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4th year passmedicine by topic > Growth & Development > Flashcards

Growth & Development Flashcards

1
Q

Developmental milestones: gross motor

3 months

A

Little or no head lag on being pulled to sit
Lying on abdomen, good head control
Held sitting, lumbar curve

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2
Q

Developmental milestones: gross motor

6 months

A 
Lying on abdomen, arms extended
Lying on back, lifts and grasps feet
Pulls self to sitting
Held sitting, back straight
Rolls front to back
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3
Q

Developmental milestones: gross motor

7-8 months

A

Sits without support (Refer at 12 months)

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4
Q

Developmental milestones: gross motor

9 months

A

Pulls to standing

Crawls

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5
Q

Developmental milestones: gross motor

12 months

A

Cruises

Walks with one hand held

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6
Q

Developmental milestones: gross motor

13-15 months

A

Walks unsupported (Refer at 18 months)

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7
Q

Developmental milestones: gross motor

18 months

A

Squats to pick up a toy

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8
Q

Developmental milestones: gross motor

2 years

A

Runs

Walks upstairs and downstairs holding on to rail

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9
Q

Developmental milestones: gross motor

3 years

A

Rides a tricycle using pedals

Walks up stairs without holding on to rail

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10
Q

Developmental milestones: gross motor

4 years

A

Hops on one leg

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11
Q

Developmental milestones: fine motor and vision

3 months

A

Reaches for object
Holds rattle briefly if given to hand
Visually alert, particularly human faces
Fixes and follows to 180 degrees

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12
Q

Developmental milestones: fine motor and vision

6 months

A

Holds in palmar grasp
Pass objects from one hand to another
Visually insatiable, looking around in every direction

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13
Q

Developmental milestones: fine motor and vision

9 months

A

Points with finger

Early pincer

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14
Q

Developmental milestones: fine motor and vision

12 months

A

Good pincer grip

Bangs toys together

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15
Q

Developmental milestones: fine motor and vision

building bricks

A

15 months Tower of 2
18 months Tower of 3
2 years Tower of 6
3 years Tower of 9

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16
Q

Developmental milestones: fine motor and vision

drawing milestones

A 
18 months	Circular scribble
2 years	Copies vertical line
3 years	Copies circle
4 years	Copies cross
5 years	Copies square and triangle
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17
Q

Developmental milestones: fine motor and vision

book milestones

A

15 months Looks at book, pats page
18 months Turns pages, several at time
2 years Turns pages, one at time

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18
Q

hand preference before ?months is abnormal and may indicate cerebral palsy

A

hand preference before 12 months is abnormal and may indicate cerebral palsy

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19
Q

Developmental milestones: speech and hearing

3 months

A

Quietens to parents voice
Turns towards sound
Squeals

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20
Q

Developmental milestones: speech and hearing

6 months

A

Double syllables ‘adah’, ‘erleh’

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21
Q

Developmental milestones: speech and hearing

9 months

A

Says ‘mama’ and ‘dada’

Understands ‘no’

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22
Q

Developmental milestones: speech and hearing

12 months

A

Knows and responds to own name

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23
Q

Developmental milestones: speech and hearing

12-15 months

A

Knows about 2-6 words (Refer at 18 months)

Understands simple commands - ‘give it to mummy’

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24
Q

Developmental milestones: speech and hearing

2 years

A

Combine two words

Points to parts of the body

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25
Q

Developmental milestones: speech and hearing

2½ years

A

Vocabulary of 200 words

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26
Q

Developmental milestones: speech and hearing

3 years

A

Talks in short sentences (e.g. 3-5 words)
Asks ‘what’ and ‘who’ questions
Identifies colours
Counts to 10 (little appreciation of numbers though)

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27
Q

Developmental milestones: speech and hearing

4 years

A

Asks ‘why’, ‘when’ and ‘how’ questions

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28
Q

Developmental milestones: social behaviour and play

A 
6 weeks	Smiles (Refer at 10 weeks)
3 months	Laughs
Enjoys friendly handling
6 months	Not shy
9 months	Shy
Takes everything to mouth
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29
Q

Feeding milestones

A

May put hand on bottle when being fed 6 months
Drinks from cup + uses spoon, develops over 3 month period 12 -15 months
Competent with spoon, doesn’t spill with cup 2 years
Uses spoon and fork 3 years
Uses knife and fork 5 years

