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Peds > Behavior and Development > Flashcards

Behavior and Development Flashcards

1
Q

development quotient

A

dev age/chronologic age *100. 70-85- close f/u. 85= normal

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2
Q

primitive reflex

A

present at birth. gone in 3-6mo. if have CNS injury, become stronger and more sustained.
Moro: birth-4mo
hand grasp- birth-1 to 3mo
rooting: turn head to same side of stimulus when corner of mouth stimulated: birth-6mo
atonic neck reflex- head to one side, arm and leg extend on same side and flex on pop: 2-4wk to 6mo

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3
Q

postural reflex

A

not present at birth= acquired. facilitate oritentation of body. CNS damage cause delay dev
head rigging: keep head vertical despite tilted body.
parachute: outstretch arm and legs when body moved head first in downward direction

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4
Q

gross motor milestone

A

birth- head side to side
2mo- lift head when prone. lag when lift from supine position
4mo: roless over, no head lag from supine, rushes chest up with arms
6mo: sits alone, lead with head when pull from supine
9mo: pulls to stand, cruises
12mo- walk

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5
Q

fine motor milestone

A

birth: fisted hands
3-4mo: hands to midline together then to mouth
4-5mo: reach for obj
6-7mo: rakes. transfer obj from hand to hand
9mo: use immature pincer
12mo: mature pincer (tip of index finger

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6
Q

motor dev red flags

A
  1. persistent fisting after 3mo- earliest sign of NM prob
  2. early rolling over, pulling to stand instead of sitting, persistent toe walking- spasticity
    3) spontaneous postures ~ scissoring in spastic kid, frog leg position with hypotonic infant
    4) : early hand dominance (bf 18mo) - hemiparesis
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7
Q

language milestone

A

Prespeech: : 0-10mo
1) brith- attune to human voice, dd parents
2) 2-3: coo (voos), musical sounds
3) 6mo: blabbing (mix vowel + consonants
naming period: 10-18mo
1) 9-12: jargon- parsody
2) 12mo: 1-3 words
3) 18: 20-50 words
word combination period 18-24mo- telegraphic
2y: 25-50% speech intelligible
3y: 3 word sentence. 75% speech intelligible

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8
Q

DD speech or language delay

A

1) global dev delay or MR
2) hearing impairment
3) enviro deprivation
4) pervasive dev D, like autism

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9
Q

intellectual dev

A

dep on attention, information processing, memory. language in infants is best indicator of intellectual potential. motor correlates poorly

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10
Q

stages in cog dev

A

1) sensorimotor: birth -2yo: explore through physical manipulation of obj
2) functional play: >1yo: rec obj and their function
3) imaginative play: 24-30mo: use symbols- blocks to build forts
4) concrete thinking: preschool- elementary- interpret literally
5) abstract thinking: adolescent

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11
Q

obj permanence

A

9m = why separation anxiety start 6-18mo

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12
Q

cause and effect

A

9-15mo

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13
Q

magical thinking

A

noral in preschool toddler years. inanimate obj are alive and have feelings

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14
Q

red flags in cog dev

A

language estimate verbal IQ, problem solving measure nonverbal so delay in both = think MR
if only language delay ck hearing prob or communication D
only problem solving delay then visual or fine motor prob
discrepancy btw language and problem solve - learning disability

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15
Q

social skills

A

self and indeed at 15mo. parallel play at 2y. together play at 3

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16
Q

motor deficits

A

cerebral palsy, metabolic abn, chromosomal abn, MN disease, degen diseasl, SC injury, myopathies, CNS strucural defects

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17
Q

cerebral palsy define and RF

A

static encephalopathies caused by injury to developing brain in which motor func is primary affected. IQ could be normal.
P: neuro damage- motor prob, seizure, cog defict, MR, learning disability, sensory loss visual and auditory deficits
RF: mom (multiple gestation, premie), prenatal (IUGR, congeital, TORCH), perinatal (traumatic delivery, low apgar, premature or postdate), postnatal hypoxic encephalopathy, intraventricular hemorrhage, trauam, kernicterus)

