplegic CP

32
Q

Who might walk with CP

A 
If primitive reflexes persist at 2 years, unlikely to walk
Sitting by age 2 more likely to walk
Hemi, 100%
Di, 85%
Quadriplegia, much less and variable
33
Q

GMFCS III

A

Crutches or manual wheelchair

34
Q

GMFCS II

A

Walk only (not run) and holds rail

35
Q

What are 3 methods of making better social connections in CP

A
  1. Cognitive behavioral therapy
  2. Stepping Stones Triple P
  3. Acceptances and Commitment Therapy
36
Q

AACPDM hip guidance GMFCS I, x-ray

A

None unless Type I gait, then 2, 6, and 10

37
Q

IV

A

Walker or power chair

38
Q

What curve is cut off for progression

A

40 degrees

39
Q

Most significant MRI finding

A

Periventricular leukomalacia

40
Q

What is lissencephaly

A

“smooth brain” no folds (gyry) and grooves (sulci)

41
Q

Other MRI CP findings

A

cortical infarcts of hemiplegia

42
Q

What defines Spasticity

A

2 things

  • Resistance to external movement which increases with increasing speed and varies with direction of joint movement
  • and/or
  • resistance to external movement rising rapidly above a threshold speed or joint angle
43
Q

What GMFCS are most diplegics

A

I-III (98%)

44
Q

AACPDM hip guidance GMFCS III, x-ray

A

Age 2 to 8, yearly, then every other until 16

45
Q

% of kids with neuroimaging abnormalities

A

80%

46
Q

Which GMFCS has most chance decreased bone mineral density

A

IV and V. Bone mineral density z score less than -2.0

PM&R Pediatric Boards (14 decks)

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