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