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18
Q

cerebral palsy epi, dx, classification

A

epi- .2-.5%
dx- repeated neurodev examinations with incr tone, opacity, hypotonia, asylum reflexes, mV D, abn pattern in disappearance of primitive reflexes.
classification: spastic cerebral palsy- incr tone, scisorring = sign of spasticity, early hand pref, seizure, scoliosis; extrapyramidal cerebral palsy= athetoid CP, writhing, oral motor mvt= prob speech/drooling, hypotonia of neck and trunk limiting exploration

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19
Q

pervasive dev disorder (PDD)

A

affect multiple dev areas, especially behavior and learning

autism

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20
Q

ADHD

A

30-50% have 1st degree relative with it
dop and NE prob
dx bf 7
comorbidity: anxiety, conduct D, ODD, OCD

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21
Q

hearing impairment- etio, prognosis

A

screen bc outcome better if intervene bc 6mo- less delayed speech and language defect, behavioral prob
80% auto recessive. 20% pre/peri/postnatal factors( congenital infection, prematurity, bacterial meningitis, middle ear anomalies)
prog: degree of loss, etiology( inherited is better. acquired associated with more other neural def), family support, after age two>bf, timing of amplification- early=better, cochlear implants- improve hearing

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22
Q

hearing medical eval

A

genetic eval. Cr lvl bc kidney disease + hearing = aport, viral serologies, CT head

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23
Q

blindness

A

leading cause: trachoma infection. especially developing countries
retinopathy of prematurity
congenital cataracts
haptic perfection- tactile sensation to dev mental image

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24
Q

colic: define, sig, epi,

A

crying>3hr
sig: disrupt attachment, cause family stress.
10% newborn- healthy, well fed. being 2-4wk and end 3-4mo
periods of irrtability

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25
Q

enuresis

A

etio- genetics - chromsome 13; infection, DM, child abuse; constipation is comorbid

26
Q

sleep

A

0-4wks: day light reversal.
>4wks: start clustering sleep time
3mo: 50% sleep through the night= 5hr after 12am for 4 wks
abn- trained night waking and feeding= parent need to stop intervening when baby fusses. 4-8mo

27
Q

nightmare

A

> 3yo. but can start at 6mo. REM

28
Q

night terror

A

common 3-5yo. non REM stage 4 sleep. autonomic arousal

29
Q

feeding

A

appetite decr after 1yo. autonomy more important so avoid power struggles

30
Q

breath -hold spells

A

5%. start btw 6-18mo. disappear by 5yo
involuntary and harmless
cyanotic speels- most common- frustration/anger - cries- becomes cyanotic- apnea and loc or seizure
pallid spells: unexpected event- fright- hypervasogvagl repsonse- become pale and limp
if induced by excitement or excursus need to ECG to r/o dysrrhythmia

31
Q

bowel control

A

avg 29mo. range 16-48mo

32
Q

bladder control

A

32 mo. range 16-60

33
Q

discipline

A
34
Q

pubertal growth spurt

A

50% of wt and 25% ht. happens 18-24hr earlier in female than males

35
Q

male puberty

A

6-12mo after female

1) testical enlargement 11-12
2) facial and axillary hair- 2y after pubic hair

36
Q

female puberty

A

1) breast buds - thelarche at 9.5yo
2) public hair
3) menarch avg 12.5

37
Q

tanner male

A

1: preadolescent. no PH, prepubertal testes
2: testes larger, PH
3: tests larger, penis length incr, darker coarse, curlier hair
4L darkening of scrotal skin, penis length/width incr, PH extending over symphysis pubis
5: adult size genitals, adult PH spread to medial surface of thighs

38
Q

tanner female

A

1: pre adolescent breast, no PH
2. elevation of breast and nipple, space downy hair
3: enlargement of breast do sep of areola and breast. darker coarser curlier hair
4: areola and nipple project to form secondary mound. adult type hair cover symphysis pubis
5: nipple project, areola recede. adult PH spread to medial surface of thigh.

