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MS4 - Paediatrics and Epidemiology > Developmental milestones > Flashcards

Developmental milestones Flashcards

1
Q

Gross motor 3 months

A

Lifts head

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2
Q

Gross motor 6 months

A

Sits with support Rolls

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3
Q

GM 9 m

A

Sits Crawl

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4
Q

GM 12 m

A

Stand / walk

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5
Q

GM 18 m

A

Run Jump

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6
Q

GM 2 yrs

A

Stairs 2 feet per step

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7
Q

GM 3 yrs

A

Stands on 1 foot Stairs 1 foot per step

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8
Q

Fine motor/vision 3 m

A

Holds small object

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9
Q

FM/V 6 m

A

Transfer objects hand to hand

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10
Q

FM/V 9 m

A

Pincer grip

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11
Q

FM/V 12 m

A

Tower of 2

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12
Q

FM/V 18 m

A

Draw straight lines

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13
Q

FM/V 2 yrs

A

Tower 7 blocks Draw circle

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14
Q

FM/V 3 yrs

A

Build complex structures Eg. bridges

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15
Q

Speech and Language 3 m

A

Turns to sound

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16
Q

S+L 6 m

A

Babbles

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17
Q

S+L 9 m

A

Responds to name

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18
Q

S+L 12 m

A

1-2 words

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19
Q

S+L 2 yrs

A

Joins 2 - 3 words

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20
Q

S+L 3 yrs

A

Phrases / sentences

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21
Q

Social/Play 6 weeks

A

Smiles

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22
Q

S/P 3 m

A

Laughs

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23
Q

S/P 6 m

A

Finger feed

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24
Q

S/P 9 m

A

Waves good bye

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25
Q

S/P 12 m

A

Object permanence

26
Q

S/P 18 m

A

Uses spoon

27
Q

S/P 2 yrs

A

Removes a garment

28
Q

S/P 3 yrs

A

Uses fork Puts on clothing

29
Q

Delayed development

A

Take longer than 2SD of the population to acquire skills

30
Q

Williams syndrome

A

Develop good social skills but poor cognitive skills

31
Q

Autism development

A

May gain language skills early on But may lose them soon after

32
Q

What hormone promotes growth

A

IGF1 (stimulated by GH) Released from liver

33
Q

Mid parental height calculation

A

Average of both parents heights in CM add 7 cm if a boy take away 7cm if a girl

34
Q

Target parental range

A

For boy: mid parental height +/- 10cm For girl: mid parental height +/- 8.5 cm

35
Q

Height velocity

A

Height in one year - height in earlier year/ number of years

36
Q

Consequence of low height velocity

A
  • need to check GH by giving insulin- if GH increase then normal
  • Check Bone age
  • Check: FBC (anaemia), U/Es, TFTs, Coeliac screen (±IGFs)
  • Karyotype in all girls (turners)
37
Q

Average age of menarche

A

13

38
Q

Sexual precosity in girls

A

8 (before this any sexual features development will need to be investigated)

39
Q

Sexual precosity in boys

A

9

40
Q

Peak height velocity in girls

A

breast stages 2-3, early

41
Q

Peak height velocity in boys

A

12-15 mls testes, late

42
Q

Tanners Breast developmental stages

A

B1 to B5

stage 1: prepubertal projection of nipple

stage 2: the breast bud

stage 3: similar to a small adult breast

stage 4: the areolar and nipple stand proud of the breast

stage 5: the nipple and breast have the same contour

43
Q

Pubic hair developmental Tanner stages

A

P1 to P5

stage 1: prepubertal

stage 2: there are a few long downy hairs at the labia majora or at the base of the penis

stage 3: the pubic hair spreads across the pubes

stage 4: the pubic hair has reached adult but it smaller in area than stage 5

stage 5: the pubic hair spreads to the inner thighs

44
Q

Male genitals developmental Tanner stages

A

stage 1: prepubertal

stage 2: scrotal enlargement and reddening, testicular enlargement

stage 3:

penile lengthening, thinning of the scrotal skin, testicular enlargement

begins between 10.5 and 14.5 years

stage 4: glans enlargement, penile broadening, testicular enlargement, scrotal increase in size and deepening of pigmentation

stage 5: adult

45
Q

Factors affecting height

A

Familial short stature

Intrauterine growth retardation

Constitutional delay in growth and puberty (commonest reason underlying short stature consultations)

46
Q

Pathological causes of short stature

A

Hypothyroidism (autoimmune)

Chronic disease (coeliac, crohn’s, cystic fibrosis)

Excess corticosteroids (Cushing syndrome common), (disease rare)

Deprivation (emotional)

Growth hormone deficiency

47
Q

Ix of short stature

A

Record birth weight

Record both parental final heights – MPH (TPR)

Measure height velocity

48
Q

True vs psuedo precocious puberty

A

True- comes from pitiutiary multiple sexual fx eg breast as well as pubic hair

Psuedo- not from pituitary- something else releasing hormone eg making penis/testes grow only

49
Q

Indication of true precocious puberty

A

Medical emergency

Suggestive of pituitary tumour in most boys (and some girls) with it

50
Q

Congenital adrenal hyperplasia main cause

A

21 hydroxylase deficiency

51
Q

21 hydroxylase deficiency genetics

A

autosomal recessive

52
Q

Role of 21 hydroxylase

A

making aldosterone and cortisol

NOT REQUIRED FOR ANDROGENS

53
Q

Pathophysiology of congenital adrenal hyperplasia

A

Cant produce cortisol

More ACTH is produced to make cortisol

but this higher level of ACTH leads to male androgen production

54
Q

Congenital adrenal hyperplasia presentation in girls

A
  • clitromegally (but cant make a penis because havent got the male genes (SRy gene))
  • labia majora closes forming a scrotum like shape, but no testes
  • androgens make you fuse your epiphysis, making you grow faster, but restricting how tall you can grow
55
Q

Congenital adrenal hyperplasia presentation in boys

A

salt losing crisis at 6 weeks (Low Na, High K, Acidosis, Low glucose) due to low cortisol and aldosterone

56
Q

Role of aldosterone

A

Absorb Na

Lose K

57
Q

Less common presentation of adrenal congenital hyperplasia

A

simple virilising CAH

58
Q

Turners syndrome sx

A
59
Q

Hashimotos vs primary hypothyroid Ix

A

Both low T4 high TSH

Hashimotos ; positive thyroid peroxidase antibodies

60
Q

Downs syndrome sx

A

Single palmar crease

Flat nasal gap

Sandal gap

Epicanthal fold (eyes)

61
Q

Klinefelter’s syndrome genetics

A

47 XXY

62
Q

Klinefelter’s syndrome phenotype

A

Male

atrophic testes

wide-set nipples

learning difficulty

MS4 - Paediatrics and Epidemiology (25 decks)

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