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My Child Health > Development > Flashcards

Development Flashcards

1
Q

What is the median age?

A

the age when 50% of the population achieve a skill

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2
Q

What is the limit age?

A

the age when a skill has been acquired by 97.5% of children

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3
Q

What is cephalocaudal direction?

A

this is the direction of motor control so it starts at the head, then moves to the trunk and then down the legs as the child learns to walk

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4
Q

What are the four areas of development?

A
  • gross motor
  • fine motor and vision
  • hearing and language
  • social behaviour and play
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5
Q

What is involved in gross motor development?

A
  • head control
  • sitting
  • standing
  • walking
  • running
  • stairs
  • hopping
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6
Q

What are the primitive reflexes that are lost in gross motor development?

A
  • sucking
  • palmar/plantar grasp
  • ATNR (move hands when head turns to stop rolling)
  • moro (when dropped)
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7
Q

When should a child be walking alone?

A

14 months

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8
Q

What is involved in fine motor and vision development?

A
  • hand regard
  • grasping
  • building towers
  • drawing
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9
Q

What is involved in hearing and language development?

A

babbling to knowing names to asking questions to telling stories

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10
Q

What is involved in social behaviour and play development?

A

social smile to feeding to dressing and interactive playing

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11
Q

What are the median age and limit age for a social smile?

A

6 weeks for median

8 weeks for limit

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12
Q

What is developmental delay?

A

the failure to attain appropriate developmental milestones for the child’s corrected chronological age

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13
Q

What are the three types of developmental delay with examples?

A
  • Delay: global eg Down’s or specific eg Duchenne’s muscular dystrophy
  • Deviation: eg autism
  • Regresion: eg Rett’s syndrome
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14
Q

What are the main red flags for development?

A
  • Asymmetry of movement
  • Not reaching for objects by 6 months
  • Unable to sit unsupported by 12 months
  • Unable to walk by 18 months (check creatinine kinase)
  • No speech by 18 months
  • Concerns regarding vision or hearing
  • Loss of skills
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15
Q

What is a global development delay and what is the main example?

A
  • a significant delay in 2 or more of the four domains
  • potentially genetic
  • eg Down’s syndrome
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16
Q

What are the medical tests for Down’s syndrome?

A 
cardiac
vision
hearing
thyroid
sleep
growth
developmental screening
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17
Q

What are some specific developmental delays?

A

Eg Duchenne’s, cerebral palsy, language impairment

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18
Q

What are the features of Duchenne’s?

A
  • affects men
  • can affect the cardiac muscles
  • CK should be checked
  • lordosis with muscles that appear big but are non-functioning
  • Gower’s sign is where children use knees to get up and is a sign of pelvic girdle weakness
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19
Q

What are the types of cerebral palsy?

A
  • hemiplegic (one side of the body)
  • diplegic (both legs)
  • quadriplegic (both arms and legs)
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20
Q

What are the conditions associated with cerebral palsy?

A
  • learning difficulties
  • epilepsy (this is common)
  • visual impairment
  • feeding
  • communication
  • sleep
  • behavioural problems
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21
Q

What are the two main types of hearing impairment?

A
  • conductive (ear canal tissue)

- sensorineural (nerve tissue)

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22
Q

What is the autistic triad?

A

-Communication
-Social interaction
-Flexibility of thought/imagination
plus anxiety, repetitive behaviours and sensory issues

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23
Q

What are some common features of autism?

A
  • echoing
  • changed intonation
  • memorising chunks of video
  • avoidance of eye contact
  • no joint attention
  • no empathy
  • sensory issues
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24
Q

What is needed in the history part of approach to delay?

A

concerns
PMHx
FHx
pregnancy information

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25
Q

What is needed in the examination part of approach to delay?

A 
observation
dysmorphism
eye contact
head circumference
skin and CNS
vision
hearing
26
Q

What is needed in the investigation part of approach to delay?

A 
check thyroid function
CK
oligoarray CGH
FRAX (fragile X)
after this test for what is indicated
27
Q

What is needed in the intervention part of approach to delay?

A

therapy
family support
education
referral

28
Q

What is the role of the physiotherapist in the management of a child?

A
  • establish patient concerns
  • gross motor function (ROM, tone, movement, symmetry)
  • functional goal setting
  • targeted intervention (exercises, tone management (eg botox), equipment or hydrotherapy
29
Q

What is the best walker for cerebral palsy?

A

K walker which encourages them to stand more upright in extension rather than flexion in a normal walker

30
Q

What are some other tools used by physios in the management of cerebral palsy?

A
  • splints are used to keep ankles down and heels on the ground
  • braces are used to keep knees straight
31
Q

When should children be able to string two words together?

A

2 years old

32
Q

What gender needs more speech and language therapy usually?

A

Boys

33
Q

What are some of the most common things that stop women from breastfeeding?

A
  • marketing of replacements
  • embarrassment within the community
  • perception that the mother doesn’t have enough milk (this is usually untrue)
34
Q

What are the constituents in breast milk that are also in formula milk?

