Developmental and Community Paediatrics Flashcards
List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 6 weeks
Hold head steady for several seconds
staring
stills to mother’s voice
smiling
List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 6-9 months
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
List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 1 year
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
List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 18 months
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
List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 2-2.5 year?
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
List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 3-3.5 year?
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
List one gross motor, fine motor/vision, hearing/speech, and social feature of child at 4-5 years?
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)
What is the difference between global development delay and intellectual developmental disability?
GDD up to age of 5, then replaced by intellectual
List two prenatal causes of intellectual developmental disability
Genetic: chromosomal syndrome- down’s etc
Acquired: foetal alcohol, rubella, infarct
List one perinatal cause of intellectual developmental disability
Intra-ventricular haemorrhage, Hypoxic ischaemic
encephalopathy,
List one postnatal cause of intellectual developmental disability
post cranial radiotherapy, acquired brain injury (NAI/RTA)
List two conditions whose cause is undertermined that result in developmental diability
autism
epilepsy
cerebral palsy
Two causes of delayed walking (gross motor)
Cerebral palsy
Duchenne muscular dystrophy (DMD)
Antenatal insult (e.g. stroke)
Part of global developmental delay
Two causes of speech delay
Familial
Hearing impairment
Poor social interaction/deprivation
Autistic spectrum disorder
Duchenne muscular dystrophy
Part of global developmental delay eg Down syndrome
What is the advice for breast feeding?
exclusively breast feed for first 6 months
When should solid foods be introduced?
from 6 months
Should baby have cow’s milk?
no cow’s milk before 1 year
What is normal sleep in newborn?
16 hours
Normal sleep for 1 year?
14 hours
Normal sleep for 2 years?
12 hours
List two reasons why child might be sleeping poorly
Lack of safety
Sleeps mostly in day
Environment- TV
Poor sleep hygiene
How to divide the key ages?
6 weeks
6-8 months
10-12 months
18 months
2 years
3 years
5 years
6 month old baby cannot turn over onto tummy. List two causes of their abnormal motor development
cerebral palsy
spinal cord lesion
global developmental delay
antenatal insult-stroke
duchenne muscular dystrophy
Differentials for delay in speech and language?
hearing loss
global developmental delay
normal familial pattern
social deprivation
autism
List three features of autistic child?
social- no eye contact, prefers to be on own
speech- repetition, limited expression
behavior- routine and violent
How to divide causes of developmental issues?
prenatal
perinatal
postnatal
What is a red flag in the development of a child?
regression of skills- neglect/NAI until proven otherwise
Which is the most common delayed domain in development?
speech and language
How many domains of development must be affected to use the term ‘global development delay’
2 or more
Who would be involved in MDT of patients with developmental delays/disabilities?
paediatrician
nurse
speech and language therapist
occupational therapist
social worker
GP
What problems may a down’s syndrome have upon discharge from hospital
feeding difficulties due to hypotonia
delayed developmental milestones
Who should be involved in the follow up of down syndrome baby? (neonatal discharge planning?
GP
health visitor
paediatrician
speech therapist
physio
dietician
ENT audiology
List two prenatal causes of developmental impairment
genetic- trisomy 21
acquire- foetal alcohol
brain malformation
Name one perinatal cause of developmental impairment
intraventricular haemorrhage
hypoxic ischaemic encphalopathy
Name one postnatal cause of developmental impairment
brain injury
List three red flags for development in child
regression
no speech by 18 months
concern about vision + hearing
walk and sit upright at appropriate ages
Would you be concerned about bottom shuffler for gross motor delay?
no, normal variant
List two complications of cerebral palsy?
seizures
aspiration pneumonia
List one primary and one secondary cause of nocturnal enuresis
primary- small bladder, overactive bladder, structural abnormalities
Secondary- diabetes, UTI, pyschosocial, constipation
Differential for delay in passing meconium?
meconium ileus
hirschprungs
Name two conditions that are tested for in neonatal blood spot test= Guthrie test/heel prick test
- PKU
- Congenital hypothyroidism
- Cystic fibrosis
- Sickle cell anaemia
- MCADD
- Rare metabolic disorders
When do the anterior fontanelle close?
18 months
When do the post fontanelle close?
2 months
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?
Any live vaccines.
E.g. MMR (measles)
BCG for TB
Varicella zoster is also live (the latter two are not routine immunisations)
Name the inherited metabolic diseases which form part of the heel prick test
Phenylketonuria, MCADD, Maple syrup urine disease, isovaleic acidaemia, homocystinuria and glutaic aciduria type 1.
Which cancer are children with down’s syndrome at highest risk for?
ALL
List two types of cerebral palsy
spastic hypertonia- UMN
dyskinetic- muscle tone issues
ataxic- coordination issues
mixed
List two patterns of spastic cerebral palsy
monoplegia- one limb
hemiplegia- one side of body affected
quadriplegia- all four limbs affected
Signs and symptoms of cerebral palsy?
failure to meet milestones
decreased tone
hand preference below 18 months
speech coordination walking problems
feeding and swallowing problems
learning difficulties
What is a key sign of cerebral palsy to remember for exams?
hand preference below 18 months is a key sign of cerebral palsy
State two gaits observed in cerebral palsy
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
Management of cerebral palsy?
THink of symptoms and team members involved
OT
Speech and language therapy
dietician
physiotherapy- prevent muscle contractures and maximise function
surgeons
paediatrician
