Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FRACP Exam > Developmental > Flashcards

Developmental Flashcards

1
Q

ADHD

-comorbidities-

A

psychiatric disorder: 50-90%

  • ODD 70% males, 40% females
  • conduct disorder 33%
  • learning difficulties 20-60%
  • anxiety 20-30%
  • depression 33%
  • tic disorders 10-20%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ADHD

-criteria-

A

One of the following 2:

A. Inattentive signs (6 or more; > 6 months duration)

  • fails to give close attention or makes careless mistakes
  • cannot sustain attention
  • does not follow through or finish tasks
  • difficulty organising tasks
  • dislikes / avoids tasks requiring sustained mental effort
  • easily distracted by external stimuli
  • does not listen when spoken to
  • loses things necessary for tasks
  • forgetful

B. Hyperactive / Impulsive signs (6 or more; >6 months duration

– fidgets, squirms in seat

  • leaves seat
  • runs about / climbs
  • cannot play quietly
  • always “on the go” or “driven by a motor”
  • talks excessively
  • blurts out answers before questions completed
  • difficulty waiting his turn
  • interrupts or intrudes others (games, conversations)

Symptoms present before 7 yo (some symptoms required only)

Symptoms present in 2 or more settings (some symptoms required only)

Clinically significant impairment

Not associated or caused by another disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Adolescent cognition

A

middle childhood (6-11)

  • shift from “preoperational “ to “concrete logical operations” (Piaget)
  • apply rules based on observations, factor in multiple points of view, and interpret their perceptions using physical laws

early adolescence (10-13)

  • transition from concrete operational thinking to formal logical thinking
  • reason from principles, weigh many opinions, and think about the process of thinking

middle adolescence (14-16)

  • question and analyze extensively
  • understand the intricacy of the world, see beyond themselves, and use moral and legal context
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Autism

A

DSM IV criteria

1. qualitative impairment of social interaction (>2)

2. qualitative impairment of communication (>1)

3. restrictive or repetitive patterns of behaviour, interests and activities (>1)

4. onset before 3 years

associations: seizures (1/3), ↓IQ (75%), vision/ hearing problems, ADHD, depression/ schizophrenia

screening: recommended 18mo-2yrs with Modified Checklist for Autism in Toddlers questionnaire (M-CHAT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Blindness

A

legal blindness: vision 20/200 or worse

incidence: 1/35,000

causes:

  • retinopathy of prematurity (most common)
  • amblyopia (usually secondary to cataracts)

others: albinism, hydrocephalus, infection, birth asphyxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Car restraints

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cerebral palsy

A

incidence: 3.6/1000

definition: non-progressive motor impairment arising before or after birth

causes:

birth: preterm/LBW, congenital malformations, kernicterus

acquired: trauma, meningitis, stroke

unknown: 50% no identified risk

diagnosis: usually <18months with failure to obtain motor milestones or assymetric gross motor function, hypertonia, hypotonia

comorbidities: epilepsy, learning disorders, behavioural issues, sensory impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Classification CP

A

Limb distribution:

  • hemiplegia: 39%
  • diplegia: 34%
  • triplegia: 3%
  • quadriplegia: 24%

Motor disorder:

  • spastic: 83%
  • dyskinetic: 6%
  • ataxic: 5%
  • hypotonic: 2%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Constipation

A

prevalence:

  • constipation: 37% 5 to 12 years
  • constipation with overflow: 1-4%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Crying

A

duration of crying:

2 weeks: minimal

6 weeks: 3 hours/day

12 weeks: 1 hour/day

excessive crying: less than 5% infants with excessive crying have pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Deafness

A

inherited: 50% childhood deafness

genetics: 80% AR

Connexin 26 defect (50%): disrupts K+ flow in ear

  • early onset deafness 1-6yrs

other: 18% AD with variable penetrance; 2% XLR

syndromes: Usher, Pendred, Jervell Lange-Nielson, Brachio-otorenal, Alport, treacher-collins, Waardenberg, NF-2

infections: TORCH, bacterial meningitis, mumps, mastoiditis, TB, Kawasaki, EBV, scarlet fever, pertussis

neonatal causes: hyperbilirubinaemia, hypoxia, GBS meningitis, PPHN, prolonged ventilation, LBW

drugs: aminoglycosides, frusemide

endocrine: hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Denver Screening Test

A

age: birth to 6 yrs

domains:

  • personal-social
  • fine motor-adaptive
  • gross motor
  • language

use: screening tool but limited socioemotional development scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Development Table

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Developmental delay

A

Gross motor

2 yrs: not walking

3-5 yrs: not pedalling tricycle, clumsy, falling frequently, not hopping

5-8 yrs: unable to throw, catch or kick ball

Fine motor

<1 year: hand preference

10 mths: pincer grip

3-5 yrs: avoiding fine motor tasks

Personal/ social

3-5 yrs: disinterested in peers, little awareness of toileting needs, inability to dress self