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30
Q

Dressing milestones

A

Helps getting dressed/undressed 12-15 months
Takes off shoes, hat but unable to replace 18 months
Puts on hat and shoes 2 years
Can dress and undress independently except for laces and buttons 4 years

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31
Q

Play milestones

A 
Plays 'peek-a-boo'	9 months
Waves 'bye-bye'
Plays 'pat-a-cake'	12 months
Plays contentedly alone	18 months
Plays near others, not with them	2 years
Plays with other children	4 years
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32
Q

Development problems - Referral points

A

doesn’t smile at 10 weeks
cannot sit unsupported at 12 months
cannot walk at 18 months

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33
Q

Gross motor problems

most common causes of problems:

A

variant of normal, cerebral palsy and neuromuscular disorders (e.g. Duchenne muscular dystrophy)

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34
Q

Speech and language problems - always check?

A

always check hearing

other causes include environmental deprivation and general development delay

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35
Q

General contraindications to immunisation

A

confirmed anaphylactic reaction to a previous dose of a vaccine containing the same antigens
confirmed anaphylactic reaction to another component contained in the relevant vaccine (e.g. egg protein)

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36
Q

Situations where vaccines should be delayed

A

febrile illness/intercurrent infection

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37
Q

Contraindications to live vaccines

A

pregnancy

immunosuppression

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38
Q

DTP: vaccination should be deferred in children with

A

an evolving or unstable neurological condition

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39
Q

Immunisation schedule

At birth

A

BCG if risk factors
At birth the BCG vaccine should be given if the baby is deemed at risk of tuberculosis (e.g. Tuberculosis in the family in the past 6 months).

40
Q

Immunisation schedule

2 months

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
Men B

41
Q

Immunisation schedule

3 months*

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
PCV

42
Q

Immunisation schedule

4 months

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Men B

43
Q

Immunisation schedule

12-13 months

A

Hib/Men C
MMR
PCV
Men B

44
Q

Immunisation schedule

2-8 years

A

Flu vaccine (annual)

45
Q

Immunisation schedule

3-4 years

A

‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio)
MMR

46
Q

Immunisation schedule

12-13 years

A

HPV vaccination

47
Q

Immunisation schedule

13-18 years

A

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)

Men ACWY

48
Q

Children in the UK receive two doses of the Measles, Mumps and Rubella (MMR) vaccine before entry to primary school. This currently occurs at

A

12-15 months and 3-4 years as part of the routine immunisation schedule

49
Q

Contraindications to MMR

A

severe immunosuppression
allergy to neomycin
children who have received another live vaccine by injection within 4 weeks

immunoglobulin therapy within the past 3 months

50
Q

MMR pregnancy should be avoided for at least ?month following vaccination

A

pregnancy should be avoided for at least 1 month following vaccination

51
Q

Adverse effects MMR

A

malaise, fever and rash may occur after the first dose of MMR. This typically occurs after 5-10 days and lasts around 2-3 days

52
Q

Normal changes in puberty

A

gynaecomastia may develop in boys
asymmetrical breast growth may occur in girls
diffuse enlargement of the thyroid gland may be seen

53
Q

Males

first sign is testicular growth at

A

around 12 years of age (range = 10-15 years)

54
Q

Testicular volume ?ml indicates onset of puberty

A

esticular volume > 4 ml indicates onset of puberty

55
Q

Males maximum height spurt at ?yrs

A

maximum height spurt at 14

56
Q

first sign is breast development at around ?years

A

11.5 years of age (range = 9-13 years)

57
Q

Females height spurt

A

reaches its maximum early in puberty (at 12) , before menarche

58
Q

Females menarche at

A

13 (11-15)

59
Q

factors which point towards child abuse include:

A

story inconsistent with injuries
repeated attendances at A&E departments
late presentation
child with a frightened, withdrawn appearance - ‘frozen watchfulness’

60
Q

Possible physical presentations of child abuse - fractures

A

particularly metaphyseal, posterior rib fractures or multiple fractures at different stages of healing

61
Q

Possible physical presentations of child abuse include sexually transmitted infections e.g. Chlamydia, Gonorrhoea, Trichomonas