39
Q

sexually active female screen for

A

culture of gonorrheaew. immunofluorescent ab for chlamydia. syphilis serologic test, POP for HPV, wet mount of trichinous vaginalis

40
Q

sexually active male screen for

A

annual syphilis, urinalysis of pyruria, urine ligase for chlamydia

41
Q

problem drinking

A

intoxicated 6+ in 1y or having problems in areas attributable to drinking

42
Q

binge drinking

A

5+ consecutive drinks at one sitting.

43
Q

smoking complications

A

CAD. peptic ulcer disease, preg complications- stillbirth, low birth wt,

44
Q

obesity

A

wt >20% ideal body wt= >95% for age and sex.

45
Q

obesity heath effects

A

earlier pubertal dev, HTN and CVD, hyperchol, elevated triglycerides, DM2, gallbladder disease, orthopedic prob, poor body image - depression

46
Q

OCP distadvantages

A

CI: breast or endometrial ca, stroke, CAD, liver disease

relative CI: HTN, migrane HA, dibetes, sicke cell anemia, elevated lipids, smoking

47
Q

most common std

A

herpes simplex, HPV, C trachomatis

48
Q

T vaginalis

A

yellow green discharge. strawberry cervix. pH>4.5. tx- oral metronidazole (if alc= antabuse) tx partner. protozoa

49
Q

bacteria vaginosis

A

decr in lactobacilli cause inr in gardenella vaginalsi, mycoplasma hominis, gram neg
gray white vaginal disrachge. fishy, little info
pos whiff test. - enhance on KOH. clue cells
pH>4.5.
tx- oral metronidazole or topical clindamycin. partners don’t need tx

50
Q

candidal vulvovaginitis

A

candida albicans. ithcing, white curdle dc. inflm. fungal hyphae on wet mount. oral fluconazole. partners don’t need tx

51
Q

cervicitis

A

inflm of mucous men of endocerviz. chlamydia or gonorrhea.
purulent endocervical dx, fribale edematous erythmaouts, dyruria, urinary freq, most asx
culture endocervix is gold standard.
tx: clamydia- doxy, erythromycine or azithromycine
gonorrhea- I’m ceftriazone or oral ciprofloacin.
tx partner

52
Q

PID

A

lower abd tenderness, cervical motion tenderness, uni/bl adnexal tenderness. and 1 of: fever, wbc>10.5K, infm pelvic mass, incr ERS or CRP, lab evidence of gonorrhea or clamydia
inpt tx- iv cefoxitin + oral doxy or IV clindamycine + gentamicin

53
Q

urethritis

A

M>F. info of urethra. but if in F, ck for cervicitis.
most common is gonorrhea or chlamydia.
clinical: dysuria, inc urinary freq, mucopurulent dx, asx infection
dx: pos leukocyte esterase on first void urine specimen, greater than 10bc on gram stain. definitive dx- culture

54
Q

newborn growth

A 
1-2mo old 
term: 100cal/kg/d= 20-30g wt gain
preterm- 115-130kcal
VLBW: 150kcal
double wt by 5mo triple by 12
55
Q

sleep through the night

A

by age 4-6mo

56
Q

car seat

A

under 13yo = back seat. until 2yo, face rear

57
Q

acetaminophen v vaccine

A

may lower ab response for some immunizations

58
Q

RUQ mass + pallor on 9mo old DD

A

hepatic neoplasm, hydronephrosis, neuroblastoma, teratoma, wilm’s tumor

59
Q

hepatic neoplasm

A

can cause asx abd tumor. may have jaundice

60
Q

hydronephrosis

A

multicystic kidney could cause this. ck for UTI

61
Q

neuroblastoma

A

most common neoplasm in infants. 50% present

62
Q

wilm’s

A

likely in 9mo with asx RUQ mass and no jaundice, lymphadenopathy, norm dev. smooth mass and rarely cross midline. 50% have ab pain, V, HTN
mean age of dx-3yo

Peds (21 decks)

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