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Pediatrics > Behavioral And Developmental Pediatrics > Flashcards

Behavioral And Developmental Pediatrics Flashcards

0
Q

Gross Motor milestones?

A

Birth – turns head

Two months – lifts head, head lag

Four months – rolls over, no head lag, pushes chest up with arms

Six months – sits alone, leads with head when being raised

Nine months – pulls to stand

12 months – walks

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1
Q

Developmental quotient and interpretation?

A

(Developmental age/chronologic age)*100

DQ >85 – normal
DQ <70 – abnormal
DQ 70-85 – close follow up

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2
Q

Reflexes in infant with CNS damage?

A
  1. Primitive reflexes are stronger and last longer than six months
  2. Postural reactions are delayed
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3
Q

Primitive reflexes? Postural reflexes?

A

Moro reflex
Hand grasp
Atonic neck reflex
Rooting reflex

Head righting
Parachute

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4
Q

Fine motor milestones?

A

Birth – hands tightly fisted

3 to 4 months – hands together to midline then mouth

4 to 5 months – reaches for objects

6 to 7 months takes objects with whole hand and transfers to other hand

9 months – immature pincer (thumb and index finger)

12 months – mature pincer (Thumb and tip of index finger)

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5
Q

Developmental red flags for MOTOR?

A
  1. Persistent fisting beyond three months suggest neuromotor problems
  2. Early rolling, early pulling to a stand, persistent toe walking indicate spasticity
  3. Spontaneous postures suggest motor abnormalities
  4. Early hand dominance (<18 months) suggest weakness of opposite upper extremity/hemiparesis
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6
Q

Language milestones?

A

Birth – tunes to human voice

2-3 months – vowel sounds

Six months – babbling

9-12 months – jargon, mama/dada

12 months – 123 words

18 months to word phrases

Two years – two word sentences

Three years – three word sentences

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7
Q

Differential of speech/language delay?

A
  1. Mentally retardation
  2. Hearing impairment
  3. Environmental deprivation
  4. Pervasive developmental disorders (autism etc.)
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8
Q

Single best predictor of intellectual potential?

A

Language

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9
Q

Red flags in cognitive development and interpretation?

A
  1. Both language and problem-solving delayed – mental retardation
  2. Only language skills delayed – hearing impairment/communication disorder
  3. Only problem solving skills delayed – visual or fine motor problems
  4. Discrepancy between language and problem-solving skills – learning disability
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10
Q

Cerebral palsy? Symptoms that lead to diagnosis?

A

Non-progressive encephalopathies that primarily affect motor function

  1. Increased tone/specificity
  2. asymmetric reflexes
  3. abnormal patterns and the disappearance of primitive reflexes or emergence of postural responses
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11
Q

Types of cerebral palsy (and subtypes)?

A
  1. Spastic (diplegia, hemiplasia, quadriplegia)

2. Extrapyramidal cerebral palsy

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12
Q

Spastic diplegia versus spastic hemiplegia versus spastic quadriplegia – areas affected? Clinical signs? Risk factors?

A

Lower extremity weakness versus unilateral weakness versus head, neck, all limbs weakness

Early rolling over/scissoring versus early hand preference versus dysphasia, face weakness, reflux, aspiration, speech problems

Prematurity versus perineal vascular insults/postnatal trauma versus hypoxic ischemia encephalopathy, trauma

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13
Q

Extrapyramidl cerebral palsy – areas affected? Clinical clues? Risk factors?

A

Extraparametal motor system, arms, oral

Hypotonia of neck and trunk, problems with feeding, speech, drooling

Full term infant with hypoxia ischemia leading to basal ganglia damage

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14
Q

Genetic causes of mental retardation?

A

CHROMOSOMES – down syndrome, fragile X
METABOLISM – Hurler syndrome
SINGLE GENE – tuberous sclerosis

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15
Q

Prenatal/perinatal problems leading to mental retardation?

A 
Infection (torch)
Hypoxia
Drugs/alcohol
Placental insufficiency
Malnutrition
Malformation (hydrocephalus)
16
Q

Autism versus Asperger’s?

A

No language delay in Asperger’s

17
Q

Specific criteria for ADHD?

A
  1. Symptoms before age 7
  2. Symptoms in more than one environment
  3. Impairment in school or personal relationships
  4. Inattention (difficulty organizing, forgetfulness)
  5. Hyperactivity
  6. Impulsivity
18
Q

Drugs for ADHD?

A

Ritalin (methylphenidate) and Adderall (amphetamine)

19
Q

Most common reason for hearing impairment?

A

80% – autosomal recessive inheritance

20% – perinatal/prenatal/postnatal factors

20
Q

Prognosis: inherited deafness versus acquired deafness? Age?

A

Acquired deafness has higher risk for neurologic impairment

Children who become deaf before two years of age (before able to incorporate language structure) are at a disadvantage

21
Q

Deafness with elevated creatinine level?

A

Alport syndrome

22
Q

Leading causes of blindness in children?

A
  1. Chlamydia (primary cause a worldwide)
  2. Retinopathy of prematurity
  3. Congenital cataracts
23
Q

Colic?

A

Crying that lasts >3 hours per day and occurs >3 days per week

24
Q

Enuresis? Types?

A

Urinary incontinence beyond when the child is capable of continence?

Nocturnal versus diurnal
Primary (never been dry) versus secondary (six months of prior dryness)

25
Q

Causes of enuresis?

A
  1. Genetic’s (chromosome 13)
  2. Psychosocial (stress)
  3. Urine volume (lack of normal diurnal variation in vasopressin)
    four. Bladder capacity
  4. Organic causes (UTIs, Diabetes)
  5. Constipation
26
Q

Medications for NIGHTTIME enuresis?

A
  1. DDAVP – decreases urine volume

2. Imipramine (Tricyclics)

27
Q

Normal sleep patterns? Abnormal sleep patterns?

A
  1. Day-night reversals in first week of life
  2. Sleeping through the night (5+ hours after midnight for 4+ weeks) after three months of age
  3. Trained night awakenings (infant does not resettle without parental intervention)
  4. Trained night feedings (infant continues to wait to eat)
28
Q

Nightmares versus night terrors?

A

After three years old, during REM sleep, remember dream in detail

Versus

3 to 5 years of age, 90 to 120 minutes after sleep onset, non-REM stage 4 sleep, Child does not remember episode

29
Q

Children are more likely to have tantrums if?

A

Poor fine motor skills or expressive language

30
Q

Types of breath holding spell? Prognosis?

A
  1. Cyanotic – precipitated by event that makes child frustrated. Can lead to unconsciousness/seizures
  2. Pallid – triggered by unexpected event resulting in hypervasovagal response

Prognosis: harmless and stops by 5 years

31
Q

Arrival of newborn for other children?

A

Especially stressful for children under three

Jealousy with children under six

32
Q

Average age bowel control? Bladder control?

A

29 months; 32 months

33
Q

Disciplining children?

A
  1. Before six months: no discipline
  2. Mobile infant: distraction
  3. 18 months to 3 years: ignoring, timeout, disapproval
  4. Preschool age: logical consequences
  5. After 5: negotiation, restriction approval
34
Q

Normal hand preference when?

A

18 months

35
Q

When the child able to play peekaboo/pattycake?

A

13 months

36
Q

Development of object permanence?

A

9 months

Pediatrics (38 decks)

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