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Developmental Delay

-investigations-

A

1st LINE:

  • chromosomes (including fragile X)
  • FBC/EUC/TFTs/CK/Lead/Urate/Ferritin/Biotinidase

2nd LINE:

metabolic screen: IF family hx/ consanguinity/regression/ organomegaly/ coarse face

neuroimaging: IF abnormal head size/ seizures/ focal neurology

EEG: IF speech regression/ seizures/ neurodegenerative

genetics: IF dysmorphic, abnormal growth, sensory impairment, odd behaviour, family hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dyslexia

A

definition: difficulty with accurate and or fluent word recognition due to a deficit in the phonologic component of language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Enuresis

A

definition: urinary incontinence in a child who is adequately mature enough to achieve continence

classification

  • diurnal: daytime (day dryness from 4 yrs)
  • noctural: night time (night dryness from 6 yrs)

distribution:

  • 22% day only, 17% both day/night, 61% night only

prevalence noctural enuresis:

  • 15% 5yr olds
  • 7% 8 yr olds
  • 1% 15 yr olds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Erikson’s stages

A
19
Q

Global developmental delay

A

impairment in at least 2 of the following areas:

1. motor

2. speech and language

3. cognition

4. personal/social

5. daily-living skills

20
Q

Hearing impairment

A

causes:

conductive (mild-moderate)

  • chronic middle ear effusion

SNHL (severe):

  • congenital infection eg. rubella, CMV, meningitis
  • birth asphyxia
  • kernicterus
  • ototoxic drugs
  • tumours
  • inherited defect

treatment:

hearing aids: amplification of sound

cochlear implant: >12months with severe SNHL

21
Q

Hearing tests:

A

neonatal:

otoacoustic emissions: measure sounds waves produced in middle ear by measuring echo when sounds are played

auditory brainstem response (ABR): measures how brain responds to sound via electrodes on the head

middle ear function:

pneumatic otoscope: most sensitive/specific

tympanometry/acoustic reflectometry: supportive

children:

audiometry: test conductive and sensory hearing in both ears

22
Q

Hymen anatomy prepuberty

A

variations:

  • crescenteric (most common): no tissue at 12 o’clock
  • annular (2nd most common)
  • fimbriated: erratically shaped
23
Q

Intellectual Disability

A
24
Q

Intelligence scales

A

Bayley Scales: 0-2yrs

Differential Abilities Scales: 2.5- 17 yrs

Kaufman Assessment Battery for Children: 2.5- 12.5yrs

Leiter International Performance (non-verbal abilities): 2.5-18 yrs

McCarthy Scales of Children’s Abilities: 2.5- 8.5 yrs

Stanford-Binet Intelligence Scale: 2- 23 yrs

The Griffiths Mental Scales: 2-8 yrs

Wechsler Preschool + Primary Scale of Intelligence (WPPSI): 3-7 yrs

Wechsler Intelligence Scales for Children (WISC III): 6-12yrs

25
Q

Language development

A

3 months: cooing

6 months: babbling

1yr: 1 -2 words

2 yrs: 50 words, 2 word combos

3 yrs: 3 word combos, 3 colours, personal pronouns, able to be understood by family

4yrs: 4 word combos, 4 colours, able to be understood by stranger

26
Q

Overweight/Obese

A

In children

overweight: 85th-95th percentile

obese: >95th percentile

27
Q

Piaget’s

A

Piaget’s 4 stages of intellectual/cognitive development:

sensorimotor: birth through ages 18-24 months

preoperational: toddlerhood (18-24 months) to childhood (age 7)

concrete operational: 7 to 12 years

formal operational: adolescence through adulthood

28
Q

Sexual abuse findings in females

A

findings on examination in only 5-10%

most suspicious findings:

  1. tears, deep notches or clefts in posterior hymen (3- 9 o’clock)
  2. attachments of fusion between labia minora and hymen
  3. AP diameter > 20mm with no stool present (strong marker) – uncommon
29
Q

Sleep association disorder

A

incidence: 1/3 toddlers

clinical: child wakes in middle of night and can’t fall back to sleep unless learned associations are presents

management: check in without physical contact at decreasing intervals for a period of time until the child learns to self-soothe

30
Q

Sleep stages

A

STAGES

Stage 1: beginning, slow eye wave, hypnic jerks

  • EEG: theta waves

Stage 2: unconscious, easily wakened, no eye movements

  • EEG: sleep spindles, k complexes

Stage 3: slow-wave sleep associated deep sleep, dreaming/parasomnias more common

  • EEG: delta waves

REM: rapid eye movements, low muscle tone, decreased HR/BP, increased gastric motility, deep sleep and hard to wake

