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History taking > Common paeds hsitory - developmental delay > Flashcards

Common paeds hsitory - developmental delay Flashcards

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1
Q

If a child was presenting with developmental delay, what would you want to establish first?

A
  • Red book - check this
  • Which domain the delay is in
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2
Q

What key milestones would you want to ask about when asking about developmental delay?

A
  • Smiling 6 weeks
  • Turns to sounds - 6 months
  • Sitting by 9 months
  • First words - 18 months
  • Walking - 18 months
  • Short sentences - 3 years
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3
Q

What would you ask about the motor domain in a dvelopmental assessment?

A
  • How mobile
  • Hand dominance
  • Balance problems
  • Behavioural problems
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4
Q

What would you want to ask about language/social problems in a developmental delay history?

A
  • Senses - hearing/vision
  • Vocalisation/articulation
  • Comprehension - follows commands, responds to voice
  • Non-verbal - pointing, gestures, facies
  • Social responsiveness - reactions, tantrums, playing, gestures
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5
Q

What domains would you want to cover in developmental history?

A
  1. Gross motor
  2. Fine motor/vision
  3. Hearing and language
  4. Social
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6
Q

What would you want to make sure to ask about in addition to developmental domains in a developmental history?

A
  • Prenatal problems
  • Perinatal problems
  • Postnatal problems
  • General symptoms
  • Neuro symptoms
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7
Q

What would you want to ask about prenatal problems in a developmental history?

A
  • Alcohol/drugs in pregnancy
  • Maternal infection
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8
Q

What would you want to ask about perinatal problems in a developmental history?

A

Prolonged/difficult labour/difficulties

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9
Q

What would you want to ask about postnatal problems in a child with developmental delay?

A
  • Meningitis
  • Encephalitis
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10
Q

What general symptoms would you want to ask about in a developmental history?

A
  • Fever
  • Behaviour
  • Activity/apathy/alertness
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11
Q

What neurological features would you want to ask about in a developmental delay history?

A
  • Fits/LOC
  • Headache
  • Dizziness
  • Vision/hearing loss
  • Weakness
  • Wasting
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12
Q

What features associated with generalised developmental delay would suggest chromosomal/genetic abnormalities as a cause?

A

Dysmoprhic features

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13
Q

What features associated with generalised developmental delay would suggest alcohol/drugs in pregnancy as a cause?

A

History of maternal drug/alcohol use

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14
Q

What features associated with generalised developmental delay would suggest TORCH infection as a cause?

A

History of toxo/rubella/CMV/herpes

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15
Q

What features associated with generalised developmental delay would suggest extreme prematurity as a cause?

A

Born < 28 weeks

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16
Q

What features associated with generalised developmental delay would suggest hypoxic brain injury?

A

Perinatal hypoxic insult

17
Q

What features associated with generalised developmental delay would suggest hypoglycaemia as a cause?

A

Period of neonatal hypoglycaemia

18
Q

What features associated with generalised developmental delay would suggest Intracerebral haemorrhage as a cause?

A
  • Risk factors - difficult labour, prematurity
  • Usually diangosed within first few days
19
Q

What features associated with generalised deelopmental delay would suggest meningitis/encephalitis as a cause?

A

Onset after episode of meningitis/encephalitis

20
Q

What are prenatal causes of Generalised developmental delay?

A
  • Chromosomal/genetic problems
  • TORCH infection
  • Maternal Alcohol/drug use
21
Q

What are perinatal causes of generalised developmental delay?

A
  • Extreme prematurity
  • Hypoxic brain injury
  • Hypoglycaemia
  • Intracerebral haemorrhage
22
Q

What are post-natal causes of generalised developmental delay?

A
  • Meningitis/encephalitis
  • Head injury
  • Hypoxic episode
  • Hypoglycaemic episode
23
Q

What are causes of motor delay?

A
  • Cerebral palsy
  • DMD or other dystrophies
  • Hip dysplasia
24
Q

What features associated with motor delay would suggest CP as a cause?

A
  • Muscle stiffness/weakness/floppiness
  • Spasm/dyskinesia/ataxia
  • Caused by pre/peri/postnatal insult
25
Q

What features associated with motor delay would suggest DMD?

A
  • Progressive muscle weakness - beinning proximally
  • Onset 2-3 years
26
Q

What features associated with motor delay would suggest hip dysplasia?

A

Usuaully identified at brith but may present later with a limp

27
Q

What are causes of social/language delay?

A
  • Deafness
  • Articulation problems
  • Familial delay
  • Lack of stimulus
  • Autism
  • ADHD
28
Q

What features associated with social/language delay would suggest Deafness as a cause?

A

Cause of deafness - e.g. chronic otitis media

29
Q

What features associated with social/language delay would suggest articulation problems as a cause?

A

Birth defects - e.g. cleft palate

30
Q

What features associated with social/language delay would suggest a familial cause?

A

Similar history in family

31
Q

What features associated with social/language delay would suggest lack of stimulus as a cause?

A
  • Poor interaction with parents
  • May show signs of neglect
32
Q

What features associated with language/social delay would suggest autism as a cause?

A
  • Imposition of routines
  • Doesn’t seek friendships, prefers own company
  • Limited gestures and expressions
33
Q

What features associated with social/developmental delay suggest ADHD as a cause?

A
  • Hyperarousal/Hyperactivity
  • Inattentiveness

History taking (53 decks)

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