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BPT exams > General paediatrics > Flashcards

General paediatrics Flashcards

1
Q

Hearing test is indicated for OME if persistent for ____ months or ____

A

Persistent for more than 3mo or other risk factors (Trisomy 21)

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2
Q

When is grommets recommended for OME ?

A

Bilateral fluid in ears and hearing impairment

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3
Q

Pure tone audiometry is recommended in children above age _____

A

5 years

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4
Q

What is automated audiometry brainstem response and when is it used?

A

It is used to investigate newborns of concern or those that do not pass two OAE tests.

It involves measuring brainstem electrophysiological responses to click stimuli using electrodes placed on the scalp. This assesses hearing throughout the entire hearing pathway; form the external ear through to the brainstem

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5
Q

What age group is …

1) Visual reinforcement audiometry suitable for?
2) Conditioned play audiometry suitable for?

A

1) Visual reinforcement audiometry suitable for 9mo to 36mo

2) Conditioned play audiometry 2-5 yr

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6
Q

In POTS increase in HR by XX

A

In POTS increase in HR by 40bpm or >130bpm

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7
Q

How do you manage POTS?

A

1) Increase blood volume (fluid and salt intake)
2) Exercise (minimise deconditioning)
3) Compression stockings
4) Medication - Fludrocortisone, Beta blocker (no consensus on whether beta 1 selective better)
5) Social supports

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8
Q

Plasma ______ and _____ are the major factors affecting ESR

A

Fibrinogen and globulin (IVIG thus can lead to increased ESR levels)

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9
Q

____ of congenital torticollis is due to congenital muscular causes. Of these the majority are related to_______

A

82% due to congenital muscular causes.

Of these, the majority are related to sternocleidomastoid muscle mass - thickening of the SCM muscle and limitation of passive range of motion

Palpable “mass” in inferior 1/3 of affected SCM

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10
Q

Consider surgery for congenital torticolis if persistent after _____ months

A

If persistent after 6-12mo

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11
Q

Which craniosynostotic syndrome is commonly associated with cloverleaf skull deformity (premature closure or coronal, metopic and lambdoi)

A

Pfieffer Type 2

Other signs- severe hand and foot anomalies, limb malformations

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12
Q

Nasolacrimal duct obstruction is due to ____

A

Persistence of membrane at the distal valve of Hasner

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13
Q

_______ is a characteristic lab findings in chlamydia pneumonia

A

Eosinophilia

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14
Q

What are the major risk factors that indicate neuroimaging in children above 2yo post trauma?

A
  • Focal neurological findings
  • Skull fracture, especially findings of basillar fracture
  • Seizures
  • Persistent altered mental state (e.g. agitation, lethargy, repetitive questioning)
  • Prolonged LOC
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15
Q

SGH is between which layers?

A

Periosteum and aponeurosis

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16
Q

Moderate evidence of benefit that breastfeeding reduces_________

A

Moderate evidence - prevention of T1DM, IBD, recurrent OME and wheezing

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17
Q

In patients with ITP, the presence of _____ or ______ - identifies patient at increased risk fo ICH

A

Haematuria or head trauma

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18
Q

What is the rate of ITP following MMR vaccine (within 6 weeks)

A

1/25,000

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19
Q

What is the mechanism of action of Transexamic acid?

A

Binds to lysin receptor on plasminogen and inhibits plasmin activity

Plasmin normally cleaves fibrin into fibringogen (dissolves clot)

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20
Q

At what age do pupils start responding light?

At what age is colour perceived?

When do kids start to blink/squint?

A

Pupils - 30 weeks

Colour is perceived at 34 weeks (red first)

Blinking/squinting after premature birth - 26 weeks

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21
Q

When does suck and swallow reflex start?

When does rooting reflex start?

A

Swallow - 34 weeks

Rooting - 28 weeks

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22
Q

Peak crying for babies is?

A

Peak purple crying 6-8 weeks

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23
Q

First tooth comes around when?

A

First tooth 5-7 months

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24
Q

When should all 20 primary teeth be present?

A

30 months (2.5yr)

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25
Q

As per Erickson stages:

  • Adolescents?
  • Toddler?
  • School age?
A
  • Adolescent: Identity vs confusion
  • Toddler: Attachment vs Autonomy (early infancy)
  • School age: Initiative vs Industry
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26
Q

By what age should children be able to sit?

A

Usually by 6mo; but 9mo is a red flag

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27
Q

By what age do children normally crawl?

A

9mo

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28
Q

Children should typically walk by______

A

18mo

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29
Q

Kids should be able to transfer between hands by ________

A

6mo

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30
Q

Babbling by _______

A

9mo

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31
Q

Children should be able to scribble by _____

A

18months

32
Q

Tower of 3 cubes by _____

A

18months of age

33
Q

Draw a vertical line by _____

A

2 years of age

34
Q

Draw a circle by ______

A

3yo

35
Q

Draw a cross by _____

A

4y

36
Q

Draw a triangle by _____

A

5yo

37
Q

Speech should be understood by family by _____

Speech should be understood by strangers by _____

A

Family by 3y (3 word sentences, 3 primary colours)

Strangers by 4y (4 word sentences and name 4 colours) Also count to 5!

