General paeds and psych Flashcards
When do the anterior and posterior fontanelles normally close
Ant-9-18 months
Post- 2 months
What is craniosynostosis?
Early fusion of the sutures
What is the most common non syndromic cause of craniosynostosis
What suture is involved
What does the head look like?
Scaphocephaly
Saggital suture
Long and thin with a prominent occupit
Anterior plagiocephaly
What is the shape of the head
What suture is involved
Asymmetrical
Prominent forehead and hear on the affected side
Coronal- one side
If both coronal sutures are fused what is the head shape called
Brachycephaly
Posterior plagiocephaly
What suture is involved
Head shape?
One lamboid suture
Flat back of the head on the affected side, ear moves back
prominent forehead on the other side
Trigonocephaly
What suture is involved
Meitopic
Multiple sutures fused- what are the two head shapes called
Turricephaly
Kleeblattschadel
Craniosynostosis syndromes
What is the usual inheritance
What gene is involved
What is the most common syndrome
AD
FGFR
Crouzon syndrome
Crouzon syndrome
What gene
Face shape
What syndrome is similar with syndactyly?
FGFR2
Brachycephaly with proptosis, maxillary hypoplasia and a beaked nose
Apert syndrome
Craniosynostosis syndromes
Which is involved with turricephaly
Gene
Hands
Pfeiffers syndrome
FGFR 1
Short, broad widely spaced fingers and toes
Craniosynostosis syndromes
Which is involved with a clover leaf skull
Inheritance
Carpenters
AR
Craniosynostosis syndromes Chotzen syndrome Inheritance and gene Facial shape Hands
AD TWIST gene
Asymmetrical plagiocephaly with ptosis
Some syndactyly
How big does your head have to be to call it macrocephalic?
> 3 SD from normal
CP
When is the insult most likely
Antenatal period
CP What is the most likely cause of Spastic Diplegia Spastic hemiplegia Extrapyramidal Which will have early hand preference
Prematurity- IVH and PVLM
neonatal stroke- has early hand preference
Kernicterus and asphyxia
Rett syndrome
Gene
Inheritance
Main characteristics
X linked dominant MCP2 Progressive microcephalaly Developmental regression Wringing movements of hands (autistic-like) Seizures Cyanotic episodes
Menkes kinky hair disease Inheritance Hair features Features at birth Characteristic blood test Features later in life
X linked recessive Thin friable silvery Hypothermic and hypotonic Low copper and caeruloplasmin GDD and optic atrophy
When do you develop handedness
2 years old
Development
What are the 4 main red flags for gross motor function
Asymmetry, persisting primitive reflexes, not sitting by 8months, not walking by 18m
Development
Outline the normal pattern of gross motor milestones
3m- head control when prone 4m- roll 6m- sit unsupported 9m- pull to stand and crawl 12m- walk 18m- run badly 2y- run well and jump 3- balance for 3s, throw and catch, tricycle 4- hop 5- balance for 6s and heel toe walk
Development
Outline the stages and ages for stairs
2- 2 feet for steps
3- alternate feet up
4- alternate feet down
Development When do the following primitive reflexes go away Placing Moro Palmar Rooting ATNR Landau Parachute
Placing-6w Palmar grasp- 3m Rooting and Moro-4m ATNR- 6m Landau-12m Parachute- never!
Development
Outline the normal pattern of fine motor development
3m- grasp 6m- transfer 9m- pincer 12m- throw and object into a cup 18m- scribble 2y- line, 6 block tower 3y- circle, 9 block tower 4y- square 5y- triangle person
