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1 Paediatrics > Developmental and Community Paediatrics > Flashcards

Developmental and Community Paediatrics Flashcards

1
Q

List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 6 weeks

A

Hold head steady for several seconds

staring

stills to mother’s voice

smiling

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2
Q

List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 6-9 months

A

sitting to standing position
rolling

palmar grasp
transfers objects from hand to hand

ma, da by 6m
dada, gaga 9 months polysyllables

enjoys bath, stranger aware

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3
Q

List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 1 year

A

walking alone
rise to sitting from lying

bangs blocks together
throws objects away

says 1-3 words with meaning
says own name

comes when called
drinks from cup
waves bye
cooperates with dressing

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4
Q

List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 18 months

A

climbs stairs two feet at a time
unsteady run

scribbles
tower 3-4 cubes

points to body part- tummy
obeys simple instructions

spoon feeds self
takes of shoes, socks

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5
Q

List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 2-2.5 year?

A

runs safely
kicks ball
jumps

turns one page of book

50 words or more
gives name

no sharing, plays alone (terrible two’s)
simple imaginative play
dry by day

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6
Q

List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 3-3.5 year?

A

walks upstairs like adult
tricycle

copies circle
holds pencil

gives full name and sex

plays with other children
eats with fork and spoon
pulls pants up and down alone

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7
Q

List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 4-5 years?

A

walks stairs like adult
hops

matches names and colours
triangle and stick man

fluent clear speech
counts to 20

brushes teeth
toilet trained (upper limit 4)

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8
Q

What is the difference between global development delay and intellectual developmental disability?

A

GDD up to age of 5, then replaced by intellectual

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9
Q

List two prenatal causes of intellectual developmental disability

A

Genetic: chromosomal syndrome- down’s etc

Acquired: foetal alcohol, rubella, infarct

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10
Q

List one perinatal cause of intellectual developmental disability

A

Intra-ventricular haemorrhage, Hypoxic ischaemic
encephalopathy,

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11
Q

List one postnatal cause of intellectual developmental disability

A

post cranial radiotherapy, acquired brain injury (NAI/RTA)

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12
Q

List two conditions whose cause is undertermined that result in developmental diability

A

autism
epilepsy
cerebral palsy

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13
Q

Two causes of delayed walking (gross motor)

A

 Cerebral palsy
 Duchenne muscular dystrophy (DMD)
 Antenatal insult (e.g. stroke)
 Part of global developmental delay

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14
Q

Two causes of speech delay

A

 Familial
 Hearing impairment
 Poor social interaction/deprivation
 Autistic spectrum disorder
 Duchenne muscular dystrophy
 Part of global developmental delay eg Down syndrome

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15
Q

What is the advice for breast feeding?

A

exclusively breast feed for first 6 months

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16
Q

When should solid foods be introduced?

A

from 6 months

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17
Q

Should baby have cow’s milk?

A

no cow’s milk before 1 year

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18
Q

What is normal sleep in newborn?

A

16 hours

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19
Q

Normal sleep for 1 year?

A

14 hours

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20
Q

Normal sleep for 2 years?

A

12 hours

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21
Q

List two reasons why child might be sleeping poorly

A

Lack of safety
Sleeps mostly in day
Environment- TV
Poor sleep hygiene

22
Q

How to divide the key ages?

A

6 weeks
6-8 months
10-12 months
18 months
2 years
3 years
5 years

23
Q

6 month old baby cannot turn over onto tummy. List two causes of their abnormal motor development

A

cerebral palsy
spinal cord lesion
global developmental delay
antenatal insult-stroke
duchenne muscular dystrophy

24
Q

Differentials for delay in speech and language?

A

hearing loss
global developmental delay
normal familial pattern
social deprivation
autism

25
Q

List three features of autistic child?

A

social- no eye contact, prefers to be on own
speech- repetition, limited expression
behavior- routine and violent

26
Q

How to divide causes of developmental issues?

