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USA Peds Final| 161 Questions| With
Complete Solutions
1973 law that gave all individuals equal opportunity to employment, transportation, and public spaces correct answer: ADA (Americans with Disabilities Act The contextual framework for Early Intervention is based on _________-centered services correct answer: Family Each child receiving Early Intervention services must have goals as written out in the ______ (acronym) correct answer: IFSP (Individualized Family service plan) The IEP is developed by a_______. correct answer: Team This amendment to IDEA extended services for children birth - years of age correct answer: Amendment Part C The IEP identifies _________ goals, not therapy goals as we have learned to write them correct answer: Educational Federal legislation that guides services for children from 0 - 3 years old with disabilities and/or develop- mental delays correct answer: Early Intervention Which provisions are mandated rights to children with disabilities in public schools correct answer: Availability of
assistive technology, right to due process and parent participation PL94-142, Part C, Section 504, and IDEA all refer to parts of the following correct answer: Federal law and Federal regulation IDEA assures right to education for all children in the ______ restrictive environment correct answer: Least Education for all Handicapped Children Act was passed by congress in 1975. This act is now known as _______ (acronym). correct answer: IDEA OTs and PTs are often involved in acquisition of equipment that the child needs to benefit from an education. This equipment is referred to as ______ ______ and the cost is covered by the school district. correct answer: Assistive Technology _________ services begin at age 14 and are implemented at age
- This promotes the movement from school to post-school activities. correct answer: Transition Acronym for the required component of IDEA mandates that school districts provide access to general education and specialized educational services correct answer: FAPE: Free Appropriate Public Education The plan for children ages 3-21 years that defines the child's education goals for the calendar year, including his/ her
What is the role of OTs and PTs in the public school setting? correct answer: - "supportive services that a student needs in order to learn"
- provide seating/positioning advice
- Behavior modification
- "Related services" When are heart sounds heard during maturation of the cardiac system? correct answer: week 8- Which statement about the foramen oval is correct? correct answer: The foramen oval allows blood to bypass the lungs and flow from the right atrium to the left atrium When is surfactant produced? correct answer: 28-32 weeks: amount of surface increases to ensure adequate lung inflation at birth Results of Bronchopulmonary dysplasia (BPD) correct answer: Infants will exhibit higher respiratory rates and slower physical growth. Affects endurance, activity tolerance, and environmental exploration Babies born with serious RDS will eventually get a diagnosis of _____. correct answer: BPD S/S of Asthma correct answer: - coughing: worse at night
- wheezing
- chest tightness
- shortness of breath
Pathophys of Cystic Fibrosis correct answer: Absent/failed chloride ion channels (Autosomal recessive disease) What condition would you expect in a premature infant with S/S of:
- rapid, shallow breathing
- sharp pulling in of the chest below the ribs with each breath
- counting sounds
- flaring of the nostrils correct answer: RDS What type of Cardiac Condition is artial/ventrical septal defects? correct answer: Acyanotic What are the 4 defects of Tetralogy of Fallot? correct answer: Pulmonary stenosis Right ventricular hypertrophy Overriding aorta Ventricular septal defect
- "PROV" What is Hypoplastic Left Heart Syndrome? correct answer: underdevelopment of the entire left side of the heart, mitral valve is small, left ventricle is small
- surgical correction and/or transplant needed Infant symptoms of a heart problem? correct answer: - SOB during feeding
- sweating during feeding
- turning blue inside the mouth (gums/tongue)
- passing out
d. ventricular septal defect correct answer: a. arterial septal defect remember "PROV" OM for children with Cardiopulmonary Conditions correct answer: 6 minute walk test Different chest deviations to observe in a pulmonary exam correct answer: - pectus excavatum - funnel chest
- pectus carinatum - pigeon chest How long should RR on infants be counted for? correct answer: full 60 seconds What is an ominous sign, usually a result of hypoxia that should be acted quickly upon? correct answer: Bradycardia! Child is extremely critical What are the four components of Physical Fitness in children? correct answer: 1. cardiorespiratory endurance
- muscular strength and endurance
- flexibility
- body composition What is the general physical activity guideline for children and adolescents? correct answer: children and adolescents should do a t least 60 minutes (1 hour) or more of moderate-to-vigorous physical activity daily What is the aerobic physical activity guideline for children and adolescents? correct answer: most of the 60 minutes a day
