Paediatric development: Flashcards
Learning outcomes:
What are the 4 areas of development?
- Gross motor
- Fine motor and visioon
- Speech and hearing
- personal, social and emotional
Gross motor:
In babies? head control, rolling, sitting up,
Fine motor: What are they?
Speech and language:
What are the two types?
Personal emotional and social development:
What is this?
Is the baby smiling?
Waving? Laughing? Playing peek a boo? Feeding?
PAG developmental tables read:
Gross motor: Outline : Read
Essential milestones that must be remebered:
4-6 weeks?
6-7 months
9 months?
10 months?
12 months?
18 months?
24 months?
Fine motor skills: Development: Fine motor skills:
Read PAG:
Why is it important we study child development?
What can it be a marker of?
Neglect?
School? Social life?
Early assessment and understanding of the problem assists later develeopment
Correcting for prematurity with development:
Correct until 2 years of age
Speech and language development read:
Social development read:
PAG Notes:
Ways children can be picked up to have devlopmental delay:
Formal assessments for when a developmental disorder is found?
What tests and further investigations are done?
Terminology:
Global development delay?
specific?
regression of milestones?
Key red flags: For developmental delay:
PAG Read and know!
Other important red flags requiring immediate assessment:
What does a developmental history aim to find out?
Developmental history: continued:
Family history?
Developmental examination: Outline: What are you interested in:
- Full systems exam
- include neuro- looking for persistence of primitive reflexes, ocular abnormalities (e.g clouding of cornea in storage disease, hearing etc)
- Look for neurocutaneous stigmata: cafe au lait spots (tuberosclerosis) , depigmented patahces, port wine spots
- Look for heaptosplenomegaly - may suggest a metabolic disorder
- if case is borderline- always follow up and
- always refer to paeds:
*
What are investigations for global developmental delay (first line investigations)
MRI
LP
24 hour ECG
Further bloods: Plasma
Key causes of global developmental delay:
Read and understand:
Contraction of SCM muscles on respiration: causes head bobbing
MCQ:
When pulmonary vascular resistance decreases:
at 4-6 weeks shunt changes
What questions to as when you see the baby you think has heart failure?
Lots of questions
- Feeding
- Cyanosis
- Sacral oedema
- WOB
- Intercostal withdrawing
- color of child
- level of arousal
- are they tired fter feeds?
- Notice anything about the breathing?
- Feeding?
MCQ:
C- Characteristic
A- area
R- radiation
I- Intensity
o- Occurence timing:
MCQ:
What techniques can be used to improve success in decreasing voluntary guarding in abdominal exmamination:
1) Distraction
2) Stethoscope technique
3) Legs up to abdomen
4) Parents help hold
Examine with a teddy bear first-
Starting at hands- blowing up glove:
Key points: From Dr
Look from a far, look at how mother is interacting with child
Look at pattern of breathing through clothes
ALWAYS measure: Height, weight HC
Hx taking: Key points: Know useful open ended question, know when the problem started (especially if recurrent, no each episode, is it better worse? trend? acute? chronic problem?) Whats the average interval when they are well?How long are they well
Work out the trend:
Thorough system review in all paeds patients!!!!!!
