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EOY4 > Community Paediatrics > Flashcards

Community Paediatrics Flashcards

1
Q

Give developmental milestone for hearing, speech and language for the following ages:

  • Newborn
  • 3-4 months
  • 7 months
  • 12 months
A
  • Newborn = startles to loud noises
  • 3-4 months = coos/laughs/vocalises
  • 7 months = Eye contact, responding to name
  • 12 months = 2-3 words other than dada or mama
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2
Q

Give developmental milestone for hearing, speech and language for the following ages:

  • 20-24 months
  • 2.5 - 3 years
A
  • 20-24 months = joins 2+ words together

- 2.5-3 years = 3-4 word sentences

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3
Q

Give developmental milestone for social, emotional and behavioural development for the following behaviours:

  • Smiling responsively
  • Scared of strangers
  • Symbolic play
  • Taking turns
A
  • 6 weeks
  • 10 months
  • 18-24 months
  • 3-4 years
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4
Q

Give age for vision and fine motor skills for the following developmental milestone:

  • Follows moving objects by turning head
  • Palmar grasp
  • Hand transferring
  • Mature pincer grip
A
  • 6 weeks
  • 4-6 months
  • 7 months
  • 10 months
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5
Q

Give age for vision and fine motor skills for the following developmental milestone:

  • Drawing with crayon
  • Block tower of 3
  • Block tower of 8
  • Block bridge
A
  • 16-18 months
  • 18 months
  • 2.5 years
  • 3 years
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6
Q

Give age for gross motor development for the following developmental milestone:

  • Raises head to 45 degrees when prone
  • Sits without support
  • Crawling
  • Standing
  • Walking unsteadily
A
  • 6-8 weeks
  • 6-8 months
  • 8-9 months
  • 10 months
  • 12 months
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7
Q

Give age for gross motor development for the following developmental milestone:

  • Running
  • Pedalling tricycle
  • Kicking a ball and hopping
A
  • 2-3 years
  • 3-4 years
  • 4-5 years
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8
Q

At what age should you be worried if a child hasn’t done the following?

  • Standing
  • Walking unsteadily
A
  • 12 months

- 18 months

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9
Q

Give 3 differential diagnoses for motor delay

A
  • Cerebral Palsy
  • Duchenne Muscular Dystrophy
  • Downe’s Syndrome
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10
Q

What is the triad of symptoms seen in ADHD?

A
  • Inattention (hard to follow instructions, can’t listen to small details, easily distracted)
  • Impulsivity (interrupting, can’t take turns, ‘on the go’)
  • Hyperactivity (restless, lots of talking)
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11
Q

Give 2 other features of ADHD

A
  • Short temper

- Difficulty in forming good relationships

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12
Q

Give 3 diagnostic criteria of ADHD

A
  • Has to be present in 2+ settings e.g. at home and at school
  • Has to impact on ADLs/functioning
  • Has to have been present for MORE THAN 6 months
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13
Q

What are the screening tests for ADHD? (3)

A
  • Conner’s Tests
  • QB Test
  • Strengths and weaknesses
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14
Q

Who is involved in the MDT management of a child with ADHD?

A
  • School/teachers
  • Community paediatrician
  • Educational Psychologist
  • ?CAHMS
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15
Q

What is the management for ADHD in UNDER 5s? (2)

A
  • ADHD focussed parent training course

- Only give meds if have second opinion/ as a last resort

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16
Q

What is the management for ADHD in OVER 5s?

A
  • Conservative
    • Parental education e.g. strategies/ support groups such as ADHD solutions
    • Liaise with school
  • Medical
    • Stimulants e.g. methylphenidate or lisdexamfetamine
    • can have different preparations e.g. short vs long acting
    • Atomoxetine is not preferred
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17
Q

What baseline assessments do you need to do before commencing medications for ADHD?

A
  • Height and weight + plot a growth chart (meds can stunt growth)
  • Pulse and BP
  • CVS exam
  • ECG if indicated
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18
Q

Define Autism Spectrum Disorder

A

A neurodevelopmental condition characterised by:

impairment in social interaction

communication

repetitive stereotyped behaviour, interests, and activities.

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19
Q

What are the symptoms of ASD?

A

Usually evident before 2-3 years

Impaired social interaction - play alone, can’t regulate social interaction

Repetitive behaviours - stereotyping, stick to routines

+/- intellectual/language impairment

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20
Q

What are 2 associated conditions with ASD?