should be aerobic and should include vigorous physical activity at least 3 days a week What is the muscle-strengthening physical activity guideline for children and adolescents? correct answer: as part of the 60 minutes or more of physical activity, muscle strengthening should be on at least 3 days of the week What is the bone-strengthening physical activity guideline for children and adolescents? correct answer: as part of the 60 minutes or more of physical activity, bone-strengthening should be on at least 3 days of the week What is the test that measures student fitness in the key areas called? correct answer: FitnessGram What is the Brockport Fitness Test? correct answer: health- related criterion referenced test for youth with disabilities Strength training considerations in children with Autism correct answer: Consider strength training using Progressive Resistive Exercises (PREs). Evidence suggests that moderate to vigorous physical activity may reduce stereotypical behaviors in addition to having positive health benefits. Strength training considerations in children with Spina Bifida correct answer: Train active muscle groups 2-3 times per week, 1-3 sets of 8-12 repetitions using free weights, machines, or isokinetic exercise machines
What is the most common pelvic tendency in an AT? correct answer: posterior pelvic tilt: ASIS is higher than PSIS and the lumbar spine is flexed, thoracic kyphosis, shoulder protraction, increased cervical extension What wheelchair considerations causes a Posterior Pelvic Tendency or sliding out of the chair? correct answer: Seat depth too long Back support too short Sling back upholstery Elevating leg rests Lower extremities are not supported well Open up hip angle to sit in less hip flexion What physical considerations causes a Posterior Pelvic Tendency or sliding out of the chair? correct answer: tight HS reposition themselves by sliding can not maintain 90° of hip flexion PT role in the transition process from pediatrics to geriatrics correct answer: preparing children with disabilities to take personal responsibility for health and fitness at an early age
- teaching self management and self advocacy at school, work and community What are the 2 types of Autism? correct answer: 1) deficits in social communication and social interaction
- restricted repetitive behaviors, interests, and activities (RRBs).
What are the 3 levels of Autism Spectrum correct answer: - Level 3: "Requires very substantial support". Severe deficits in verbal and nonverbal social communication skills causing severe impairments in functioning. RRBs interfere with function.
- Level 2: "Requires substantial support". Marked deficits in verbal/ nonverbal communication skills. RRBs are obvious to casual observer and interfere with functioning in many contexts.
- Level 1: "Requires support". Difficulty initiating social interactions. Examples of atypical response to social situation. Risk factors for Autism correct answer: - advanced paternal age
- maternal antidepressant use
- shorter time between births
- smaller, premature babies
- maternal flue during pregnancy
- Defects in the following genes: 7, 8, 15, 18 and translocation of 3:
- 40% of children diagnosed with Fragile X Syndrome will have a diagnosis of Autism Is there a link between vaccines (like Thimerosal) and ASD? correct answer: No evidence Characteristics and Diagnostic Criteria of ASD correct answer:
- Impaired social-emotional reciprocity
- Impaired communication skills including non-verbal
- Difficulty developing and maintaining relationships
- Restricted repetitive and stereotyped behavior movements, use of objects, or speech
- Insistence on sameness
- Highly restricted interest in focus or intensity
Define Hyposensitivity correct answer: Partial or poor (low) registration leading to sensory craving and impaired sensory discrimination Define hypersensitivity correct answer: sensory defensiveness leading to sensory avoidance Hypersensitivity with gravitational insecurity correct answer: Does not like feet not touching the ground, fear of movement, does not like not being in upright position. Creates "fight or flight" feelings. Affects P.E., playground, and sport involvement Test of Sensory Functions in Infants correct answer: - Standardized, 4-18 months
- Objective way to assess how babies respond to sensory input
- takes about 20 mins Short Sensory Profile correct answer: - Screening tool for potential sensory processing disorders Sensory Integration and Praxis Test (SIPT) correct answer: - Standardized test for children ages 4 to 8 years 11 months
- takes 2 hours
- examines tactile, visual, proprioceptive, vestibular function
- requires qualification to administer Sensory integration intervention goals should focus on what? correct answer: improved skills and functional outcomes
If sensory impairment does not show dramatic changes, what should you do? correct answer: Use compensatory strategies for the long term which includes modifying the environment or using equipment or other products What does the use of external compression, such as a SPIO vest or compression garments provide? correct answer: Provides extra proprioception which is calming SIT: Sensory Integration Therapy correct answer: - "The Primary goal of SIT, is to promote the child's ability to organize progressively and increasingly complex, successful adaptive responses to sensory input"
- 1:1 therapy with the child using variety of sensory equipment and experiences to "re-wire" the nervous system to improve sensory processing for improved function Sensory Diets correct answer: - "Planned and scheduled daily program of specific sensory activities designed by the therapist to help the patient feel calm, alert, and organized"
- Think of it like a nutritional diet: need it to function, need it often when "hungry"
- Use any or all of the sensory systems- whatever the child craves for input or what they need to calm down What is the Willbarger Brushing program? correct answer: FIRM rhythmical strokes with surgical brush down the arms, legs, and back followed by gentle joint compressions. Helps some children with tactile hypersensitivity. Done throughout the day.
