PHTH 564 Final Exam - Complex Populations
define palliative care for children - correct answer active total care of the child's body, mind
and spirit and also involves giving support to families
when should palliative care be offered? - correct answer at diagnosis and continued throughout
the course of illness, whether the outcome ends in cure or death
what is the leading cause of death in children in BC? - correct answer natural causes including
prematurity and perinatal causes, congenital anomalies, genetic, metabolic, neurological and
chromosomal disorders and childhood cancers
list the 4 broad categories of children who need palliative care - correct answer 1. life
threatening, curative treatment available but may fail (e.g., cancer)
2. long period of treatment which aims to prolong life but premature death is anticipated (e.g.,
CF)
3. progressive conditions without curative treatment options (e.g., sanfilipo syndrome)
4. severe disability that leads to complications which can lead to a premature death (e.g.,
severe CP)
what domains does palliative care focus on? - correct answer physical (function and symptoms)
emotional (how is the child feeling?
social (how is the family doing?)
spiritual (how do you make sense of this?
trajectory (what is likely ahead?)
describe the dual process mode of grief - correct answer acknowledges that grief is not step by
step bu rather a process that individuals will oscillate between focusing on their loss and
distracting themselves from their loss (YOU CAN HAVE BIG FEELS, ACKNOWLEDGE THEM BUT
CAN ALSO CONTINUE FORWARD WITH LIFE)
based on these 3 patient goals, what are the associated healthcare team's adjacent goals?
Patient goals:
- living as long as possible
,PHTH 564 Final Exam - Complex Populations
- life as long as possible while being comfortable
- live as comfortably as possible, today - correct answer - cure
- balance life-prolonging treatments with quality of life
- optimize comfort at the end of life
what is a physiotherapists role in palliative care? - correct answer - aim treatment to
patient/family's goals
- maximize independence and QOL within a philosophy of comfort and supportive care allowing
patient to fulfill their individual wishes
outline the SPIKES acronym for braking bad news (pediatric palliative care) - correct answer S -
setting
P - perception
I - invitation
K - knowledge
E - emotion
S - summary
what is the WHO-5 Well Being Index? - correct answer self-administered questionnaire shown
to reliably measure emotional functioning
score 50 or below is indicative of low mood
a score of 28 or below indicates likely depression
define self-compassion and the 3 elements of it - correct answer a restorative cognitive coping
approach that enhances one's self-regulatory and coping capacity
3 elements:
- self-kindness
- common humanity
- mindfulness
list the 3 most common pediatric cancers? - correct answer leukemia
brain tumors
MSK tumors
,PHTH 564 Final Exam - Complex Populations
what is the most common pediatric cancer? - correct answer leukemia
specifically acute lymphoblastic leukemia
define leukemia - correct answer cancer of the blood/blood forming tissues including bone
barrow
leukemia can be either L________ or M_________ - correct answer lymphoid OR myeloid
(these are the type of blood cells affected)
what genetic predisposition makes you more susceptible to leukemia? - correct answer down
syndrome
list the major signs and symptoms of leukemia and their causes (5) - correct answer - fatigue -->
due to now Hb (anemia)
- bruising, bleeding, petechia (tiny spots of bleeding on skin) --> low platelets
- inflection, fevers --> low WBC
- bone pain, vertebral fractures, decreased weightbearing --> bony leukemic infiltrates
- chloromas (collection of leukemic cells in brain and skin
what is the name treatment for leukemia? - correct answer multi-agent chemo
what is the length of treatment for leukemia? - correct answer 2-3 years
what are the side effects of treatment for leukemia? - correct answer steroid myopathy
chemotherapy induced peripheral neuropathy (CIPN)
deconditioning
what relapse treatment is used for leukemia following chemo treatment? - correct answer stem
cell transplant (SCT/BMT)
CAR-T therapy
what is the 2nd most common pediatric cancer? - correct answer brain/CNS tumors
list the major signs and symptoms of brain/CNS tumors (4) - correct answer torticollis
headaches/irritability
impaired balance and coordination
ataxia
list the 3 most common treatments used for brain tumors in the pediatric population: - correct
answer surguery to remove part or all of the tumor
, PHTH 564 Final Exam - Complex Populations
chemo
radiation
what is the survival rate for pediatric brain tumors? - correct answer 75%
where are posterior fossa tumors located? - correct answer in the cerebellum
define posterior fossa syndrome (PFS) + some signs/symptoms associated - correct answer a
neurological condition that can develop after surgery to remove tumors from the posterior
fossa region of the brain, particularly in children
S&S:
hypotonia
mutism
feeding issues
irritability
define sarcoma - correct answer malignant tumor arising from mesenchymal cells (e.g., skeletal
muscle, smooth muscle, fat, fibrous tissue, bone and cartilage)
treatment for sarcomas - correct answer chemo
surgery
radiation
list the types of sarcomas (2) - correct answer osteogenic sarcoma
ewing's sarcoma
define osteogenic sarcoma - correct answer most common bone tumor
found in long bones (e.g., distal femur, proximal tibia) and flat bones (pelvis, mandible, scapula)
list the signs and symptoms of osteogenic sarcomas (5) - correct answer variable/prolonged
bone or joint pain
altered weight bearing +/- limp
possible palpable mass/firm welling along shaft of bone +/- decreased ROM
pain may be referred to different location from tumor
history of sports injury +/- no improvement
define palliative care for children - correct answer active total care of the child's body, mind
and spirit and also involves giving support to families
when should palliative care be offered? - correct answer at diagnosis and continued throughout
the course of illness, whether the outcome ends in cure or death
what is the leading cause of death in children in BC? - correct answer natural causes including
prematurity and perinatal causes, congenital anomalies, genetic, metabolic, neurological and
chromosomal disorders and childhood cancers
list the 4 broad categories of children who need palliative care - correct answer 1. life
threatening, curative treatment available but may fail (e.g., cancer)
2. long period of treatment which aims to prolong life but premature death is anticipated (e.g.,
CF)
3. progressive conditions without curative treatment options (e.g., sanfilipo syndrome)
4. severe disability that leads to complications which can lead to a premature death (e.g.,
severe CP)
what domains does palliative care focus on? - correct answer physical (function and symptoms)
emotional (how is the child feeling?