38
Q

Peekabo by ____

A

9mo (also stranger fear)

39
Q

Undress, feed doll, point by ____

A

18mo

40
Q

Wash hands, dry by day by ____

A

2yo (partially dress too)

41
Q

By age 3 most kids can do what (socially/personally)

A

Dress fully (50% can do button), brush teeth, interactive play

42
Q

When can kids wipe their bottom by?

A

4yo (also 90% can do buttons)

43
Q

When can kids start using fork typically?

A

3yo

Spoon by 2yo

44
Q

(Red flag)

If not rolling by _____

A

9months

45
Q

Handedness by ______

A

18-24months

46
Q

Global developmental delay is being behind in ___ or more milestones

A

Behind in 2 or more milestones

47
Q

___% of the population has intellectual disability

A

3% - characterised by IQ <70 (2SD below) AND adaptive functioning (need both)

48
Q

Most common screening tests for evaluating development?

Formal assessments to evaluate development?

Most common assessments for cognitive testing in younger kids

A

PEDS - screening
ADST - screening
ASQ - screening

Formal assessment:
- Bayley Scales of Infant development 0-3yo
(not good for predicting long term future intelligence)
- Griffiths Mental Developmental Scales 0-6yr)

Stanford-Binet Intelligence scale (in kids above 2) (evaluate IQ)
WPPSII (from preschool-7y) (better for cognition)
WISCS - generally above 7yo (better for cognition)

49
Q

Kids with NF1 may have developmental issues with______

A

ADHD

50
Q

Kids with Duchenne Dystrophy may have developmental issues related with_____

A

Verbal working memory

51
Q

What are the DSMV criteria for Autism spectrum disorder

Clue RNR + MRIS

A

Social communication (impairment in all three) :

1) Reciprocity - conversation, building on topics, asking questions
2) Non-Verbal communication - limited use
3) Relationships - difficulty making friends/peers, unimaginative play

Repetitive and restrictive behaviours (Need 2/4):

1) Motor - head hitting, vocalisations
2) Routine and rigidity
3) Interests - highly fixed
4) Sensitivities

Language and intellect separate

52
Q

3 Most common comorbidities with autism?

A

Anxiety, ADHD, Sleep issues

53
Q

Medical conditions Autism is related to?

A

Seizures, Fragile X syndrome, Tuberous sclerosis

54
Q

Prevalence of autism is 0.5%; what is the risk of a second child with autism?

A

5% chance

if you have two children with autism - 25% chance; MCDA twins - 65%

55
Q

Normal kid to 2-4yr, then regress to autism, quite severely.

Develop bowel and bladder issues….

A

Heller Dementia

56
Q

Prevalence of ADHD?

A

~5-10%

57
Q

What is the DSM V criteria for ADHD?

A

1) Inattentive ADHD - inattention in 6 of 9 symptoms
2) Hyperactive ADHD - 6 of 9 symptoms
3) Minimum 6 months
4) Some Sx present before 12y
5) Some impairment present in two or more settings
6) Clear evidence of impairment in school or functioning
7) Does not meet criteria for pervasive developmental disorder or other psych diagnsosis

58
Q

Most common comorbidities associated with ADHD?

A

Oppositional defiant disorder, conduct disorder (40%), learning disabilities (40%), and anxiety disorders

59
Q

4 common controversies associated with treatment for ADHD?

A

1) Cardiac - unexplained death
- if fam hx need ECHO/ECG but otherwise no significant concerns
2) 1-2 cm growth suppression
3) Drug abuse
- - actually reduced the chances of substance abuse
4) Cause tics

60
Q

First line stimulant for ADHD?

A

First try Ritalin short acting; can consider Long acting Ritalin if goes well ( Concerta)

Otherwise can try Dexemphetamine

61
Q

How do you differentiate Tourettes from Tics?

A

Tourrettes:

  • Multiple motor and one vocal tix
  • > 3mo and everyday
  • under 18y

+ Functional impact

62
Q

1st line treatment for Tics?

A

Haloperidol

63
Q

if one parent has had issues with eneuresis what are the chances the child will be affected?

A

60% (75% if both parents had been affected)

64
Q

Rough rule of sleep for babies to 6yr?

A

Babies sleep for 16 hours

birth - 6yr

65
Q

What is the TEN4FACES rule?

A

If these criteria are met, have clinical concern for abuse:

Bruising in TEN location (Torso, Ear, Neck) in child <4years-old
Any bruising in child <4-6months-old
Injury to FACES (Frenulum, Angle of jaw, Cheek, Eyelid, Sclera) in child of any age

66
Q

What are the five fractures that are highly suggestive of abuse?

A 
Classic metaphyseal lesions
Posterior rib fractures
Scapular fracture
Spinous process fracture
Sternal fracture
67
Q

First line treatment for catatonia?

A

Lorazepam

68
Q

First line treatment for bipolar disorder?

A

Atypical antipsychotic

69
Q

What IQ would be mild intellectual disability?

A

<70 is mild
<55 is moderate
<40 is severe

70
Q

Which disorder is related to ADHD?

A

ODD

71
Q

Which disorder is common in Autsim?

A

Anxiety

72
Q

What is the most common age for object permanence?

A

12 months

73
Q

What development is important for early infancy?

A

Early infancy - first 12 months -> secure attachment

74
Q

First line medication for tics?

A

Clonidine or Haloperidol

75
Q

What physiological changes would you note in REM sleep?

A

Decreased muscle tone, increased HR and increased HR

BPT exams (24 decks)

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