  • EEG: rapid low voltage

Normal sleep pattern

  • 4-5 cycles of 90-120 minutes each

Age related changes:

  • birth: 50% sleep in REM
  • childhood/adulthood: 25% REM
31
Q

Speech disorders

A

dysarthria: both speech and non-speech difficulty due to lack of strength and muscle control

dysphonia: phonation disorder usually secondary to anatomical problem

dyspraxia: difficulty planning/coordinating the movements required to make speech

phonological delay: problems producing different sounds required for speech

pragmatic language impairment: have trouble understanding the meaning of what others are saying and trouble using words to get needs met

32
Q

Speech problems

A

3 main areas:

1. articulation

  • difficulty pronouncing sounds in syllables or saying words

2. fluency

  • the flow of speech is interrupted by abnormal stoppages eg. stuttering

3. resonance

  • problems with pitch, volume or quality of sound
33
Q

Straddle injury

A

clinical: typically unilateral and superficial to the anterior portion of the genitalia.

  • involve the mons, clitoral hood, labia minora anterior or lateral to the hymen
  • straddle injury to the hymen or posterior fourchette is rare

classified as penetrating or nonpenetrating

nonpenetrating: minor trauma to external genitalia: lacerations or abrasions of the labia in girls

penetrating injuries: more serious/extensive and often indicative of sexual assault .

findings concerning for sexual abuse:

  • < nine months
  • perianal, rectal, vaginal, or hymenal injury without hx penetrating trauma
  • extensive or severe trauma
  • presence of nonurogenital trauma
  • lack of correlation between history and physical findings
  • abnormal genital secretions
34
Q

Temper tantrum

A

definition: 2-5 mins of out of control behaviour including screaming, stomping, hitting, head banging and falling down as a display of frustration, anger and inability to cope

age: 1-3 yrs considered normal behaviour

prevalence: 80% 2-3yrs approx once per week

treatment:

  • parental education
  • identify triggers
  • alter environment to avoid triggers and limit frustration
  • use distraction
  • behaviour modification with positive/negative reinforcement
35
Q

Tympanometry

A

use: determines TM mobility by inserting pressure in the ear canal

abnormal:

  • middle ear effusion/perforation: stiffness of TM
36
Q

Wechsler Intelligence Scale for children

A

age: 6-16yrs

time: 45-65 minutes

assesses: general intelligence with scores for 5 indexes

  1. verbal comprehension index
  2. visual spacial index
  3. fluid reasoning index
  4. working memory index
  5. processing speed index

identify: specific learning, dyslexia, dyscalculia

NOT tested: reading ability

37
Q

GMFCS

Gross Motor Function Classification System

A

system: 66 items developed for children with CP

5 levels:

I (30%): walk independently, reduced coordination

II (20%): difficulty on uneven surfaces

III (10): assist device for walking, wheelchair for distance, sits independently

IV (12%): mobility device, support for sitting/transfers

V (14%): no independant mobility

prognosis: plateau at age 5

38
Q

Functional Mobility Scale

(FMS)

A

Functional mobility for 3 distances:

  • home: 5m
  • school: 50m
  • community: 500m

measures: what your child actually does

  • allows responsive change to intervention
39
Q

Hip Surveillance

A

who: all CP GMFCS I to V

age: 12 months corrected

tests: clinical assessment and XR

40
Q

Movement Disorder

A

spasticity: velocity dependent resistance of a muscle to stretch

  • R1 “catch”
  • R2: passive end range

dystonia: movement disorder with involuntary sustained or intermittent muscle contractions causing twisting/repetitive movements and postures

  • basal ganglia
41
Q

Medications for CP

A

baclofen: GABA agonist

diazepam: facilitates GABA

tizanidine: alpha 2 agonist

L-dopa: dopaminergic

artane: anticholinergic for dystonia

tetrabenazine: dopamine depletor for dystonia

*trial medication for at least 3 months

42
Q

Other CP treatment

A

Selective Dorsal Rhizotomy

  • L1-S1 laminectomy/dorsal root transection
  • irreversible

Baclofen pump: subfascial implant

  • small amount crosses
  • risk of malfunction: withdrawal

Deep brain stimulation: neurostimulator below clavicle

  • dyskinetic CP
  • limited response
43
Q

Behavioural management

A

4 pronged approach

1. environmental modulation

  • remove TV from room/ fences/ remove matches

2. time out for prioritised behaviour

  • clear boundaries (if appropriate give a warning 1st)
  • safe but boring environment
  • 1 min/yr of age (up to 5 mins)
  • if he comes out, he goes straight back in
  • usually works in 1-2 months
  • if > 5 yrs – more effective to use removal of privledges

3. ignore other behaviours

  • difficult for parents
  • avoid eye contact
  • walk away/ distract themselves/ separate room

4. praise for good behaviours

  • be specific
  • immediate
  • sticker charts

FRACP Exam (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions