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Pediatrics_Dr. Liu > Lec 1. Development > Flashcards

Lec 1. Development Flashcards

1
Q

When is the Germinal Period?

A

conception - 2 weeks

  • chromosomes duplicate: normally 46 chromosomes (23 from the sperm, 23 from the egg)
  • mitosis takes place eventually forming a clustered hollow, ball of cells (blastocyst) that becomes embedded in the uterine wall.
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2
Q

When is the embryonic period?

A

Weeks 3-8

  • Zygote becomes firmly embedded in the uterine wall, now known as an embryo
  • Rapid cell division and differentiation occur with cells developing into organs and body structures (organogenesis)
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3
Q

What is the Amniotic sac for?

A

protects embryo from damage from bumping and minimizes temperature changes.

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4
Q

How long is the Fetal Period?

A

weeks 9 to birth

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5
Q

Fetus becomes responsive to stimuli after ___ weeks.

A

10

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6
Q

By ___ month, mother can feel movement.

A

5th

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7
Q

By ___ months, can suck thumb/ hand and eyes can open and close.

A

7

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8
Q

By which month, the fetus has a good chance of suriving even if it’s early birth?

A

7th month or later

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9
Q

Fetal alcohol spectrum disorders (FASD) affects up to __ % of the U.S. populatio.

A

1

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10
Q

What are the physical findings with FASD?

A

growth retardation for height and weight; abnormal facial feature.

  • small head
  • low nasal bridge
  • epicanthal folds
  • small eye openings
  • short nose
  • thin upper lip
  • flat midface
  • smooth philtrum
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11
Q

What are the CNS dysfunction with FASD?

A

mental retardation; microcephaly; hyperactivity; learning and/or developmental disabilities.

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12
Q

What are the possible ocular anomalies of FASD?

A
  • optic nerve hypoplasia
  • Coloboma
  • Micro-cornea
  • Cataract
  • High refractive error
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13
Q

What are the infectious agents during pregnancy?

A
  1. Rubella
  2. Chicken pox (varicella) and Fifth Disease (parvovirus B19)
  3. Cytomegalovirus (CMV)
  4. Toxoplasmosis
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14
Q

When is rubella infection happens and how can rubella affect the baby?

A

Infection in 1st trimester results in deafness, mental retardation, cataracts and retinopathy

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15
Q

What can infection of Chickenpox and Fifth Disease affect the baby?

A

Exposure in the first half of pregnancy can result in birth defects including chorioretinitis and cataract.

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16
Q

What can infection of Cytomegalovirus (CMV) do to babies?

A

It increase risk for low birth weight (LBW), neurological problems and chorioretinal lesions.

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17
Q

What can infection of Toxoplasmosis do to babies?

A

If the infection is early, it can produce more severe involvements.
In the eyes, it can cause chorioretinal lesions (Cytomegalovirus also cause this), optic atrophy, cataract (rubella and chickenpox also cause this) and strabismus.

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18
Q

What are the Maternal Metabolic Disorders that can affect the baby?

A
  1. Thyroid disease
  2. Diabetes
  3. Nutrition
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19
Q

What can poor control of the mom’s Thyroid disease do her unborn baby?

A

Poor control can lead to decreased birth weight, mild cognitive impairment, congenital malformation and fetal death.

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20
Q

What can poor glucose control of the mom’s Diabetes do her unborn baby?

A
  • abnormal iris vasculature that resolves spontaneously 2 weeks after birth, sectoral optic nerve hypoplasia.
  • increases risk for increased fetal size, C-section and congenital anomalies.
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21
Q

What can poor nutrition do to the unborn baby?

A
  • LBW

- inadequate folic acid can lead to premature birth and neural tube defects

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22
Q

What can Preeclampsia/ Toxemia of pregnancy do to the unborn baby?

A
  1. Asymptomatic hypertention, proteinuria and diffuse edema in 2nd half of pregnancy.
  2. Infant may have retinopathy of prematurity (ROP), vascular changes, CWS, dot and blot hemorrhage and optic nerve head pallor
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23
Q

Tobacco exposue to the unborrn baby can cause what?

A

_Nicotine and carbon monoxide are vasoconstrictors that reduce blood flow to fetus
- this can increase risks for spontaneous abortion, preterm delivery, low birth weight (LBW) and sudden infant death syndrome (SIDS)

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24
Q

Drug exposure to the unborn baby can cause what?

A
  • High risk for prematurity, neurological and learning problems
  • Oculomotor problems, optic nerve anomalies and ROP.
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25
Q

Normal gestation is ____ weeks
Average birth weight is ____ lbs
Average length is ____ inches

A

40
7.5
18

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26
Q

What is the Apgar Scoring?

A

It’s to evaluate the infant’s physical condition, 1 and 5 mins, after birth.

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27
Q

In the Apgar Scoring, ___ % of children score 7 or above.

A

90

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28
Q

Scoring 4-6 indicate child may need what?

A

some assistance breathing

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29
Q

Scoring 1-3 indicate child may need what?

A

prompt lifesaving measures are needed

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30
Q

What are the different things doctors look for in the Apgar Scoring?

A

Heart rate, respiratory effort, muscle tone, color, and reflex irritability.

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31
Q

Infants born before ___ weeks is considered premature.

A

37

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32
Q

Low birthweight is ____ lbs.
Very low birthweight is ___ lbs.
Extremely low birthweight is ___ lbs.

A
  1. 5 - 3.3

3. 4 - 2.2

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33
Q

at ___ lbs, the baby has low chance of surival, high risk of neurologic, lung and other problem if they survive.

A

1.5

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34
Q

What is the general guidelines for birth weight over the course of a year?

A

doubled by 5 months and tripled by 1 year of age

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35
Q

What is the general guideline for height by 1 year of age?

A

50% increase in height by 1 year

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36
Q

Gross Motor is the control of _____ muscles, and Fine Motor is the control of _____ muscles.

A

large, small

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37
Q

During baby’s 5 months Early Motor Milestones, the baby can do what?

A

Rolls over one way, imprecise reaching for objects

38
Q

During baby’s 5-8 months Early Motor Milestones, the baby can do what?

A

Sits alone, creeping, grasps and manipulates

39
Q

During baby’s 8-10 months Early Motor Milestones, the baby can do what?

A

Crawling, standing up holding furniture, cruising

40
Q

During baby’s 1 year Early Motor Milestones, the baby can do what?

A

Standing, walking holding adults hands

41
Q

During baby’s 15 months Early Motor Milestones, the baby can do what?

A

Walking, throws objects, holds spoons, turns book pages, can build 2 block tower

42
Q

During baby’s 2 year Early Motor Milestones, the baby can do what?

A

Jumps, runs, kicks, climbs stairs, scribbles, builds 6 block tower, eat by themselves, most children have chosen a dominant hand

43
Q

During baby’s 3 year Early Motor Milestones, the baby can do what?

A

Hops 2 or 3 steps, throws a ball 10 feet, zippers and buttons, draws circle

44
Q

During baby’s 5 year Early Motor Milestones, the baby can do what?

A

Copy circle, cross square and triangle, mature pencil grip

45
Q

In baby’s Normal Cognitive Development, When is the Sensoimotor Stage?

A

birth to 2 years.

  • child’s thinking is limited to direct experiences and actions
  • not able to create symbols to represent an object/activity
  • object permanence by 18 months
46
Q

In baby’s Normal cognitive development, When is the Preoperational Stage?

A

2-7 years

  • symbol formation (ex. language)
  • concepts of time, space and quantity
  • classifies objects into categories
  • egocentric (inability to take another person’s perspective)
47
Q

In baby’s Normal Cognitive Development, When is the Concrete Operations Stage?

A

7-11 years

  • can conceive how objects change, not just how they appear at different times
  • can reverse thinking (smallest to largest as well as larest to smallest)
  • ability to shift to another perspective or see thinks from a view other than one’s own (decentration)
48
Q

In baby’s Normal Cognitive Development, When is the Formal Operations Stage?

A

11 years on

  • Stage of abstract thought
    • can reflect on their own thoughts
    • can consider several explanations for same event
  • Some people never reach this stage
49
Q

During what month, the baby can recognize familiar faces?

A

4-5

50
Q

During when can the baby have a sense of self, attachment to caregivers, anxiety about strangers?

A

6-12

51
Q

During when can the baby separate anxiety?

A

1 year

52
Q

During when can the kid be self-reliance, toilet trained, temper tantrums?

A

2 years

53
Q

During when can the kid have impulse control, sense of what is appropriate?

A

5 years

54
Q

During when can the kid sense of competence/success, builds loyal friendships, tics developed, obsessive behavior?

