Child health Flashcards
Developmental milestones? (2)
- Median age - age when 50% population achieve a skill
* Limit age - age when skill should have been acquired by 97.5% of children
Development delay?
Failure to attain appropriate developmental milestone’s for child’s corrected chronological age
Patterns of abnormal development? (3)
- Delay = global or specific
- Deviation e.g. autism
- Regression e.g. Rett’s syndrome
Red flags for development? (7)
- Asymmetry of movement
- Not reaching objects by 6 months
- Unable to sit unsupported by 12 months
- Unable to walk by 18 months (check CK)
- No speech by 18 months
- Vision or hearing
- Loss of skills
Global developmental delay?
Significant delay in 2 or more of
- gross/fine motor, speech/language
- cognition, social/personal, ADL
Screening for Down’s syndrome? (7)
- Cardiac
- Vision
- Hearing
- Thyroid function
- Sleep related breathing disorders
- Growth charts
- Development
Developmental delay IQ? (3)
- Mild learning disability = 50 - 70
- Severe learning disability = 20 - 50
- Profound learning disability = <20
Specific developmental delays? (4)
- Motor delays = DMD, cerebral palsy
- Language delays
- Sensory deficits = oculocutaneous albinism, Treacher-collins
- Developmental deviations = autisim
Sign for duchennes muscular dystrophy?
Gower’s manoeuvre
Conditions associated with cerebral palsy? (8)
- Mobility problems
- Learning difficulties
- Epilepsy
- Visual/hearing impairment
- Communication difficulties
- Feeding difficulties
- Sleep problems
- Behaviour problems
Autistic triad? (3)
- Communication
- Social interaction
- Flexibility of thought/imagination
Autistic communication? (2)
Receptive language
- Delayed
- Abstract language difficult
- Expressive > receptive
Expressive language
- Delayed
- Echoes
- Odd tone/pitch
- Chunks of video speak
ASD flexibility of thought/imagination? (3)
- Concrete and literal
- Concept of time
- Ritualistic behaviour
ASD sensory issues? (7)
- Fussy eater
- Textures of clothes
- Sleep
- Toilet training
- Hair washing./cutting
- Nail cutting
- Noise
Developmental delay Ix? (5)
- Chromosomes
- Neonatal PKU, thyroid studies, CK
- MRI brain
- EEG
- Metabolic studies
Assessments for development? (4)
- Griffiths = 0-8 yrs
- Bayleys = 0-3 yrs
- Schedule of growing skills = 0-5 yrs
- ADOS (ASD)
Normal HR, respiratory rate and BP of <1 y/o? 1-2? 2-5? 5-12? >12?
<1
- HR = 110-160
- RR = 30-40
- Systolic = 70-90
1-2
- 100 -150
- 25-35
- 80-95
2-5
- 95-140
- 25-30
- 80-100
5-12
- 80-120
- 20-25
- 90-110
> 12
- 60-100
- 15-20
- 100-120
Examples of how child anatomy differs from adult? (4)
- High anterior larynx/floppy epiglottis
- Flexible ribs
- Blood volume 80mls/kg
- HbF at birth
What is the commonest cause of acute illness in children?
Sepsis
Bronchiolitis?
Ax?
Tx?
Inflammtory injury to bronchioles (crackles)
- Ax = viral
- Tx = supportive
Croup?
Ax?
Tx?
Narrowing of upper airway - laryngotracheobronchitis
- Ax = viral
- Tx = steroid
Important differentials for croup? (3)
- Epiglottitis
- Foreign body
- Bacterial trachietis
Is every child with wheeze asthmatic?
No - could be episodic wheeze after bronchiolitis
CNS conditions affecting children? (2)
Dx? (2)
- Meningitis
- Encephalitis (commonly viral)
Dx
- Lumbar puncture
- Imaging
Sign for meningococcaemia?
Fulminant purpura
Reflex anoxic seizures?
get a fright/bang head + stop breathing
Breath holding attacks?
Often when crying
