Term
| what does the natural perspective help with for tx of pediatric pts? |
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Definition
| consideration of diseases which are static vs progressive, potential complications, and planning and intervention strategies. |
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Term
| what may be the hardest part of spina bifida cystica affected pts transition to a wheelchair? |
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Definition
| the pt themselves may appreciate their newfound mobility, but the family may feel like a failure has occurred. |
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Term
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Definition
| multiple congenital contractures |
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Term
| what is important to the pediatric physiatric hx? |
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Definition
| communicating w/the parents to understand their thoughts and expectations |
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Term
| when do children start to develop stranger anxiety? |
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Definition
| around 9 months (look past their eyes). if the pt is older than 3 however, the dr. should introduce himself to the child directly |
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Term
| what does the pediatric physiatric hx consist of? |
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Definition
| birth hx (pregnancy [breech?], delivery [breech?], BW, early problems, fam hx), gross motor skills (rolling, sitting, walking), fine motor (handedness [shouldn't be L-handed in under 12 mos], pincer grasp), ADL's (eating, dressing, bathing), communication (babbling [is it trending toward meaningful?], words, pointing, eye contact), social skills, and equipment. |
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Term
| what is a good way to address complaints of hypotonia (most common) in an infant? |
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Definition
| consider central disorders first (trisomy 21 or 18, deletion or metabolic disorder), spinal cord injury (differentiate from cerebral palsy), anterior horn cell disease (spinal muscular atrophy), polyradiculoneuropathy (guillain-barre), neuromuscular junction defects (botulism and other inherited disorders), myopathy (inherited congenital, inflammatory, progressive [becker's duchenne's]), and connective tissue defects (ehler danlos) |
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Term
| what are developmental warning signs? |
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Definition
| significant head lag (at 4 mos), early rolling (less then 4 mos), early standing (scissoring, spasticity), early hand preference (less than 18 mos), not walking by 15 mos, no words by 15 mos (hearing ok?), and no two word sentences by 2 years. |
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Term
| what are physical warning signs? |
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Definition
| children that don't look you in the eye/don't imitate by 18 mos: think autism, abnormal tone, abnormal persistence of infantile responses (asymmetric tonic neck reflex 7 mo [if persists to 4, child may not walk], moro gone at 4 mo, asymmetric parachute at 18 mos) |
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Term
| when should you start considering a power chair for a disabled pt? how much does this cost? (*exam question*) |
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Definition
| when the pt is ~2 yrs cognitively, start thinking about a power chair. this may cost $10-20,000. |
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Term
| what is the biggest hurdle to get through for cerebral palsy/spina bifida pts in terms of them reaching their lifetime potential? |
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Definition
| their degree of socialization: which is subject to their mobility, language/speech, physical appearance, handicap minimization, encouragement to socialize, and appropriate expectations. |
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Term
| what is the developmental perspective for pediatric rehab? |
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Definition
| early manipulation of the environment promotes independence (in the context of the child cognitive and physical abilities - try to parallel normal development). interventions should be functional (helping them learn how to best get around). |
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Term
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Definition
| the individuals w/disability education act which allows the "child find" so that children w/developmental delays can be evaluated quickly and action can be taken to help them. |
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Term
| how might a sibling of a disabled pt behave? |
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Definition
| behavior problems, precocious maturation, guilt resentment, embarrassment, tolerance, and resiliency. |
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Term
| when do you fit a limb-deficient child w/upper extremity prosthesis? lower extremity? (*possible exam question*) |
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Definition
| *upper extremity: around 6 mos. *lower extremity: when the child is pulling to stand. the prosthesis must be functional in order to accept. |
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Term
| what is usually different appearance-wise between disabled pts w/anterior horn disease (spinal muscular atrophy) and pts w/a metabolic disorder or cerebral palsy? |
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Definition
| the anterior horn pts will look good cognitively |
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Term
| what are sample rx's for DME (durable medical equipment)? |
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Definition
FO: foot orthoses
AFO: ankle orthoses
KAFO: knee orthoses
HKAFO: hip orthoses
TLSO: thoracolumbarsacral orthoses |
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Term
| what are the car seat recommendations for children? |
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Definition
| rear facing until 1 yr. then turn the pt around and put them in a 5 point over the shoulder, through the legs car seat until they are 4 y/o and 40 lbs. booster seat until 8 yrs and 80 lbs. no front seat until 12 y/o. |
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Term
| what are the early signs of concussion? |
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Definition
| dazed/confused, h/a, balance/coordination deficit, n/v, dinged/foggy, and delayed deterioration |
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Term
| what is the daily folic acid recommendation for spina bifida prevention in sexually active females? (*exam question*) |
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Definition
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