A

6-12 years

55
Q

During ___ months, the baby is babbling, sounds develop meaning.

A

4

56
Q

During ___ months, the baby responds to emotional overtones in speech, combines vowel sounds with single consonant sounds, imitates adult.

A

7

57
Q

During ___ year, the kid can recognize names, common words and single words.

A

1

58
Q

During ___ years, the kid knows 50 vocabulary, combines 2-3 words.

A

2

59
Q

During ___ years, the kid knows about 900 word vocabulary, 3-5 word sentences.

A

3

60
Q

During ___ years, the kid’s fluent in spoken language, can hold elaborate conversations.

A

7

61
Q

VA measured by VEP (visual evoked potential) reaches adult levels by agej of ____.

A

6 months

62
Q

VA measured by FPL (forced choice preferential looking) reaches adult levels by age of _____.

A

3-5 years

63
Q

Looking at oculomotor system, Infants fixate on lights, visual and auditory objects by ___.

A

3 months

64
Q

looking for oculomotor system. At birth, infant uses a series of ______ saccades to reach a target.

A

hypometric

65
Q

looking for oculomotor system. Infant’s saccades nearly adult-like by ____.

A

4 months

66
Q

T/F Infant’s pursuits are slow and short during 8-10 weeks.

A

False, 6-8 weeks

67
Q

Infant’s pursuits is nearly adult like by ____.

A

4 months.

68
Q

T/F Infant’s OKN result is symmetric at birth.

A

False. Asymmetric at birth (Poorer responses nasal to temporal)

69
Q

T/F Infant’s OKN result is symmetric by 3-6 months.

A

True

70
Q

Do babies have Vestibular Ocular Reflex (VOR) at birth?

A

Yes

71
Q

When can infants coordinate eye-head movements?

A

3 months

72
Q

How far can newborns converge their eyes?

A

10 inches, but inaccurate and unstable

73
Q

When when can infant’s converge like an adult?

A

6 months

74
Q

Is there stereopsis at birth?

A

No

75
Q

When is the average onset of stereopsis?

A

3.5 months

76
Q

When is stereopsis reaches adult like?

A

6 months (respond to stimuli less than 1 min arc)

77
Q

T/F At birth, accommodation is present and accurate.

A

False, present but inaccurate

78
Q

T/F Accommodation reaches adult like by 6 months.

A

False. 4 months

79
Q

Contrast sensitivity rapid improves by _____ months and continues to develop into childhood.

A

3-4

80
Q

Color vision reaches in full by ____ months.

A

4

81
Q

Most Common Vision Disorders in a Clinical Population of Children 6 months to 6 years of Age are:

A
  • Refractive error
    • Hyperopia (33%)
    • Astigmatism (22.5%)
    • Myopia (9.4%)
  • Strabismus (21%)
  • Amblyopia (7.9%)
  • Binocular and Accommodative Problems (6%)
  • Peripheral Retinal Abnormalities (0.5%)
82
Q

Largest emmetropization changes occur during the first ______ months of life.

A

12-18

83
Q

Most infants have what type of refractive error?

A

hyperopic (average +2.00D)

84
Q

During infancy, about ___% are myopic, ___% have astigmatism and ___% have anisometropia.

A

25, 50, 25

85
Q

What is the prevalence of strabismus?

A

3-5% with 1-2% infantile esotropia, 2-2.5% accommodative esotropia, 1-2 exotropia and >0.5% vertical tropia.

86
Q

What is the percentage prevalence of amblyopia?

A

3-5%

87
Q

What is the most common cause of vision loss in people under 45?

A

amblyopia

88
Q

What are the types of amblyopia?

A

it can be:

  1. refractive (anisometropia, isometropia and meridional)
  2. strabismic (constant, unilateral)
  3. Deprivation: 1:10,000-15,000
89
Q

Ocular diseases is high risk in which groups of children?

A

Premature, multi-handicapped and drug-exposed

90
Q

What are the types of ocular disease that can cause severe visual loss in children?

A
  1. retinal diease (ROP)
  2. Optic nerve anomalies (ONH atrophy, hypoplasia)
  3. lesions of higher visual pathway
  4. Cataract
  5. Developmental anomalies (Microphthalmia, aniridia, coloboma)
91
Q

Which color blindness are more common in children?

A

X-linked recessive protan (red) and deutan (blue). About 8-10% males,

Pediatrics_Dr. Liu (3 decks)

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