development

Question 1

6 m.o. boy, Stewart, is being reviewed as he was born prematurely at 29 weeks. his mum is v anxious as he is not reaching the same milestones as her best friend’s baby who was born at the same month at term

(a) name 4 differnt milestones you would expect a 6 month old to exhibit

Answer 1

• gross motor: rolls from front to back
• fine motor: palmar grasp
• hearing/speech: bablling/turning towards sounds
• social: enjoys bath and attempts to bring objects to mouth

Question 2

(b) what is the most likely reason that Stewart’s development is delayed?

Answer 2

pre-term birth

Question 3

(c) how would you explain this to his anxious mother and what is the prognosis?

Answer 3

• explain it
  
  • clearly, concisely and at a level she can understand with multiple opportunities for her to ask qns in a calm and quiet environment
• prognosis
  
  • babies born earlier are at a higher risk of developemental delay but she is bringing Steward to clinic for regular review so we can detect this earlier and hopefully minimise any difficulties faced

Question 4

(d) on the way out the door, she has one final question: what will Stewart’s next immunisation be and when will he recieve it?

Answer 4

Hib/Men C booster + MMR + pneumococcal (3rd dose) at 12-13 months

Question 5

A teenage girl aged 13 years with abdominal stretch marks and height tracking steadily along 50th centile since the age of 5, whose current weight Is >99.6th centile

Dx?

Answer 5

simple obesity

Question 6

A girl aged 9 years whose height has dropped from the 50th centile to below the 9th centile, but whose weight has increased to above the 75th centile. She has coarse hair and feels the cold.

Dx?

Answer 6

hypothyroidism

Question 7

A boy aged 5 who eats ‘next to nothing’ and whose weight/height are tracking along the 2nd centile

Dx?

Answer 7

constitutional short stature

Question 8

A boy aged 14 years with no signs of secondary sexual development whose weight and height centiles have both dropped from the 50th to the 25th centile over the past 2 years

Dx?

Answer 8

Crohn’s disease

^{The fact his weight and height have dropped centiles shows there is pathology making E (Crohn’s disease) the correct answer over simple Pubertal Delay}

Question 9

A one year old baby who is reluctant to take solid foods, whose weight has dropped from the 75th to 2nd centiles.

Dx?

Answer 9

failure to thrive / weight faltering