A

ADHD

Epilepsy

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21
Q

What are the aims of treatment in a child with ASD?

A

Decreased disability

Learning and development e.g. improved social skills, communication

Family help!

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22
Q

Give 4 examples of non-pharmacological methods of managing a child with ASD

A

Parental education

ASD preschool program

Structured teaching method

Applied Behavioural analysis

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23
Q

Give 3 pharmacological methods of managing a child with ASD

A

SSRIs can help to reduce stereotyped behaviour and anxiety

Antipsychotics can help to reduce anxiety, aggression and self-injury

Methylphenidate if ADHD is co-existing

24
Q

Define cerebral palsy

A

a disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain.

25
Q

What are the 3 groups of causes of cerebral palsy?

A

Antenatal - Congenital infections (TORCH), cerebral malformation

Intrapartum: birth asphyxia

Post natal: IVH, meningitis

26
Q

How might cerebral palsy present?

A

abnormal tone early infancy

delayed motor milestones

abnormal gait (scissor)

feeding difficultie.

27
Q

Give three examples of potential co-existing conditions with cerebral palsy

A

Intellectual difficulties

Epilepsy

Squints

28
Q

What are the 4 classifications of cerebral palsy?

A

spastic (70%): (hemiplegia, diplegia or quadriplegia)

dyskinetic

ataxic

mixed

29
Q

What are the pharmacological management options of cerebral palsy?

A

Diazepam

Baclofen

Botulinum toxin/surgery

Anticonvulsants

PEG

30
Q

What are the features of patau syndrome? which trisomy is it?

A

13

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

31
Q

What are the features of Edward’s syndrome? which trisomy is it?

A

18

Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers

32
Q

What are the features of fragile X syndrome?

A 
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
33
Q

What are the features of Noonan syndrome?

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

34
Q

What are the features of Prader-Willi syndrome?

A

Hypotonia
Hypogonadism
Obesity

35
Q

What are the 3 main referral points for developmental delay?

A

doesn’t smile at 10 weeks

cannot sit unsupported at 12 months

cannot walk at 18 months

36
Q

Give an example of a fine motor skill problem and what it may indicate

A

Hand preference by 12 months

Cerebral palsy

37
Q

What are 2 fine motor milestones for 3 months?

A

Reaches for objects

Fixes and follows to 180 degrees

38
Q

What are 2 fine motor milestones for 6 months?

A

Palmar grasp

Can pass objects from one hand to the other

39
Q

What is a fine motor milestone for 12 months?

A

Pincer grip

40
Q

When should a child be able to build a brick tower of 6 blocks?

A

2 years

41
Q

When should a child be able to copy a vertical line and a circle respectively?

A

vertical line = 2 years

circle = 3 years

42
Q

When should a baby gain head control?

A

3 months

43
Q

When should a baby be able to sit without support?

A

7-8 months

Refer if hasn’t happened by 12

44
Q

When should a baby be able to crawl and cruise respectively?

A

Crawl = 9 months

Cruise = 12 months (/walk with a hand held)

45
Q

Hone should a baby be able to walk unsupported?

A

13-15 months

Refer if hasn’t happened by 18

46
Q

When should a baby be able to smile?

A

6 weeks

Refer if hasn’t happened by 10

47
Q

When should a baby be able to laugh

A

3 months

48
Q

When does a baby become shy around strangers?

A

9 months

49
Q

When should a baby be able to play peek a boo and wave bye bye respectively?

A

PAB = 9 months

BB = 12 months

50
Q

When should a child be able to play with other children?

A

4 years

51
Q

When should a baby be able to say mama and dada

A

9 months

52
Q

When should a baby be able to respond to their name

A

12 months

53
Q

When should a baby be able to combine 2 words

A

2 years

54
Q

Give 4 clinical features of down’s syndrome?

A

Face = protruding tongue, small low set ears, round face

Single palmar crease

Hypotonia

Pronounced sandal gap

55
Q

Give 3 congenital features of down’s syndrome

A

Congenital heart defects (lots of them)

Duodenal atresia

Hirshprung’s

56
Q

Give 4 examples of later complications of down’s syndrome

A

Learning difficulties

Hypothyroidism

Alzheimers

Repeated respiratory infections (+ otitis media with effusion = ? hearing impairment)

EOY4 (22 decks)

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