Desarrollo normal y envejecimiento Flashcards
32.1.
The embryo becomes a fetus by the end of which week of
pregnancy?
A. 4
B. 8
C. 12
D. 16
E. 20
32.1. B. 8
The prenatal period involves the development of the embryo and
fetus. After implantation when the egg divides it becomes an embryo.
Rapid growth occurs and by the end of 8 weeks, the embryo can be
recognized as human and is referred to as a fetus.
32.2.
Which of the following is an important milestone that occurs
around 16 to 20 weeks of pregnancy?
A. Beginning of the sucking reflex
B. Detection of fetal movement
C. Development of layers in the cerebral cortex
D. Smell development
E. Taste development
32.2. B. Detection of fetal movement
Women usually detect fetal movements between 16 to 20 weeks into
the pregnancy. Taste and smell development occur in the fetus
around 7 months. The sucking reflex typically does not appear until
28 weeks. The cerebral cortex layers typically don’t appear until 6
months of pregnancy.
32.3.
How does the developing fetal brain compare to the adult
brain?
A. Apoptosis occurs more frequently
B. Cerebral cortex layers are more numerous
C. Increased number of neuronal connections occur
D. More neurons are generated
E. White matter is less sensitive to injury
32.3. D. More neurons are generated
The fetus develops more neurons than it needs for adult life and
pruning occurs to get rid of these neurons and apoptosis, or cell
death occurs. White matter in the fetal brain, especially before 22
weeks, is more sensitive to damage, such as from hypoxia. At birth,
the number of new neurons is negligible, and the branching of
dendrites and new connections will occur afterward. The cerebral
cortex does not begin to form layers until 6 months of pregnancy
32.4.
An Obstetrics doctor (OB) brought up concerns of fetal
growth delay and the mother was referred for a fetal echo and
cardiac concerns were noted. At birth, examination of the
infant is noted for small eyeballs, underdevelopment of the
midface, and a thin upper lip, along with a large distance
between the eyes. Which psychiatric disorder is this patient
most likely at risk for later in childhood and adolescence?
A. Attention deficit hyperactivity disorder
B. Anxiety
C. Bipolar disorder
D. Feeding and eating disorders
E. Schizophrenia
32.4. A. Attention deficit hyperactivity disorder
The infant above has symptoms characteristic of fetal alcohol
syndrome. It affects about one-third of infants born to alcoholic
women and symptoms include growth retardation and dysmorphic
faces with microcephaly, hypertelorism (large distance between the
eyes), microphthalmia (small eyeballs), short palpebral fissures,
inner epicanthal folds, short palpebral fissures, short philtrum, thin
upper lip, short, upturned notes, etc. Cardiac defects and central
nervous system (CNS) manifestations, including seizures, are often
present. Other psychiatric symptoms or central nervous system
(CNS) manifestations include hyperactivity, attention deficit, and
learning and intellectual disabilities.
32.5.
Which reflex does not disappear until the 12th month of life?
A. Abdominal
B. Grasp
C. Knee
D. Plantar (Babinski)
E. Startle (Moro)
32.5. D. Plantar (Babinski)
Reflexes present at birth include rooting, grasp reflex, the plantar
(Babinski), the knee and abdominal reflexes, and the startle (Moro)
reflex along with the tonic neck reflex. In healthy children, by 4
months old, the grasp, startle, and tonic neck reflex disappear. It
takes until 12 months for the Babinski reflex to disappear
32.6.
Which is the most common cause of malformations in the
first year of life?
A. Autosomal genetic diseases
B. Chemical/drug exposures
C. Maternal endocrine diseases
D. Maternal infections
E. Preconception exposures
32.6. A. Autosomal genetic diseases
Autosomal genetic diseases are thought to account for most of the
malformations in the first year of life (15% to 20%). Cytogenetic or
chromosomal abnormalities are thought to account for 5%. Maternal
endocrine conditions (4%), maternal infections (3%), and chemicals,
drugs, radiation, hyperthermia, and preconception exposures (<1%)
are less common causes.
32.7.
A mother expresses frustration that her 2-year-old cannot put
on her shoes and struggles with feeding herself. During play,
she can only build a tower of a few cubes and says “no” to her
mother often and struggles with taking turns. Which of the
following is the net most appropriate intervention by the
psychiatrist?
A. Arrange more playdates to focus on turn-taking and playing
with other children
B. Have the child evaluated by early intervention services
C. Reassurance that these behaviors are normal for her age
and in another year, most of those milestones should be met
D. Recommend a private occupational therapy evaluation
E. Refer for parent management training to help the mother
set up a behavioral chart to reinforce positive actions
32.7. C. Reassurance that these behaviors are normal for
her age and in another year, most of those milestones
should be met
At 2 years old, a toddler should be able to pull on simple clothing
items and say “no” to their mother. Parallel play, in which they play
side by side without interacting with other children is normal for this
age. Typically, a 2-year-old can build a tower of six or seven cubes.
