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paeds > development + immunisations > Flashcards

development + immunisations Flashcards

1
Q

developmental screening questions

A

any concerns about:
way child is behaving/learning/developing
way child moves/uses limbs
how child talks + understands speech
how child is learning to do things for self
enjoy playing - how play?
ever stopped doing something could previously do?
get along with others?
hand dominance?

pregnancy - problems, infections, intoxication, prolonged/difficult labour, postnatal infections

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2
Q

whats global developmental delay

A

sig delay in milestones in 2+ areas

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3
Q

causes of profound disability

A

chromosomal abnormalities
cerebral palsy
inborn errors of metabolism

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4
Q

cerebral palsy - presentation

A 
hypertonia+reflexia/floppiness
delayed motor development
tiptoes/abnormal gait
hand preference at 6mo
floppy at birth
jerky, random, uncontrolled or clumsy movements
SALT, vision problems
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5
Q

cerebral palsy - RFs

A

premature

low birth weight

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6
Q

cerebral palsy - managing increased tone

A 
physio +- SALT
daily exercises + splints
baclofen
diazepam
botox
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7
Q

age: squeal, turn to sound

A

3mo

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8
Q

age: mama, dada

A

9mo

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9
Q

age: knows/responds to name

A

1y

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10
Q

age: know 2-6 words

when to refer?

A

12-15mo

refer at 18mo

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11
Q

age: understand simple commands

A

12-15mo

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12
Q

age: combine 2 words

A

2y

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13
Q

age: short sentences, what + who Qs

A

3y

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14
Q

age: count to 10

A

3y

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15
Q

MMR: age

how feel after?

A

dose 1 - 12-15mo
dose 2 - 3-4y

malaise, fever, rash can occur 5-10d after dose 1 for 2-3d

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16
Q

what is the 6-1 vaccine?

A 
diphtheria
tetanus
whooping cough
polio
HiB
hep B
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17
Q

when is the 6-1 vaccine given?

A

8, 12, 16wk

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18
Q

cerebral palsy - explanation

A

group of conditions that can affect movement and coordination
‘very tense muscles’

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19
Q

CP - causes

A

infection in utero
bleed in brain
oxygen deprivation at birth

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20
Q

CP - types

A

spastic (70%) - contracted muscles eg tiptoes, SALT delay
ataxic - balance problems
dyskinesic (arm movements)
mixed

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21
Q

ADHD - symptoms

A

restlessness
poor conc
uncontrolled activity
impulsiveness

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22
Q

ADHD - mgmt

A

refer to specialist

methylphenidate (SEs - abdo pain, nausea, dyspepsia. monitor growth, BP/HR + psych 6-monthly)

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23
Q

autism - diagnostic criteria

A

global impairment of lang + comm
impaired social relationships
ritualistic + compulsive phenomena

also, most have decreased IQ

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24
Q

what are the associated conditions with CP?

A 
learning difficulties (50%)
epilepsy (30%)
squints (30%)
hearing impairment (20%)
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25
Q

CP - causes

A

antenatal (80%) - cerebral malformation + congenital infection
intrapartum (10%) - asphyxia/trauma
postnatal (10%) - IVH, meningitis, head trauma

26
Q

what checks are done on a child’s health?

A

neonate - examination, hearing test
1st mo - heel prick d5-9 - hypothyroid, metabolic diseases, CF
6-8wk - GP check
ongoing immunisations + monitoring of growth, vision, hearing

27
Q

what developmental delays constitute referral?

A

doesn’t smile at 10wk
can’t sit unsupported 12mo
can’t walk 18mo
can’t say 2-6 words 18mo

28
Q

what are the commonest reasons for developmental delay?