A

prenatal
perinatal
postnatal

27
Q

What is a red flag in the development of a child?

A

regression of skills- neglect/NAI until proven otherwise

28
Q

Which is the most common delayed domain in development?

A

speech and language

29
Q

How many domains of development must be affected to use the term ‘global development delay’

A

2 or more

30
Q

Who would be involved in MDT of patients with developmental delays/disabilities?

A

paediatrician
nurse
speech and language therapist
occupational therapist
social worker
GP

31
Q

What problems may a down’s syndrome have upon discharge from hospital

A

feeding difficulties due to hypotonia
delayed developmental milestones

32
Q

Who should be involved in the follow up of down syndrome baby? (neonatal discharge planning?

A

GP
health visitor
paediatrician
speech therapist
physio
dietician
ENT audiology

33
Q

List two prenatal causes of developmental impairment

A

genetic- trisomy 21
acquire- foetal alcohol
brain malformation

34
Q

Name one perinatal cause of developmental impairment

A

intraventricular haemorrhage
hypoxic ischaemic encphalopathy

35
Q

Name one postnatal cause of developmental impairment

A

brain injury

36
Q

List three red flags for development in child

A

regression
no speech by 18 months
concern about vision + hearing
walk and sit upright at appropriate ages

37
Q

Would you be concerned about bottom shuffler for gross motor delay?

A

no, normal variant

38
Q

List two complications of cerebral palsy?

A

seizures
aspiration pneumonia

39
Q

List one primary and one secondary cause of nocturnal enuresis

A

primary- small bladder, overactive bladder, structural abnormalities

Secondary- diabetes, UTI, pyschosocial, constipation

40
Q

Differential for delay in passing meconium?

A

meconium ileus
hirschprungs

41
Q

Name two conditions that are tested for in neonatal blood spot test= Guthrie test/heel prick test

A
  1. PKU
  2. Congenital hypothyroidism
  3. Cystic fibrosis
  4. Sickle cell anaemia
  5. MCADD
  6. Rare metabolic disorders
42
Q

When do the anterior fontanelle close?

A

18 months

43
Q

When do the post fontanelle close?

A

2 months

44
Q

A one year old boy is due his routine immunisations. He is on significant dose long-term immunosuppression for chronic renal disease. Which vaccination is contraindicated?

A

Any live vaccines.
E.g. MMR (measles)
BCG for TB
Varicella zoster is also live (the latter two are not routine immunisations)

45
Q

Name the inherited metabolic diseases which form part of the heel prick test

A

Phenylketonuria, MCADD, Maple syrup urine disease, isovaleic acidaemia, homocystinuria and glutaic aciduria type 1.

46
Q

Which cancer are children with down’s syndrome at highest risk for?

A

ALL

47
Q

List two types of cerebral palsy

A

spastic hypertonia- UMN
dyskinetic- muscle tone issues
ataxic- coordination issues
mixed

48
Q

List two patterns of spastic cerebral palsy

A

monoplegia- one limb
hemiplegia- one side of body affected
quadriplegia- all four limbs affected

49
Q

Signs and symptoms of cerebral palsy?

A

failure to meet milestones
decreased tone
hand preference below 18 months
speech coordination walking problems
feeding and swallowing problems
learning difficulties

50
Q

What is a key sign of cerebral palsy to remember for exams?

A

hand preference below 18 months is a key sign of cerebral palsy

51
Q

State two gaits observed in cerebral palsy

A

Hemiplegic / diplegic gait: indicates an upper motor neurone lesion
Broad based gait / ataxic gait: indicates a cerebellar lesion
High stepping gait: indicates foot drop or a lower motor neurone lesion
Waddling gait: indicates pelvic muscle weakness due to myopathy
Antalgic gait (limp): indicates localised pain

52
Q

Management of cerebral palsy?

A

THink of symptoms and team members involved
OT
Speech and language therapy
dietician
physiotherapy- prevent muscle contractures and maximise function
surgeons
paediatrician

1 Paediatrics (19 decks)

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