By 3 years old, a child should be able to do the other things
mentioned in the vignette such as put on shoes, feed themselves well,
understand taking turns, and build a tower of more blocks (9 or 10)
cubes.
32.8.
An adult is making silly faces and tickling an infant. At which
age should the infant be able to smile back?
A. Birth
B. 1 month
C. 4 months
D. 6 months
E. 10 months
32.8. C. 4 months
While an endogenous smile can be noted at birth, the spontaneous
social smile, or exogenous smile, does not typically occur until
around 4 weeks of life
32.9.
At what maximum age should a child be able to understand
complex sentences, pronouns, put two words together when
speaking, and though not fully understandable, start to use
three words together while speaking?
A. 1 year old
B. 1.5 years old
C. 2 years old
D. 3 years old
E. 4 years old
32.9. C. 2 years old
A 2-year-old should be able to put two words together for a simple
utterance and start to use three-word telegraphic utterances, with
only around half being intelligible. A 2-year-old should also refer to
themselves by name
32.10.
A child is detail oriented, very focused, and recently learned
how to play checkers well. The child can understand that
when his ice cube melts, the same amount of liquid is still
present. Which developmental period has this child entered?
A. Sensorimotor
B. Preoperational
C. Preproduction
D. Concrete operational
E. Formal operational
32.10. C. Concrete operational
The four Piaget states of cognitive development include the
sensorimotor stage (birth to 2 years old), preoperational (2 to 7 years
old), concrete operational (7 to 11 years old), and formal operational
(11 to 19 years old). Preproduction is a stage of language, not
cognitive development. Cognitive achievements in the concrete stage
are highlighted above, including principles of reversibility (i.e., can
play games backward and forward), conservation (i.e., can
understand conservation of matter), and decentration (i.e., worrying
about small details).
32.11.
What is the earliest age that infants can imitate facial
movements of adult caregivers?
A. Birth
B. 3 weeks
C. 4 months
D. 6 months
E. 10 months
32.11. B. 3 weeks
By as young as 3 weeks old, infants can imitate facial movements of
adult caregivers. They can open their mouths and thrust their
tongues when
adults do the same. By the third and fourth months,
this behavior is easily elicited, and the exogenous social smile occurs.
32.12.
A 1- to 2-year-old is most likely to display which of the
following emotional behaviors?
A. Altruism
B. Approval seeking
C. Competition
D. Self-regulation
E. Sensitivity to criticism
32.12. B. Approval seeking
In terms of emotional development, in early childhood (3 to 6 years
old) a child can display empathy, and aggression turns into
competition at this age. Self-regulation begins to occur, and children
become less reactive. By 5 years old, children typically show
sensitivity to criticism and care about the feelings of others. By
middle childhood (7 to 11 years old), altruism can be displaced and
the superego dominates. At 1 to 2 years old, some indications of
empathy are starting, though attention seeking and the need for
approval predominate.
32.13.
Which is a distinguishing factor between stranger anxiety
versus separation anxiety?
A. Crying and clingy behavior
B. Developmental ability to distinguish caregiver from others
C. Exposures to multiple caregivers
D. Occurrence when the infant is still in the mother’s arms
E. It starts later in infancy
32.13. D. Occurrence when the infant is still in the mother’s
arms
Stranger anxiety is a developmentally normal fear that starts around
26 weeks of life, whereas separation anxiety typically begins later
around 10 to 18 months. When babies are approached by strangers,
they cry and cling to their mothers. Babies with only one caregiver
are more likely to have stranger anxiety. Stranger anxiety occurs
when the infant is in the mother’s arms, whereas with separation
anxiety, the anxiety occurs when the person the infant is attached to
separates
32.14.
A toddler looks back at his mother before going ahead and
touching a dog in a park. This is an example of which of the
following developmental concepts?
A. Insecure attachment
B. Object permeance
C. Secure attachment
D. Social referencing
E. Transitional object
32.14. D. Social referencing
Social referencing, typically occurring around 2 years of age, is when
the child looks toward the parents and others for emotional cues as
to how to respond to novel events. The child must have object
permanence to be able to social reference. Transitional objects (as
coined by Donald Winnicott), such as a teddy bear, for example, can
offer a secure base as a child investigates the world around them.
With secure attachment, children are better adjusted with few
problems and receive more consistent and developmentally
appropriate parenting. Signs of insecure attachment include being
clingy and angry towards the parent, along with ambivalence and
disorganization. It is often seen with neglectful parents.
32.15.
Gender identity is thought to be fixed by which of the
following age ranges?
A. 1 to 1.5 years old
B. 2 to 2.5 years old
C. 5 to 6 years old
D. 5 to 12.5 years old
E. 13 to 15 years old
32.15. B. 2 to 2.5 years old
It used to be thought that gender identity, the conviction of being
male or female, was a function of social learning. It is now known
that rearing does not affect gender identity. Gender identity begins to
manifest at 18 months and is typically fixed by 24 to 30 months old.
