Developmental milestones Flashcards
1
Q
Gross motor 3 months
A
Lifts head
2
Q
Gross motor 6 months
A
Sits with support Rolls
3
Q
GM 9 m
A
Sits Crawl
4
Q
GM 12 m
A
Stand / walk
5
Q
GM 18 m
A
Run Jump
6
Q
GM 2 yrs
A
Stairs 2 feet per step
7
Q
GM 3 yrs
A
Stands on 1 foot Stairs 1 foot per step
8
Q
Fine motor/vision 3 m
A
Holds small object
9
Q
FM/V 6 m
A
Transfer objects hand to hand
10
Q
FM/V 9 m
A
Pincer grip
11
Q
FM/V 12 m
A
Tower of 2
12
Q
FM/V 18 m
A
Draw straight lines
13
Q
FM/V 2 yrs
A
Tower 7 blocks Draw circle
14
Q
FM/V 3 yrs
A
Build complex structures Eg. bridges
15
Q
Speech and Language 3 m
A
Turns to sound
16
Q
S+L 6 m
A
Babbles
17
Q
S+L 9 m
A
Responds to name
18
Q
S+L 12 m
A
1-2 words
19
Q
S+L 2 yrs
A
Joins 2 - 3 words
20
Q
S+L 3 yrs
A
Phrases / sentences
21
Q
Social/Play 6 weeks
A
Smiles
22
Q
S/P 3 m
A
Laughs
23
Q
S/P 6 m
A
Finger feed
24
Q
S/P 9 m
A
Waves good bye
25
S/P 12 m
Object permanence
26
S/P 18 m
Uses spoon
27
S/P 2 yrs
Removes a garment
28
S/P 3 yrs
Uses fork Puts on clothing
29
Delayed development
Take longer than 2SD of the population to acquire skills
30
Williams syndrome
Develop good social skills but poor cognitive skills
31
Autism development
May gain language skills early on But may lose them soon after
32
What hormone promotes growth
IGF1 (stimulated by GH) Released from liver
33
Mid parental height calculation
Average of both parents heights in CM add 7 cm if a boy take away 7cm if a girl
34
Target parental range
For boy: mid parental height +/- 10cm For girl: mid parental height +/- 8.5 cm
35
Height velocity
Height in one year - height in earlier year/ number of years
36
Consequence of low height velocity
- 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
Average age of menarche
13
38
Sexual precosity in girls
8 (before this any sexual features development will need to be investigated)
39
Sexual precosity in boys
9
40
Peak height velocity in girls
breast stages 2-3, early
41
Peak height velocity in boys
12-15 mls testes, late
42
Tanners Breast developmental stages
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
Pubic hair developmental Tanner stages
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
Male genitals developmental Tanner stages
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
Factors affecting height
Familial short stature
Intrauterine growth retardation
Constitutional delay in growth and puberty (commonest reason underlying short stature consultations)
46
Pathological causes of short stature
Hypothyroidism (autoimmune)
Chronic disease (coeliac, crohn’s, cystic fibrosis)
Excess corticosteroids (Cushing syndrome common), (disease rare)
Deprivation (emotional)
Growth hormone deficiency
47
Ix of short stature
Record birth weight
Record both parental final heights – MPH (TPR)
Measure height velocity
48
True vs psuedo precocious puberty
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
Indication of true precocious puberty
Medical emergency
Suggestive of pituitary tumour in most boys (and some girls) with it
50
Congenital adrenal hyperplasia main cause
21 hydroxylase deficiency
51
21 hydroxylase deficiency genetics
autosomal recessive
52
Role of 21 hydroxylase
making aldosterone and cortisol
NOT REQUIRED FOR ANDROGENS
53
Pathophysiology of congenital adrenal hyperplasia
Cant produce cortisol
More ACTH is produced to make cortisol
but this higher level of ACTH leads to male androgen production
54
Congenital adrenal hyperplasia presentation in girls
- 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
Congenital adrenal hyperplasia presentation in boys
salt losing crisis at 6 weeks (Low Na, High K, Acidosis, Low glucose) due to low cortisol and aldosterone
56
Role of aldosterone
Absorb Na
Lose K
57
Less common presentation of adrenal congenital hyperplasia
simple virilising CAH
58
Turners syndrome sx
59
Hashimotos vs primary hypothyroid Ix
Both low T4 high TSH
Hashimotos ; positive thyroid peroxidase antibodies
60
Downs syndrome sx
Single palmar crease
Flat nasal gap
Sandal gap
Epicanthal fold (eyes)
61
Klinefelter's syndrome genetics
47 XXY
62
Klinefelter's syndrome phenotype
Male
atrophic testes
wide-set nipples
learning difficulty
