Developmental/Neuro Flashcards
What are the GROSS motor 2 month milestones?
- Lifts head to 45 degree angle
- Equal movements
- Can hold head up and begin to push when lying on tummy
What are the FINE motor 2 month milestones?
- Follow past midline
2. Makes smoother movements with arms and legs
What are the language 2 month milestones?
- Coos
- Makes gurgling sounds
- Turns head towards sounds
- Squeals, laughs, responds to bell
What are the GROSS motor 4 month milestones?
- Rolls over front to back
- Bears weight on legs
- Sits with support
What are the FINE motor 4 month milestones?
- Brings hand to mouth
2. Grasps objects
What are the language 4 month milestones?
- Babbles with expression and copies sounds he hears
2. Begins to babble/makes raspberry sounds
What are the gross motor 6 month milestones?
- Rolls over in both directions
2. Begins to sit without support
What are the fine motor 6 month milestones?
- Brings hand to mouth
What are the language 6 month milestones?
- Responds to sounds by making sounds
2. Begins to say consonants “ma ma; da da”
What are the GROSS motor 9 month milestones?
- Pulls to stand
2. Crawl
What are the FINE motor 9 month milestones?
- Thumb/finger grasp–immature pincer
What are the language 9 month milestones?
- Understands “no”
- Makes a lot of different sounds
- Uses fingers to point
What are the GROSS motor 12 month milestones?
- Pulls up to stand, walks holding on to furniture
2. May stand alone
What are the FINE motor 12 month milestones?
- STARTS to scribble
2. Mature pincer
What are the language 12 month milestones?
- Uses simple gestures, like shaking head “no” or waving “bye bye”
- Says “mama” and “dada” and “uh oh”
What are the GROSS motor 18 month milestones?
- Walks alone
What are the FINE motor 18 month milestones?
- Can help undress
- Drinks from a cup
- Eats with a spoon
What are the language 18 month milestones?
- Says 4-20 single words
What are the GROSS motor 24 month milestones?
- Walks up and down stairs holding on
What are the FINE motor 24 month milestones?
- Makes or copies straight lines and circles
What are the language 24 month milestones?
- Points to things or pictures when they are named
- Knows the names of familiar people and body parts
- Says sentences with 2-4 words
What are the GROSS motor 36 month/3 year milestones?
- Walks up and down stairs one foot on each step
What are the FINE motor 36 month/3 year milestones?
- Copy circle
What are the language 36 month/3 year milestones?
- Says name, age, and sex
2. Talks well enough for stranger to understand most of the time
What are the GROSS motor 4 year milestones?
- Hops and stands
What are the FINE motor 4 year milestones?
- Scribbles*
2. Able to draw a circle
What are the language 4 year milestones?
- Can say first and last name
2. Knows basic grammar
What is abnormal language for a 4 year old?
- Doesn’t use “me” and “you” correctly
2. Doesn’t understand same vs different
What is normal speech for a 5 year old?
- Says name and address
2. Speaks clearly
What vaccines are given at 11 years old?
- Meningitis
- TDAP
- Influenza
What are the contraindications for vaccines?
- Egg allergies
- Encephalopathy within 7 days of TDAP
- Live vaccines in pregnant and immunocompromised
- Severely ill/ fever higher than 99 degrees
When does teething begin?
Begins 4-7 months
When do children start losing their teeth?
Around 7 years old (1st or 2nd grade)
After losing their teeth, when do the new permanents come in?
4-6 months later
What is the MC neurologic disorder of infants and young children?
Febrile seizures
What are Febrile seizures?
generalized seizures lasting less than 15 min and not recurring within 24 hr period WHILE having a temperature HIGHER than 100.4
What group of people does Febrile seizures affect most?
< 6 mo but >5 y/o
How do you manage Febrile seizures?
Manage the fever with Ibuprofen and Acetomentophen
Which infectious diseases are most often associated with with Febrile seizures?
- HH6 (Roseola Infantatum)
2. Influenza
First time seizures warrant which diagnostic studies?
- Head CT
- EEG
- Serial neuro exams
What is the preferred tx for seizures?
- Levetiracetam (Keppra)
Which seizure tx can cause hepatoxicity?
Carbamazepine (Tegretol)
Which seizure tx can cause gingival hyperplasia?
Phenytoin (Dilantin)
Which seizure tx can cause thrombocytopenia?
Valproic acid (Depakote)
Which seizure has a sudden loss of consciousness w/o aura; along with +/- biting; incontinence, and is usually followed by an octal phase with decreased LOC?
Tonic Conic seizures
Explain the TONIC phase of Tonic Clonic seizures.
Rigidity
Respiration stops; lasts < 1 min
Explain the CLONIC phase of Tonic Clonic seizures.
Jerking, lasts 2-3 min, followed by flaccid LOC
Which seizure has a sudden loss of consciousness with no loss of postural tone; where the child looks confused and withdrawn; the child may stare with only a twitching of the eyes and unresponsive; the seizure stops abruptly with no postictal phase?
Absence; Petit Mal
What is the difference between a partial and complex seizure?
Partial: remain localized and consciousness/mentation are not affected
Complex: cause a loss of consciousness or alteration in mentation
How does a Partial seizure present?
- Activity and thus sxs DO NOT CROSS the midline
- Unilateral tonic-clonic movements
- Sensory hallucinations (paresthesias and numbness)
- Visual distortions
- Olfactory or gustatory hallucinations
How does a Complex-partial seizure present?
- Activity does cross midline
- Automatisms
- Visceral sxs (“butterflies” in the tummy)
- Hallucinations
- Affective sxs (fear, paranoia, depression, elation/ecstasy)
What is the tx for Status Epilepticus?
Tx must begin w/in 5-10 min of activity
Intubate
Manage glucose level
Diazepam/lorazepam/Phenytoin/Keppra/Valproic acid/ and stat neurology consult
What is the treatment of Meningitis?
Neonate: Ampicillin and Gentamicin
> 1 month: Vancomycin and Rocephin
*Can also give Dexamethasone, esp in Hib meningitis
What special tests are used during PE for Meningitis?
Kernig and Brudzinski’s
<5% of kids have +
How do you diagnose Meningitis?
LP
-should be drawn before abx have been started
Petechiae and pupura are presenting sxs of which meningitis?
Meningococcal meningitis
What is the most common bacterial pathogen for neonates?
GBS and Gram negative entero-bacilli
What is the most common bacterial pathogen for infants and young children?
S. pneumo
N. meningitis
HiB
What is the most common bacterial pathogen for children >5 y/o?
S. pneumo
N. meningitis
how would an infant present with meningitis?
- Fever only
- Irritability
- Lethargy
- Difficulty feeding
- Apnea
- Seizures
- Bulging fontanelle
- Non-specific rash
How many chromosomes do Down’s syndrome patients possess?
47
How much are Down’s patients developmentally delayed?
3-6 months
How is screening done for Down’s patients?
Triple screening at 15-20 weeks
U/S for Nuchal translucency at 11-13 weeks
What genetic defect occurs in Turner’s patients?
Females with only one X (45X)
A female patient with a broad, webbed neck with short stature and a wide chest enters the office. You notice multiple nevi as well while obtaining the hx. Her complaint is amenorrhea. Based on this, what is your diagnosis?
Turners syndrome
A female patient with a broad, webbed neck with short stature and a wide chest enters the office. You notice multiple nevi as well while obtaining the hx. Her complaint is amenorrhea. Based on this, what is the best management?
Growth hormone
Estrogen therapy
Counseling
