Paediatric - Development + Immunisations Flashcards
Name 1 developmental milestone at 6 weeks
Smile spontaneously; self-soothes; turns head towards sounds
Name 2 developmental milestones at 3 months
Turns head towards sound; Recognises faces; raises head and chest while lying on stomach; brings hand to mouth; begins to babble
Name 3 developmental milestones at 6 months
Sits without support + rolls; palmar grasp; Enjoys social play; Responds to other’s emotions; finger feeds
Name 3 developmental milestones at 12 months
Crawling + unsteady walking; 2 brick tower; One or two words; Hand clapping; uses spoon/fork
Name 3 developmental milestones at 18 months
Able to run + jump; 4 brick tower; 6-12 words; imitates activities; holds spoon
Name 3 developmental milestones at 2 years
Able to take clothes off; walks upstairs; 8 brick tower; 50+ words
Name one genetic cause of developmental delay
Chromosomal disorder (eg. Down’s); Microdeletions or duplications
Name a cause of too much energy being used in childhood resulting in faltering growth
Infection (HIV) / Chronic lung or heart disease / Hyperthyroid
Name 2 medical and 2 psychosocial risk factors for faltering growth
Medical: Congenital (autism,Down’s,CP); Developmental delay; GORD; Prematurity
Psychosocial: Disordered feeding; Family stressors; FH of abuse; Poor parenting; Postpartum depression; Poverty
Short stature is defined as height below what centile?
Second centile
At what age are these immunisations administered?
BCG / 6-in-1 vaccine / 4-in-1 booster / 3-in-1 booster
BCG - at birth (only if at risk of TB)
6-in-1 vaccine - 2-4 months (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
4-in-1 booster - 3-4 years (diphtheria, tetanus, whooping cough and polio)
3-in-1 booster - 13-18 years (tetanus, diphtheria and polio)
What is the first sign of puberty in boys?
Increase in testicular volume
Which immunisations are included in the 6-in-1 vaccine?
diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B
At what age would the average child start to say ‘mama’ and ‘dada’?
9-10 months
Precocious puberty in females may be defined as the development of secondary sexual characteristics before what age?
8 years
What 9 conditions does the heelprick newborn blood spot test screen for?
- Sickle cell
- CF
- Congenital hypothyroid
- Inherited metabolic diseases
phenylketonuria (PKU)
medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
maple syrup urine disease (MSUD)
isovaleric acidaemia (IVA)
glutaric aciduria type 1 (GA1)
homocystinuria (pyridoxine unresponsive) (HCU) - Severe combined immunodeficiency (SCID)
Most children become toilet trained at or after what age?
3 years
Most children are able to briefly stand on one leg at what age?
3 years
At what age do most children sit without support, with a straight back?
7-8 months
At what age do most children have little or no head lag on being pulled to sit?
3 months
At what age do most children walk unsupported?
12-15 months
At what age do most babies begin to crawl?
9-11 months
A 12-month-old child is brought into surgery for her next routine immunisations. She has received all the recommended immunisations to date. What should be given at this stage?
12-13 months immunisations: Hib/Men C + MMR + PCV + Men B
Name a cause of failure to thrive under the following headings:
- Inadequate nutritional intake
- Difficulty feeding
- Malabsorption
- Increased energy requirements
- Inability to process nutrition
Causes of Inadequate Nutritional Intake
- Maternal malabsorption if breastfeeding
- Iron deficiency anaemia
- Family or parental problems
- Neglect
- Availability of food (i.e. poverty)
Causes of Difficulty Feeding
- Poor suck, for example due to cerebral palsy
- Cleft lip or palate
- Genetic conditions with an abnormal facial structure
- Pyloric stenosis
Causes of Malabsorption
- Cystic fibrosis
- Coeliac disease
- Cows milk intolerance
- Chronic diarrhoea
- Inflammatory bowel disease
Causes of Increased Energy Requirements
- Hyperthyroidism
- Chronic disease, for example congenital heart disease and cystic fibrosis
- Malignancy
- Chronic infections, for example HIV or immunodeficiency
Inability to Process Nutrients Properly
- Inborn errors of metabolism
- Type 1 diabetes
There is evidence that breastfeeding can reduce the risk of which two cancers?
Breast and ovarian cancer
On formula feed, babies should receive how much milk per kg of weight?
babies should receive around 150ml of milk per kg of body weight
(This is split between feeds every 2-3 hours initially, then to 4 hours and longer between feeds. Eventually babies and infants transition to feeding on demand (when they are hungry))
When does weaning usually start?
Weaning usually starts around 6 months of age
What are the 5 Frazer guidelines?
- They are mature and intelligent enough to understand the treatment
- They can’t be persuaded to discuss it with their parents or let the health professional discuss it
- They are likely to have intercourse regardless of treatment
- Their physical or mental health is likely to suffer without treatment
- Treatment is in their best interest
What vaccines are given at 8 weeks?
- 6-in-1 vaccine
- Rotavirus vaccine
- MenB
What vaccines are given at 12 weeks?
- 6-in-1 vaccine (2nd dose)
- Pneumococcal (PCV) vaccine
- Rotavirus vaccine (2nd dose)
What vaccines are given at 16 weeks?
- 6-in-1 vaccine (3rd dose)
- MenB (2nd dose)
What vaccines are given at 1 year?
- Hib/MenC (1st dose)
- MMR (1st dose)
- Pneumococcal (PCV) vaccine (2nd dose)
- MenB (3rd dose)
What vaccines are given at 14 years?
- 3-in-1 teenage booster
- MenACWY