A
  • Water
  • Proteins: whey, easier to digest, bactericidal effect
  • Carbohydrates
  • Fats: unsaturated is higher
  • Vitamins and minerals: more efficient absorption
35
Q

What are the constituents in breast milk that aren’t in formula milk?

A
  • Immunoglobulins: infection protection
  • Transfer factors: absorption of nutrients and bactericidal effect
  • Nucleotides
  • Anti-inflammatory molecules
  • Hormones: gut growth
  • Oligosaccharides: increase peristalsis and inhibit bacterial growth
  • Enzymes
  • White cells
  • Viral fragments
36
Q

What is in colostrum?

A
  • High levels of Ig esp lactoferrin
  • Strong anti-inflammatory effect
  • Stimulates gut growth
  • Acts as a laxative
  • High in Na and Cl
  • Acidic pH environment
37
Q

What promotes more breastmilk to be made?

A

the more the mother lets the baby feed, the more milk is produced

38
Q

What are the adverse symptoms that can come when a woman breastfeeds?

A
  • sore nipples
  • engorgement
  • mastitis
  • low milk production
  • loss of confidence
39
Q

What is the treatment for mothers with sore nipples from breastfeeding?

A
  • leaving a few drops of milk to dry on the breast

- for deep cracks use Lansinoh

40
Q

What can be the complications from mastitis?

A

can progress to an abscess and then to sepsis

41
Q

What is the treatment for mastitis?

A

give flucloxacillin (or clindamycin if allergic) with a large dose to stop sepsis

42
Q

When should women who are breastfeeding be given drugs?

A

once a day and before the baby’s longest sleep

43
Q

What do babies that drink formula milk move on to?

A
  • blue cows milk once they are 1

- green cows milk from 2 years

44
Q

What changes in an overweight baby in terms of growth?

A

they have their Nadir sooner so they begin to put on weight sooner

45
Q

What are the three phases of height increase determined by?

A
  • First phase of growth is determined by nutrition
  • Second phase is determined by growth hormone secretion
  • Third phase of growth (age 10/11) is determined by the age of puberty
46
Q

When is a child’s growth normal?

A
  • when they are in normal range

- when their rate of growth is in the normal range

47
Q

When does length change to height in children?

A

under 2 is length

over 2 is height

48
Q

How are boys staged for puberty?

A
  • testicular volume
  • size of genitalia
  • presence or absence of pubic hair
49
Q

How are girls staged for puberty?

A
  • breast development

hair can develop without actually being in puberty as it is from endogenous androgens

50
Q

Which gender is more likely to get early or late puberty?

A
  • girls are more likely to get precocious puberty (<8g,<9b)

- boys are more likely to get late onset puberty (>13g,>14b)

51
Q

When does menarche usually occur?

A

2-3 years after onset of puberty which is development of breasts

52
Q

What is the average height difference between men and women and why is it different?

A

boys have longer prepubertal growth and their PHV is quicker so the average height difference between men and women is 12.5-14cm

53
Q

How is a child’s eventual height estimated?

A
  • cross over between the father and the mother’s height can give an estimate of the child’s height (mid-parental centile)
  • child’s eventual height is usually within 2 centile spaces of this
54
Q

How is a growth problem investigated?

A
  • bloods: gonadotropins, Igf1 for growth, thyroid status, karyotype (Turner’s), Coeliac screen
  • XR: bone age of non-dominant wrist
  • dynamic function test: to check growth hormone
55
Q

What are the possible causes of short stature?

A
  • Genetic: due to parents, normal bone age, no endocrine abnormality
  • Constitutional growth delay: this is exclusion and is untreatable and will sort itself out
  • Dysmorphic syndromes: eg Turner’s, Down’s
  • Endocrine disorders: pituitary, adrenal
  • Chronic diseases
  • Psychosocial deprivation: poor nutrition, unloved children will grow less
56
Q

What are the antibodies that are passed from mother to child through the placenta?

A

IgG which last for one year

57
Q

What are the types of vaccines?

A
  • live virus vaccines: attenuated organisms which replicates the disease in the host
  • Inactivated vaccines: suspensions of killed organisms, subunit vaccines or conjugate vaccines (polysaccharides attached to immunogenic proteins)
58
Q

What are some contraindications to vaccines?

A 
confirmed anaphylaxis
egg allergy
severe latex allergy
acute illness 
NB- live vaccines are unsuitable for those who are immunosuppressed or pregnant
59
Q

What are the diseases that children are vaccinated against?

A
  • Diphtheria
  • Rotavirus
  • Meningococcal
  • Hib
  • Hepatitis B
  • Measles
  • Mumps
  • Rubella
  • HPV-cervical cancer
  • Flu
  • Pneumococcal
  • Shingles-adults
  • Polio
  • Tetanus
  • Whooping cough
60
Q

What is the best test for small chromosomal imbalances?

A

aCGH

My Child Health (5 decks)

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