A

true

62
Q

Possible physical presentations of child abuse include torn frenulum: e.g. from forcing a bottle into a child’s mouth

A

true

63
Q

Neglect comes under the umbrella of abuse and includes things like Failure to seek medical advice which compromises the child’s health
Child who is persistently smelly and dirty

A

true

64
Q

adults often do not believe children’s allegations of abuse

A

true

65
Q

Sexual abuse higher incidence in children with

A

special educational needs

66
Q

Features which may be present in a sexually abused child include sexually precocious behaviour

A

true

67
Q

Features which may be present in a sexually abused child include enuresis and encopresis

A

true

68
Q

Features which may be present in a sexually abused child include recurrent symptoms e.g. headaches, abdominal pain

A

true

69
Q

Child health surveillance - antenatal

A

Ensure intrauterine growth
Check for maternal infections e.g. HIV
Ultrasound scan for fetal abnormalities
Blood tests for Neural Tube Defects

70
Q

Child health surveillance - Newborn

A

Clinical examination of newborn
Newborn Hearing Screening Programme e.g. oto-acoustic emissions test
Give mother Personal Child Health Record

71
Q

Child health surveillance - GP examines baby ? weeks after birth?

A

6-8 weeks

72
Q

Heel-prick test occurs when?

A

day 5-9

73
Q

Heel-prick test covers?

A

hypothyroidism, PKU, metabolic diseases, cystic fibrosis, medium-chain acyl Co-A dehydrogenase deficiency (MCADD)

74
Q

meningitis B has now been added to the routine NHS immunisation.

Three doses are now given at:

A

2 months
4 months
12-13 months

75
Q

Otoacoustic emission test is performed on newborns

A

True

A computer generated click is played through a small earpiece. The presence of a soft echo indicates a healthy cochlea

76
Q

Distraction test is a hearing test for newborns and infants

A

false

for 6-9 months

77
Q

Auditory Brainstem Response test is routinely performed on newborns and infants

A

false

May be done if otoacoustic emission test is abnormal

78
Q

Hearing test for 18 months - 2.5 years comprises of?

A

Recognition of familiar objects Uses familiar objects e.g. teddy, cup. Ask child simple questions - e.g. ‘where is the teddy?’

79
Q

Which hearing test is Done at school entry in most areas of the UK

A

Pure tone audiometry

80
Q

Obesity in children consider tailored clinical intervention if BMI

A

91st centile or above

81
Q

Obesity in children consider assessing for comorbidities if

A

BMI at 98th centile or above

82
Q

Asian children: four times more likely to be obese than white children

A

true

83
Q

obesity more common in male children

A

false

female

84
Q

taller children: children with obesity are often above the ?th percentile in height

A

taller children: children with obesity are often above the 50th percentile in height

85
Q

Cause of obesity in children

A 
growth hormone deficiency
hypothyroidism
Down's syndrome
Cushing's syndrome
Prader-Willi syndrome
86
Q

Consequences of obesity in children

orthopaedic problems

A

slipped upper femoral epiphyses, Blount’s disease (a development abnormality of the tibia resulting in bowing of the legs), musculoskeletal pains

87
Q

Consequences of obesity in children

A 
orthopaedic problems
psychological consequences
sleep apnoea
benign intracranial hypertension
long-term consequences
88
Q

Precocious puberty

Definition

A

‘development of secondary sexual characteristics before 8 years in females and 9 years in males’

89
Q

thelarche is

A

the first stage of breast development

90
Q

adrenarche is

A

the first stage of pubic hair development

91
Q

Precocious puberty - FSH & LH raised suggests?

A 
Gonadotrophin dependent ('central', 'true') cause
due to premature activation of the hypothalamic-pituitary-gonadal axis
92
Q

Precocious puberty - FSH & LH lowered suggests?

A 
Gonadotrophin independent ('pseudo', 'false')
due to excess sex hormones
93
Q

Precocious puberty - in males gonadotrophin release from intracranial lesion presents with?

A

bilateral enlargement of testes

94
Q

Precocious puberty - in males gonadal tumour presents with?

A

unilateral enlargement of testes

95
Q

Precocious puberty - in males adrenal cause (tumour or adrenal hyperplasia)
presents with?

A

small testes

4th year passmedicine by topic (96 decks)

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