A

variant of normal
cerebral palsy
duchenne muscular dystrophy

29
Q

developmental dysplasia of the hip (DDH) - RFs

A 
breech
FH
firstborn
oligohydramnios
birth weight > 5kg
30
Q

DDH - diagnosis

A

barlow + ortolani tests

USS confirms

31
Q

DDH - mgmt

A

should spontaneously resolve 3-6wk
splints + harnesses if <4-5mo
older - surgery eg hip realignment

32
Q

fine motor + vision milestones

A

3mo - reach for object, visually alert, fix + follow to 180°
6mo - holds palmar grasp
9mo - points, early pincer
12mo - good pincer

33
Q

gross motor milestones

A 
3mo - held sitting
6mo - pulls self to sitting
7-8mo - unsupported sitting
9mo - crawl
1y - walks if hand held
13-15mo - walks unsupported
2y - runs
34
Q

social behaviour + play milestones

A 
6wk - smiles
3mo - laughs
1y - waves bye
18mo - plays alone
4y - plays with others
35
Q

feeding milestones

A

12-15mo - drinks from cup, uses spoon
3y - uses spoon + fork
5y - uses knife + fork

36
Q

dressing - milestones

A

can dress + undress at 4y

37
Q

down syndrome - features

A 
upslanting palpebral fissures
protruding tongue
small ears
rounf/flat face
single palmar crease, sandal gap
hypotonia
heart problems eg VSD, ToF, PDA
duodenal atresia + hirschprung's

male infertility, female sub
learning probs
short
resp infections

38
Q

why are kids given oral/IM vitamin K at birth?

A

newborns deficient, which can impair clotting factor production → haemorrhagic disease of the newborn (minor or severe)

39
Q

hypotonia (floppiness) - causes

A 
down's
prader willi
cerebral palsy
hypothyroidism
muscular dystrophy
40
Q

immunisations at birth

A

BCG if risk TB

hep B if RFs

41
Q

immunisations at 2mo

A

6-1
PCV
men B
oral rotavirus

42
Q

immunisations at 3mo

A

6-1

oral rotavirus

43
Q

immunisations at 4mo

A

6-1
PCV
men B

44
Q

immunisations at 12-13mo

A

Hib/Men C
MMR
PCV
Men B

45
Q

when is flu vaccine given to kids?

A

2-8y

46
Q

immunisation at 3-4y

A

4 in 1 preschool booster - diphtheria, tetanus, whooping cough + polio
MMR

47
Q

immunsation at 12-13y

A

HPV - girls

48
Q

immunisation at 13-18y

A

3-in-1 teenage booster - tetanus, diphtheria, polio

men ACWY

49
Q

heel prick test - when done? what for?

A

5-9 days

hypothyroid
CF
sickle cell
PKU, MCADD
HCU
50
Q

how many times is men B given?

A

3

51
Q

how many times is MMR given?

A

2

52
Q

how many times is polio given?

A

5

53
Q

DDH - features

A

usually found on screening/newborn exam
if unilateral - leg inequality
limp
arthritis

54
Q

red flags of developmental delay

A 
loss of skills
not fixing/following
hearing loss
low/increased tone
no speech by 18mo
persistent tip toes
can't sit unsupported by 1y
can't walk by 18mo (m) or 2y (f)
can't hold object 5mo
55
Q

duchenne’s - presentation + diagnosis

A

x linked recessive
neuromuscular disorder
progressive proximal muscle weakness from 5y - dystrophin absence
gower’s sign - arms used to stand from squat
CK++, genetic testing
hx tiptoes, speech + walking delay
calf hypertroph

56
Q

duchenne’s - management + prognosis

A

steroids can delay progression

feeding, resp + cardiac problems

57
Q

causes of delayed puberty

A

short:
turner, prader-willi

normal:
PCOS, klinefelter

58
Q

male puberty milestones

A

testicular growth 10-15y

height spurt 14y

59
Q

female puberty milestones

A

breasts 9-13y
height spurt 12
menarche 11-15

60
Q

which strains of HPV cause what?

A

6 + 11 - warts

16 + 18 - cervical cancer

61
Q

which HPV strains does current vaccination protect against?

A

6 + 11 - warts

16 + 18 - cervical cancer

62
Q

HPV vaccination - how done?

A

12-13y. done at school
may be done against parental wishes
2 doses - 6mo-2y apart
injection site reactions common

paeds (18 decks)

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