Bronchopulmonary Dysplasia (BPD) correct answer: chronic pulmonary disease that develops in premature infants who were treated with mechanical ventilation to treat RDS
- often diagnosed at 28 days of age patent ductus arteriosus (PDA) correct answer: passageway (ductus arteriosus) between the aorta and the main pulmonary artery remains open (patent) after birth
- often asymptomatic, but can cause tachycardia, dyspnea, heart murmur. cardiomegaly
- treated with meds (prostaglandins) to encourage closure pulmonary atresia correct answer: Occurs when pulmonary valve fails to develop, resulting in obstruction of blood flow from right side or heart to the lungs
- need to maintain a PDA for blood flow to the lungs until surgery can be performed What are the symptoms of tetralogy of fallot? correct answer: cyanosis, clubbing of nail beds, increased fatigue during play, poor weight gain, irritability, heart murmur Which grades of Intraventricular Hemorrhage (IVH) are high risk for neurological defects? correct answer: Grade III: Bleed into ventricles with ventricular dilation; may lead to hydrocephalus Grade IV: Ventricular bleed with destruction of white matter What is periventricular leukomalacia (PVL)? correct answer: a form of white-matter brain injury, characterized by the necrosis (or coagulation) of white matter near the lateral ventricles
What is the leading know cause of CP? correct answer: PVL What is Hypoxic Ischemic Encephalopathy (HIE)? correct answer: the result of either hypoxemia or ischemia leading to deprivation of oxygen and glucose to the brain Signs of HIE correct answer: - stupor/coma
- seizures
- changes in tone, posture, respiration/autonomic function What is necrotizing enterocolitis? correct answer: - infection and inflammation resulting in destruction of the intestines
- usually seen in first 2 weeks of life when premature infants start milk feeding
- Feeding intolerance, abdominal distension, greenish vomit, redness of abdomen What is retinopathy of prematurity (ROP)? correct answer: - abnormal blood vessel development in retina
- 2 phases: 1) delayed growth of retinal blood vessels after premature birth, 2) hypoxia from phase 1 stimulates growth of new blood vessels What is hyperbilirubinemia (jaundice)? correct answer: yellow discoloration of skin and blood caused by too much bilirubin in the blood "High risk infant" is typically defined by a neonatologist in terms of having an increased risk for developmental delays and should be closely monitored for at least one year after birth.
c. Arms extended, legs flexed, arms and legs are abducted and IR d. Arms and legs are generally flexed, legs are more abducted than adducted and slightly IR correct answer: a. Both arms & legs are generally flexed, more adducted than abducted and slightly ER Which of the following reflexes would you most expect to observe in a typically developing 7 month old? a. Rooting b. Moro c. STNR d. Stepping correct answer: c. STNR Which of the following skills typically occurs second in the maturational sequence of milestones in mobility? a. Begins to transition to sit to/from quadruped without trunk rotation b. Rolling supine to prone c. Rolling prone to supine d. Creeping (on all 4s) correct answer: b. Rolling supine to prone How long after birth is the APGAR Assessment performed? a. 2 min and 5 min b. 2 min and 10 min c. 1 min and 5 min d. 5min and 10 min correct answer: c. 1 min and 5 min Which of the following developmental milestones should be achieved by a typically developing 13month old?
a. Stands alone in an open area briefly b. Jumps with 2 foot take-off and landing c. Throws ball with trunk rotation and weight shift d. Walks up 4 stairs without holding rail correct answer: a. Stands alone in an open area briefly Klumpke's palsy results from damage to C5 and C6. True or False? correct answer: False Which of the following medical complications results from the use of high level of oxygen in infants? a. Bronchopulmonary dysplasia b. Necrotizing enterocolitis c. Respiratory distress syndrome d. Cystic fibrosis correct answer: a. Bronchopulmonary dysplasia TORCH infections can occur in an infant when: a. A baby is born prematurely b. The mother is exposed to an infection prior to the child's birth c. An infant is exposed to cat litter in the first year of life d. The father is infected with a virus at the time of conception correct answer: b. The mother is exposed to an infection prior to the child's birth All of the following are common physical therapy goals for a premature infant in the NICU except: a. Stretching out of physiologic flexion b. Family education c. Preventing deformities
