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FRACP > General paeds and psych > Flashcards

General paeds and psych Flashcards

1
Q

When do the anterior and posterior fontanelles normally close

A

Ant-9-18 months

Post- 2 months

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2
Q

What is craniosynostosis?

A

Early fusion of the sutures

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3
Q

What is the most common non syndromic cause of craniosynostosis
What suture is involved
What does the head look like?

A

Scaphocephaly
Saggital suture
Long and thin with a prominent occupit

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4
Q

Anterior plagiocephaly
What is the shape of the head
What suture is involved

A

Asymmetrical
Prominent forehead and hear on the affected side
Coronal- one side

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5
Q

If both coronal sutures are fused what is the head shape called

A

Brachycephaly

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6
Q

Posterior plagiocephaly
What suture is involved
Head shape?

A

One lamboid suture
Flat back of the head on the affected side, ear moves back
prominent forehead on the other side

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7
Q

Trigonocephaly

What suture is involved

A

Meitopic

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8
Q

Multiple sutures fused- what are the two head shapes called

A

Turricephaly

Kleeblattschadel

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9
Q

Craniosynostosis syndromes
What is the usual inheritance
What gene is involved
What is the most common syndrome

A

AD
FGFR
Crouzon syndrome

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10
Q

Crouzon syndrome
What gene
Face shape
What syndrome is similar with syndactyly?

A

FGFR2
Brachycephaly with proptosis, maxillary hypoplasia and a beaked nose
Apert syndrome

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11
Q

Craniosynostosis syndromes
Which is involved with turricephaly
Gene
Hands

A

Pfeiffers syndrome
FGFR 1
Short, broad widely spaced fingers and toes

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12
Q

Craniosynostosis syndromes
Which is involved with a clover leaf skull
Inheritance

A

Carpenters

AR

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13
Q 
Craniosynostosis syndromes 
Chotzen syndrome 
Inheritance and gene 
Facial shape 
Hands
A

AD TWIST gene
Asymmetrical plagiocephaly with ptosis
Some syndactyly

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14
Q

How big does your head have to be to call it macrocephalic?

A

> 3 SD from normal

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15
Q

CP

When is the insult most likely

A

Antenatal period

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16
Q 
CP
What is the most likely cause of 
Spastic Diplegia
Spastic hemiplegia 
Extrapyramidal
Which will have early hand preference
A

Prematurity- IVH and PVLM
neonatal stroke- has early hand preference
Kernicterus and asphyxia

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17
Q

Rett syndrome
Gene
Inheritance
Main characteristics

A 
X linked dominant
MCP2
Progressive microcephalaly
Developmental regression
Wringing movements of hands (autistic-like)
Seizures 
Cyanotic episodes
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18
Q 
Menkes kinky hair disease 
Inheritance 
Hair features 
Features at birth
Characteristic blood test
Features later in life
A 
X linked recessive 
Thin friable silvery 
Hypothermic and hypotonic 
Low copper and caeruloplasmin
GDD and optic atrophy
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19
Q

When do you develop handedness

A

2 years old

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20
Q

Development

What are the 4 main red flags for gross motor function

A

Asymmetry, persisting primitive reflexes, not sitting by 8months, not walking by 18m

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21
Q

Development

Outline the normal pattern of gross motor milestones

A 
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
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22
Q

Development

Outline the stages and ages for stairs

A

2- 2 feet for steps
3- alternate feet up
4- alternate feet down

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23
Q 
Development
When do the following primitive reflexes go away 
Placing
Moro 
Palmar
Rooting 
ATNR
Landau 
Parachute
A 
Placing-6w
Palmar grasp- 3m
Rooting and Moro-4m
ATNR- 6m
Landau-12m
Parachute- never!
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24
Q

Development

Outline the normal pattern of fine motor development

A 
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
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25
Q

What are 3 red flags for fine motor function?

A

No transferring at 7m
Early hand preference
No ADLs at 4

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26
Q

Outline the normal pattern of speech development

A 
3m- coos 
9m- babbles
12m first words 
2- 5-20 words, two word sentences
3- 50-200 words, three word sentences, 3 colours. Understood by family only 
4- 4 colours, understood by a stranger
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27
Q

What are red flags for speech development

A

No words other than mama/dada by 18m
Not understood by family at 3/strangers at 4
<20 words at 2

28
Q

Outline normal social development

A 
6w- social smile 
9m- stranger danger, peek a boo
12m- points waves 
18m- undress
2y- partially dress, tantrums, 
3y- fully dress, role play, brush teeth
4y- fantasy play, wipe bum 
5y- friends, tie shoes
29
Q

Outline ages and stages for feeding

A

Cup- 18m
Spoon-2
Knife-3
Knife and fork-4

30
Q

From when can you use a snellen chart

What is used before then?