social (how is the family doing?)
spiritual (how do you make sense of this?
trajectory (what is likely ahead?)
describe the dual process mode of grief - correct answer acknowledges that grief is not step by
step bu rather a process that individuals will oscillate between focusing on their loss and
distracting themselves from their loss (YOU CAN HAVE BIG FEELS, ACKNOWLEDGE THEM BUT
CAN ALSO CONTINUE FORWARD WITH LIFE)
based on these 3 patient goals, what are the associated healthcare team's adjacent goals?
Patient goals:
- living as long as possible
,PHTH 564 Final Exam - Complex Populations
- life as long as possible while being comfortable
- live as comfortably as possible, today - correct answer - cure
- balance life-prolonging treatments with quality of life
- optimize comfort at the end of life
what is a physiotherapists role in palliative care? - correct answer - aim treatment to
patient/family's goals
- maximize independence and QOL within a philosophy of comfort and supportive care allowing
patient to fulfill their individual wishes
outline the SPIKES acronym for braking bad news (pediatric palliative care) - correct answer S -
setting
P - perception
I - invitation
K - knowledge
E - emotion
S - summary
what is the WHO-5 Well Being Index? - correct answer self-administered questionnaire shown
to reliably measure emotional functioning
score 50 or below is indicative of low mood
a score of 28 or below indicates likely depression
define self-compassion and the 3 elements of it - correct answer a restorative cognitive coping
approach that enhances one's self-regulatory and coping capacity
3 elements:
- self-kindness
- common humanity
- mindfulness
list the 3 most common pediatric cancers? - correct answer leukemia
brain tumors
MSK tumors
,PHTH 564 Final Exam - Complex Populations
what is the most common pediatric cancer? - correct answer leukemia
specifically acute lymphoblastic leukemia
define leukemia - correct answer cancer of the blood/blood forming tissues including bone
barrow
leukemia can be either L________ or M_________ - correct answer lymphoid OR myeloid
(these are the type of blood cells affected)
what genetic predisposition makes you more susceptible to leukemia? - correct answer down
syndrome
list the major signs and symptoms of leukemia and their causes (5) - correct answer - fatigue -->
due to now Hb (anemia)
- bruising, bleeding, petechia (tiny spots of bleeding on skin) --> low platelets
- inflection, fevers --> low WBC
- bone pain, vertebral fractures, decreased weightbearing --> bony leukemic infiltrates
- chloromas (collection of leukemic cells in brain and skin
what is the name treatment for leukemia? - correct answer multi-agent chemo
what is the length of treatment for leukemia? - correct answer 2-3 years
what are the side effects of treatment for leukemia? - correct answer steroid myopathy
chemotherapy induced peripheral neuropathy (CIPN)
deconditioning
what relapse treatment is used for leukemia following chemo treatment? - correct answer stem
cell transplant (SCT/BMT)
CAR-T therapy
what is the 2nd most common pediatric cancer? - correct answer brain/CNS tumors
list the major signs and symptoms of brain/CNS tumors (4) - correct answer torticollis
headaches/irritability
impaired balance and coordination
ataxia
list the 3 most common treatments used for brain tumors in the pediatric population: - correct
answer surguery to remove part or all of the tumor
, PHTH 564 Final Exam - Complex Populations
chemo
radiation
what is the survival rate for pediatric brain tumors? - correct answer 75%
where are posterior fossa tumors located? - correct answer in the cerebellum
define posterior fossa syndrome (PFS) + some signs/symptoms associated - correct answer a
neurological condition that can develop after surgery to remove tumors from the posterior
fossa region of the brain, particularly in children
S&S:
hypotonia
mutism
feeding issues
irritability
define sarcoma - correct answer malignant tumor arising from mesenchymal cells (e.g., skeletal
muscle, smooth muscle, fat, fibrous tissue, bone and cartilage)
treatment for sarcomas - correct answer chemo
surgery
radiation
list the types of sarcomas (2) - correct answer osteogenic sarcoma
ewing's sarcoma
define osteogenic sarcoma - correct answer most common bone tumor
found in long bones (e.g., distal femur, proximal tibia) and flat bones (pelvis, mandible, scapula)
list the signs and symptoms of osteogenic sarcomas (5) - correct answer variable/prolonged
bone or joint pain
altered weight bearing +/- limp
possible palpable mass/firm welling along shaft of bone +/- decreased ROM
pain may be referred to different location from tumor
history of sports injury +/- no improvement
