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Peds patho

Scorebuilders 2010

QuestionAnswer
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
Created by: mbutterfly on 2010-02-26



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