A

6 years

Red reflexes and picture charts

31
Q 
What hearing screening tests can be used for 
Up to 6m
Up to 2 years 
2-5 years 
5 years plus
A

OAE or ABRs
Visual reinforced hearing
Play audiometery
Pure tone audiometry

32
Q

When does crying peak and resolve

A

6 weeks- 3 hrs a day

4 months

33
Q

How long does a normal 1 month old and 5year old sleep for

A

1m 16 hrs

5yrs 11 hrs

34
Q

When does object permanence start

A

9 months

35
Q

When will a child repetitively search for a hidden object

A

18m-2y

36
Q

What are the 4 criteria in DSM to diagnose autism

A

Impaired social communication and interaction
Early developmental period
Impairs school/ social settings
Restrictive or repetitive behaviours

37
Q

Is ID a criteria to diagnose autism

A

No!

38
Q

Hearing loss syndromes
Give 2 AD causes
Give 4 AR causes
Give one feature of each

A

Waardenburg- hair and skin hypopigmentation and brachio oto renal- absent kidneys and radius

Usher- blindness
Pendred- hypothyroid
Jervel Lange Nelson- QT long
Connexin 26- commonest

39
Q

What percentage of 5 year olds are dry at night
10 years
What is the first line treatment for nocturnal enuresis
What is second line and how does it work

A

85%
95%
Bed wetting alarms and desmopressin
Oxybutinin- works for overactive bladders- ACH blocker so relaxes smooth muscle

40
Q

How many calories are seen in 100mls of standard formula?

A

Around 280

41
Q

What are the main side effects of cyclosporine

A

Gum hyperplasia and hirsuitism

42
Q

What are the main side effects of tacrolimus

A

Alopecia, low Mg and diabetes

43
Q

What is first line treatment for Tourette’s syndrome

A

Haloperidol

44
Q

What are the first teeth to erupt normally
When
What is delayed

A

Lower central incisors
6-12 months
>6m beyond normal

45
Q

What is the most common hymen shape in pre pubertal girls
“Post pubertal
What is most indicative of abuse

A

Crescentic
Fimbrated
V shaped indent at 5oclock

46
Q

What does purchaser retinopathy correlate to

What is the best test for abdominal trauma initially

A

Chest wall trauma

Transaminases

47
Q

What percentage of infants never crawl

A

4%

48
Q

What is the autism risk of one sibling is affected

“2 or twins

A

10%

50-60%

49
Q

What percentage of autistic children have
Low IQ
ADHD

A

50% both

50
Q

What screen may pick up concerns of autism

What is the best screening test

A

Ages and stages

ADOS

51
Q

What are 2 general screens for developmental delay and when are they used
What is used to test for low IQ over 6. What else needs to be tested

A

Baileys- up to 3
Griffiths- up to 8
Wechsler- also need to check their reading ability

52
Q

What is the best measure of outcome in autism

What might be useful for stereotyped behaviours? Anxiety?

A

Speech at 5
Haloperidol
SSRIs

53
Q

What percentage of ADHD have ODD and anxiety

How is ODD treated

A

30% of each

Parent management training

54
Q

What are 2 screens for ADHD

A

Connors

SNAP 4

55
Q

How does methylphenidate work? Does it change final height?

What might be used for tics

A

Blocks dopamine and NE reuptake
Yes only slightly
Clonidine

56
Q

What are examples of SSRIs
What are the three main side effects
If doses are altered or meds are changed what are they at risk of

A

Fluoxetine/paroxetine
Gi, wild dreams and increased suicidal ideation.
Serotonin syndrome

57
Q

What is the main side effect of TCAs

A

Weight gain

QT prolonging

58
Q

NAI
when should a skeletal survey be repeated
What is the best modality of Neuro imaging

A

2 weeks

CT

59
Q

What is the most suspicious fracture in NAI

what are 3 others

A

Metaphyseal corner fractures

Post ribs, scapula, sternal

60
Q

What are the three DSM criteria for anorexia

What are the 2 sub types

A

Fear of being overweight
Reduced intake
Distorted perception of body image

Bulimia or restrictive

61
Q

What are three DSM criteria for bulimia

A

Bing eating
Compensating- vomiting/exercise/diuretics
At least weekly for 3m

62
Q

What is the schizophrenia risk

  • 1 parent or sibling affected
  • twins or both parents
A

10%

50%

63
Q

What meds are used first in gender reassignment

A

Puberty blockers- gnrh agonists

64
Q

What are three risks of oestrogen treatment for feminisation

A

Cardiovascular
Prolactinaemia
Hypercoagulability

65
Q

What are three side effects for masculinising therapy with testosterone

Which prerecording conditions can it worsen?

A

Acne and hair loss
Cardiovascular
Hyperlipidaemia

Mania and schizophrenia

66
Q

Are most AEDs safe with the COCP?

Which contraceptive method may not be safe

A

Yes!

Implants

67
Q

What is the treatment for
Chlamydia
Gonorrhoea

A

Azithromycin one off

IM ceftriaxone or cipro AND azithromycin

FRACP (23 decks)

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